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Una red neuronal convolucional jerárquica superó a los modelos transformadores en la predicción de la raza a partir del texto clínico, logrando una mayor precisión y equidad. Las intervenciones de equidad personalizadas son cruciales, ya que los resultados dependientes del modelo destacan los sesgos sistémicos en los registros electrónicos de salud.

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Área de la Ciencia:

  • La inteligencia artificial es inteligencia artificial.
  • Procesamiento del lenguaje natural.
  • Informática de la salud Informática de la salud.

Sus antecedentes:

  • El despliegue equitativo de la IA clínica requiere un rendimiento consistente en diversas poblaciones.
  • Los datos de raza faltantes/inconsistentes en los EHR dificultan la representación de cohorte y la evaluación de sesgo.
  • Este estudio evalúa el rendimiento del modelo de IA y la equidad en la predicción de la raza a partir del texto clínico.

Objetivo del estudio:

  • Para comparar modelos de aprendizaje profundo para la predicción de la raza a partir del texto clínico.
  • Evaluar el impacto de la optimización consciente de la equidad en la equidad del modelo.
  • Identificar los factores arquitectónicos y sistémicos que contribuyen al sesgo algorítmico.

Principales métodos:

  • Comparó cuatro modelos de transformadores y una CNN jerárquica utilizando un marco de aprendizaje activo de dos fases.
  • Aplicó una función de pérdida consciente de la equidad para mitigar las disparidades raciales.
  • Evaluación del desempeño y la equidad a través de la validación cruzada de 10 veces y auditorías de subgrupos.

Principales resultados:

  • La CNN jerárquica logró una mayor precisión y equidad (macro F1 = 98.4%) que los transformadores.
  • Las restricciones de equidad mejoraron la paridad en los transformadores, pero degradaron el rendimiento del modelo jerárquico.
  • Las disparidades persistentes indicaron limitaciones arquitectónicas y sesgos sistémicos.

Conclusiones:

  • La integración de la equidad en los modelos clínicos de PNL es factible, pero depende del modelo.
  • Las arquitecturas alineadas con la estructura del texto clínico promueven inherentemente la equidad.
  • Las desigualdades de la documentación de aguas arriba impulsan el sesgo algorítmico, lo que requiere intervenciones personalizadas.