通过基于规则的自然语言处理确定电子健康记录中的提供者级隐性偏见:一项针对前列腺癌的试点研究
Ashwin Ramaswamy1, Michael Hung1, Joe Pelt1
1Department of Urology, NewYork-Presbyterian Hospital/Weill Cornell Medical Center, New York, New York, United States of America.
PloS one
|January 8, 2025
概括
这项试点研究发现,一些医疗保健提供者表现出隐含的种族偏见,导致前列腺癌治疗建议的差异. 解决这些无意识的偏见可能有助于确保所有患者得到公平的护理.
科学领域:
- 医学伦理 医学伦理
- 健康差异 在健康上的差异
- 在瘤学瘤学.
背景情况:
- 医学中的隐性,无意识的偏见可能源于个人对种族,种族和性别的态度,可能导致歧视性护理模式.
- 缺乏真实世界的研究已经阻止了关于隐性偏见是否真正预测差异性患者护理的共识.
研究的目的:
- 为了进行第一个真实世界的试点研究提供者隐含偏见在医学.
- 通过使用非结构化临床数据检查提供者隐性偏见来评估前列腺癌护理中的治疗平价.
主要方法:
- 这项研究包括1094名前列腺癌患者,他们在2010年至2021年期间接受了3名泌尿外科瘤学家的治疗.
- 提供者接受了种族隐性关联测试,自然语言处理分析了四个质量指标的临床笔记:积极监测,生物标志物讨论和尿液/性功能评估.
- 通过统计分析 (奇二测试,菲系数) 评估了供应商种族偏见与质量指标之间的关联.
主要成果:
- 提供者C表示更喜欢白人患者,建议积极监测,并更频繁地考虑他们的生物标志物 (p<0.01,φ = 0.175;p=0.047,φ = 0.127).
- 提供者A也更频繁地考虑了白人患者的生物标志物 (p<0.01,φ = 0.179).
- 提供者B在所有评估的质量指标 (p>0.05) 中显示了治疗平价.
结论:
- 提供者在前列腺癌护理中的实践模式与患者的种族和提供者的隐含种族偏好有关.
- 向提供者提醒他们隐含的偏见可能是恢复治疗平价的策略,尽管需要进一步验证.
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