当准确的预测模型产生有害的自我实现预言时
Wouter A C van Amsterdam1, Nan van Geloven2, Jesse H Krijthe3
1Department of Data Science and Biostatistics, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, University of Utrecht, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands.
Patterns (New York, N.Y.)
|April 23, 2025
概括
医疗预测模型可能会造成伤害,充当自我实现的预言,恶化患者的结果. 即使是精确的模型在临床决策中使用时也可能是有害的,需要对验证和部署实践进行审查.
科学领域:
- 医疗信息学 医疗信息学
- 临床决策支持 临床决策支持
- 医疗保健服务研究 医疗服务研究
背景情况:
- 预测模型在医疗保健中被广泛采用,用于个性化,数据驱动的决策.
- 预计这些模型将改善患者的治疗结果,并为治疗策略提供信息.
研究的目的:
- 分析在临床决策中使用预测模型的潜在危害.
- 描述作为有害的自我实现预言的预测模型.
- 评估精确校准模型在决策中的有用性.
主要方法:
- 预测模型表现出有害的自我实现预言行为的正式描述.
- 在部署前后对模型歧视和校准进行分析.
- 理论评估模型对数据分布的影响.
主要成果:
- 预测模型可以通过自我实现的预言造成伤害,即使在部署后有良好的歧视.
- 受影响患者的负面结果并不能减少模型的歧视.
- 精确校准的模型对决策无效,因为它们不会改变数据分布.
结论:
- 在医疗决策中使用预测模型需要进行批判性重新评估.
- 临床预测模型的标准验证和部署实践可能需要修订.
- 自我实现的预言的潜在危害必须与预测准确性一起考虑.
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