临床算法和基于种族的校正遗产:历史错误,当代修订和为流行病学家提供以公平为导向的方法
Laura J Horsfall1, Paulina Bondaronek1, Julia Ive1
1Institute of Health Informatics, University College London, London, UK.
Clinical epidemiology
|July 17, 2025
概括
起源于19世纪的临床算法中的种族校正越来越多地被审查,以维持健康差异. 从算法中删除种族表明公平的承诺,但谨慎的偏见缓解对于公平的医疗保健至关重要.
科学领域:
- 医疗信息学 医疗信息学
- 健康 公平 研究 健康 公平 研究
- 医学社会学 医学社会学
背景情况:
- 临床算法对于疾病预测,诊断和管理至关重要.
- 算法中的种族校正是有争议的,可能会加剧健康差距并加强刻板印象.
- 历史起源可以追溯到19世纪中叶,最初用于证明种族等级制度的合理性.
研究的目的:
- 审查关于临床算法中种族校正的历史,临床和方法文献.
- 检查算法中基于种族的调整的起源,后果和持续性.
- 探索在算法开发中缓解偏见和公平性的新兴策略.
主要方法:
- 叙事综述综合跨学科文献 (历史,临床,方法学).
- 专注于美国和英国的发展.
- 对持久性,删除影响和偏见缓解策略的分析.
主要成果:
- 尽管受到批评,但基于种族的调整仍然存在于肺容量,心脏,脏和产科功能的当代算法中.
- 从算法中删除种族,例如在肺功能测试和产科中,显示了在不损失准确性的情况下提高公平性的潜力.
- 种族消除的影响有所不同,这强调了需要特定于背景的偏见识别和缓解的需要.
结论:
- 未来的努力必须整合多样化的数据,捕捉真正的健康决定因素,实施公平策略,并确保透明度.
- 关于种族作为社会政治构造的教育对于健康公平至关重要.
- 为了公平的患者护理,需要不断监测,评估和改进算法.
相关概念视频
Bias in Epidemiological Studies
695
Biases can arise at various stages of research, from study design and data collection to analysis and interpretation. Recognizing and addressing these biases is essential to ensure the validity and reliability of epidemiological findings.Broadly speaking, biases in epidemiology fall into three main categories: selection bias, information bias, and confounding. A more detailed description of possible biases is:
695
Strategies for Assessing and Addressing Confounding
159
Confounding is a critical issue in epidemiological studies, often leading to misleading conclusions about associations between exposures and outcomes. It occurs when the relationship between the exposure and the outcome is mixed with the effects of other factors that influence the outcome. Given that, addressing confounding is of high importance for drawing accurate inferences in research.
Confounding can be addressed at both the design phase of a study and through analytical methods after data...
Confounding can be addressed at both the design phase of a study and through analytical methods after data...
159
Confounding in Epidemiological Studies
266
Confounding in statistical epidemiology represents a pivotal challenge, referring to the distortion in the perceived relationship between an exposure and an outcome due to the presence of a third variable, known as a confounder. This variable is associated with both the exposure and the outcome but is not a direct link in their causal chain. Its presence can lead to erroneous interpretations of the exposure's effect, either exaggerating or underestimating the true association. This...
266
Introduction to Epidemiology
1.0K
Epidemiology, known as the cornerstone of public health, involves studying the distribution and determinants of health-related events in defined populations and applying these insights to control health issues. This is essential for understanding how diseases spread, identifying populations at greater risk, and implementing measures to control or prevent outbreaks. Epidemiology addresses not only infectious diseases but also non-communicable conditions like cancer and cardiovascular disease,...
1.0K
Steps in Outbreak Investigation
209
In the ever-evolving field of public health, statistical analysis serves as a cornerstone for understanding and managing disease outbreaks. By leveraging various statistical tools, health professionals can predict potential outbreaks, analyze ongoing situations, and devise effective responses to mitigate impact. For that to happen, there are a few possible stages of the analysis:
209
Statistical Methods for Analyzing Epidemiological Data
540
Epidemiological data primarily involves information on specific populations' occurrence, distribution, and determinants of health and diseases. This data is crucial for understanding disease patterns and impacts, aiding public health decision-making and disease prevention strategies. The analysis of epidemiological data employs various statistical methods to interpret health-related data effectively. Here are some commonly used methods:
540


