在临床决策工具开发中算法偏差的潜力
Jed Keenan Obra1,2, Chandan Singh3, Kenshata Watkins4
1University of California, Berkeley, Berkeley, CA, USA. jedkeenan.obra@ucsf.edu.
NPJ digital medicine
|December 10, 2025
概括
临床决策工具 (CDI) 尽管旨在减少医疗保健差异,但可以引入偏见. 这项系统性审查发现,CDI发展中的人口统计,地理代表性和可变选择存在偏差,这可能会使不平等持续存在.
科学领域:
- 医疗信息学 医疗信息学
- 医学伦理 医学伦理
- 健康 公平 卫生 公平
背景情况:
- 临床决策工具 (CDI) 旨在规范护理并减少差异.
- 然而,标准化可能会在医疗保健中无意中延续偏见和不平等.
- 在CDI开发中潜在的偏见来源需要进行系统的调查.
研究的目的:
- 在临床决策工具 (CDI) 的开发中定量描述潜在的偏差来源.
- 系统地审查690个CDI,寻找其开发过程中存在偏见的证据.
主要方法:
- 对690种临床决策工具 (CDI) 的定量系统审查.
- 分析侧重于四个潜在的偏见来源:参与者人口统计,调查人员团队地理,预测变量选择和结果定义.
主要成果:
- 在CDI开发中发现了潜在算法偏差的证据.
- 参与者的人口统计学是倾斜的 (例如,73%的白人,55%的男性).
- 调查小组显示地理偏差 (52%北美,31%欧洲).
- CDI使用了潜在偏见的预测变量 (例如,1.9%使用了种族和种族).
- 结果定义,特别是那些涉及后续 (26%),可能会引入社会经济偏见.
结论:
- 虽然CDI旨在改善护理,但可能包含固有的偏见.
- 诸如偏的人口统计,地理代表和变量选择等因素有助于潜在的偏见.
- 建议包括在CDI开发过程中考虑这些因素,并透明地将它们传达给临床医生.
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