解决肺癌查资格方面的算法偏差问题
Adoma Manful1, Sarah Mercaldo2,3, Jeffrey D Blume4
1Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
Journal of the National Cancer Institute
|December 29, 2025
概括
目前的肺癌查指南显示种族偏见,低估了黑人个人的身份. 意识到种族的策略对于公平的肺癌查资格和改善结果至关重要.
科学领域:
- 公共卫生 公共卫生
- 健康 公平 卫生 公平
- 医疗信息学 医疗信息学
背景情况:
- 肺癌查指南,包括USPSTF,是基于以白人为主的人口.
- 现有的策略表现出算法偏见,在各种种族群体中表现不一致.
- 这种不一致表明需要重新评估公平应用的资格标准.
研究的目的:
- 评估当前肺癌查资格策略在以黑人/非裔美国人为主群中的表现.
- 探索解决算法偏差的方法,以提高肺癌查资格的公平性.
- 提出和评估新的种族意识战略.
主要方法:
- 使用了南方社区队列研究 (主要是黑人/非洲裔美国人参与者).
- 评估了八个现有的肺癌查资格策略和两个新的种族意识策略.
- 在种族群体之间比较性能指标,如敏感度和假阳性率.
主要成果:
- 与白人参与者相比,现有的策略确定了较少的黑人/AA参与者有资格接受肺癌查.
- 删除种族或其他标准并没有解决资格方面的种族差异.
- 意识到种族的策略展示了最好的敏感性-特异性权衡,最大限度地减少不平等.
结论:
- 肺癌查资格的算法偏差在当前的指南中很明显.
- 意识到种族的方法对于解决差异和确保公平获得肺癌查至关重要.
- 根据种族量身定制资格门可以提高公平性和有效性.
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