The Impact of Health Care Algorithms on Racial and Ethnic Disparities

医学 卫生公平 民族 医疗保健 心理干预 衡平法 数据提取 梅德林 公共卫生 精神科 护理部 社会学 经济 法学 经济增长 人类学 政治学
作者
Shazia M. Siddique,Kelley Tipton,Brian F Leas,Christopher Jepson,Jaya Aysola,Jordana B. Cohen,Emilia Flores,Michael O. Harhay,Harald Schmidt,Gary E. Weissman,Julie Fricke,Jonathan Treadwell,Nikhil K. Mull
出处
期刊:Annals of Internal Medicine [American College of Physicians]
卷期号:177 (4): 484-496 被引量:13
标识
DOI:10.7326/m23-2960
摘要

Background: There is increasing concern for the potential impact of health care algorithms on racial and ethnic disparities. Purpose: To examine the evidence on how health care algorithms and associated mitigation strategies affect racial and ethnic disparities. Data Sources: Several databases were searched for relevant studies published from 1 January 2011 to 30 September 2023. Study Selection: Using predefined criteria and dual review, studies were screened and selected to determine: 1) the effect of algorithms on racial and ethnic disparities in health and health care outcomes and 2) the effect of strategies or approaches to mitigate racial and ethnic bias in the development, validation, dissemination, and implementation of algorithms. Data Extraction: Outcomes of interest (that is, access to health care, quality of care, and health outcomes) were extracted with risk-of-bias assessment using the ROBINS-I (Risk Of Bias In Non-randomised Studies – of Interventions) tool and adapted CARE-CPM (Critical Appraisal for Racial and Ethnic Equity in Clinical Prediction Models) equity extension. Data Synthesis: Sixty-three studies (51 modeling, 4 retrospective, 2 prospective, 5 prepost studies, and 1 randomized controlled trial) were included. Heterogenous evidence on algorithms was found to: a) reduce disparities (for example, the revised kidney allocation system), b) perpetuate or exacerbate disparities (for example, severity-of-illness scores applied to critical care resource allocation), and/or c) have no statistically significant effect on select outcomes (for example, the HEART Pathway [history, electrocardiogram, age, risk factors, and troponin]). To mitigate disparities, 7 strategies were identified: removing an input variable, replacing a variable, adding race, adding a non–race-based variable, changing the racial and ethnic composition of the population used in model development, creating separate thresholds for subpopulations, and modifying algorithmic analytic techniques. Limitation: Results are mostly based on modeling studies and may be highly context-specific. Conclusion: Algorithms can mitigate, perpetuate, and exacerbate racial and ethnic disparities, regardless of the explicit use of race and ethnicity, but evidence is heterogeneous. Intentionality and implementation of the algorithm can impact the effect on disparities, and there may be tradeoffs in outcomes. Primary Funding Source: Agency for Healthcare Quality and Research.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
希望天下0贩的0应助mochi采纳,获得10
刚刚
yyy发布了新的文献求助10
1秒前
1秒前
2秒前
2秒前
2秒前
2秒前
大模型应助不吃香菜采纳,获得10
3秒前
平淡水儿发布了新的文献求助10
3秒前
Ava应助lj采纳,获得10
3秒前
Xiyunyun发布了新的文献求助10
5秒前
一往而深发布了新的文献求助10
5秒前
王怜花发布了新的文献求助10
5秒前
6秒前
6秒前
8秒前
ll完成签到,获得积分10
8秒前
小郑完成签到,获得积分10
9秒前
坦率的松完成签到,获得积分10
9秒前
赘婿应助Veronica采纳,获得10
10秒前
11秒前
11秒前
橙子快跑发布了新的文献求助10
12秒前
韬气包发布了新的文献求助10
12秒前
enli完成签到,获得积分10
13秒前
热情飞荷完成签到,获得积分10
14秒前
桐桐应助zzznznnn采纳,获得10
14秒前
14秒前
15秒前
殷勤的汝燕完成签到,获得积分20
15秒前
15秒前
16秒前
agnes发布了新的文献求助10
16秒前
fun发布了新的文献求助10
16秒前
18秒前
崔家荣发布了新的文献求助30
18秒前
刘仁轨发布了新的文献求助10
19秒前
Hello应助浮生采纳,获得10
19秒前
科研通AI5应助悦耳静枫采纳,获得10
19秒前
20秒前
高分求助中
Continuum Thermodynamics and Material Modelling 3000
Production Logging: Theoretical and Interpretive Elements 2700
Les Mantodea de Guyane Insecta, Polyneoptera 1000
Conference Record, IAS Annual Meeting 1977 820
England and the Discovery of America, 1481-1620 600
Teaching language in context (Third edition) by Derewianka, Beverly; Jones, Pauline 550
Oligomycin, a new antifungal antibiotic 500
热门求助领域 (近24小时)
化学 材料科学 生物 医学 工程类 有机化学 生物化学 物理 纳米技术 计算机科学 内科学 化学工程 复合材料 基因 遗传学 物理化学 催化作用 量子力学 光电子学 冶金
热门帖子
关注 科研通微信公众号,转发送积分 3583447
求助须知:如何正确求助?哪些是违规求助? 3152668
关于积分的说明 9493793
捐赠科研通 2855215
什么是DOI,文献DOI怎么找? 1569480
邀请新用户注册赠送积分活动 735260
科研通“疑难数据库(出版商)”最低求助积分说明 721145