Systematic Bias in Medical Algorithms: To Include or Not Include Discriminatory Demographic Information?

摘要

TO THE EDITOR: We read the recent article by Barcenas et al who developed a prognostic model for estimating individual prognosis for women with metastatic breast cancer with great interest. We congratulate the authors for providing a robust prognostic model for metastatic breast cancer that may better inform clinical treatment decisions. Although the study was generally well conducted, we have some concerns with potential racial bias introduced to the algorithms. Although the authors report that they included race or ethnicity as covariates in the prognostic models, they did neither discuss possible implications of doing so nor did they evaluate how including these data may affect algorithmic fairness. In this letter, we would like to discuss some of the potential pitfalls of this approach and provide a brief overview of how bias against less-privileged groups can be revealed and avoided.