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Mitigating Racial And Ethnic Bias And Advancing Health Equity In Clinical Algorithms: A Scoping Review.

Publication ,  Journal Article
Cary, MP; Zink, A; Wei, S; Olson, A; Yan, M; Senior, R; Bessias, S; Gadhoumi, K; Jean-Pierre, G; Wang, D; Ledbetter, LS; Economou-Zavlanos, NJ ...
Published in: Health Aff (Millwood)
October 2023

In August 2022 the Department of Health and Human Services (HHS) issued a notice of proposed rulemaking prohibiting covered entities, which include health care providers and health plans, from discriminating against individuals when using clinical algorithms in decision making. However, HHS did not provide specific guidelines on how covered entities should prevent discrimination. We conducted a scoping review of literature published during the period 2011-22 to identify health care applications, frameworks, reviews and perspectives, and assessment tools that identify and mitigate bias in clinical algorithms, with a specific focus on racial and ethnic bias. Our scoping review encompassed 109 articles comprising 45 empirical health care applications that included tools tested in health care settings, 16 frameworks, and 48 reviews and perspectives. We identified a wide range of technical, operational, and systemwide bias mitigation strategies for clinical algorithms, but there was no consensus in the literature on a single best practice that covered entities could employ to meet the HHS requirements. Future research should identify optimal bias mitigation methods for various scenarios, depending on factors such as patient population, clinical setting, algorithm design, and types of bias to be addressed.

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Published In

Health Aff (Millwood)

DOI

EISSN

1544-5208

Publication Date

October 2023

Volume

42

Issue

10

Start / End Page

1359 / 1368

Location

United States

Related Subject Headings

  • Racial Groups
  • Humans
  • Health Policy & Services
  • Health Personnel
  • Health Equity
  • Delivery of Health Care
  • Algorithms
  • 4407 Policy and administration
  • 4203 Health services and systems
  • 1402 Applied Economics
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Cary, M. P., Zink, A., Wei, S., Olson, A., Yan, M., Senior, R., … Pencina, M. J. (2023). Mitigating Racial And Ethnic Bias And Advancing Health Equity In Clinical Algorithms: A Scoping Review. Health Aff (Millwood), 42(10), 1359–1368. https://doi.org/10.1377/hlthaff.2023.00553
Cary, Michael P., Anna Zink, Sijia Wei, Andrew Olson, Mengying Yan, Rashaud Senior, Sophia Bessias, et al. “Mitigating Racial And Ethnic Bias And Advancing Health Equity In Clinical Algorithms: A Scoping Review.Health Aff (Millwood) 42, no. 10 (October 2023): 1359–68. https://doi.org/10.1377/hlthaff.2023.00553.
Cary MP, Zink A, Wei S, Olson A, Yan M, Senior R, et al. Mitigating Racial And Ethnic Bias And Advancing Health Equity In Clinical Algorithms: A Scoping Review. Health Aff (Millwood). 2023 Oct;42(10):1359–68.
Cary, Michael P., et al. “Mitigating Racial And Ethnic Bias And Advancing Health Equity In Clinical Algorithms: A Scoping Review.Health Aff (Millwood), vol. 42, no. 10, Oct. 2023, pp. 1359–68. Pubmed, doi:10.1377/hlthaff.2023.00553.
Cary MP, Zink A, Wei S, Olson A, Yan M, Senior R, Bessias S, Gadhoumi K, Jean-Pierre G, Wang D, Ledbetter LS, Economou-Zavlanos NJ, Obermeyer Z, Pencina MJ. Mitigating Racial And Ethnic Bias And Advancing Health Equity In Clinical Algorithms: A Scoping Review. Health Aff (Millwood). 2023 Oct;42(10):1359–1368.

Published In

Health Aff (Millwood)

DOI

EISSN

1544-5208

Publication Date

October 2023

Volume

42

Issue

10

Start / End Page

1359 / 1368

Location

United States

Related Subject Headings

  • Racial Groups
  • Humans
  • Health Policy & Services
  • Health Personnel
  • Health Equity
  • Delivery of Health Care
  • Algorithms
  • 4407 Policy and administration
  • 4203 Health services and systems
  • 1402 Applied Economics