Eliminating Algorithmic Racial Bias in Clinical Decision Support Algorithms: Use Cases from the Veterans Health Administration

Justin M. List; Paul Palevsky; Suzanne Tamang; Susan Crowley; David Au; William C. Yarbrough; Amol S. Navathe; Craig Kreisler; Ravi B. Parikh; Jessica Wang-Rodriguez; J. Stacey Klutts; Paul Conlin; Leonard Pogach; Esther Meerwijk; Ernest Moy

doi:10.1089/heq.2023.0037

Eliminating Algorithmic Racial Bias in Clinical Decision Support Algorithms: Use Cases from the Veterans Health Administration

Justin M. List, Paul Palevsky, Suzanne Tamang, Susan Crowley, David Au, William C. Yarbrough, Amol S. Navathe, Craig Kreisler, Ravi B. Parikh, Jessica Wang-Rodriguez, J. Stacey Klutts, Paul Conlin, Leonard Pogach, Esther Meerwijk, Ernest Moy

Research output: Contribution to journal › Article › peer-review

1 Scopus citations

Abstract

The Veterans Health Administration uses equity- and evidence-based principles to examine, correct, and eliminate use of potentially biased clinical equations and predictive models. We discuss the processes, successes, challenges, and next steps in four examples. We detail elimination of the race modifier for estimated kidney function and discuss steps to achieve more equitable pulmonary function testing measurement. We detail the use of equity lenses in two predictive clinical modeling tools: Stratification Tool for Opioid Risk Mitigation (STORM) and Care Assessment Need (CAN) predictive models. We conclude with consideration of ways to advance racial health equity in clinical decision support algorithms.

Original language	English (US)
Pages (from-to)	809-816
Number of pages	8
Journal	Health Equity
Volume	7
Issue number	1
DOIs	https://doi.org/10.1089/heq.2023.0037
State	Published - Nov 1 2023

Keywords

Veterans Health Administration
clinical equations
health equity
predictive models
racial bias

ASJC Scopus subject areas

Health(social science)
Health Policy
Public Health, Environmental and Occupational Health
Health Information Management

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10.1089/heq.2023.0037

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List, J. M., Palevsky, P., Tamang, S., Crowley, S., Au, D., Yarbrough, W. C., Navathe, A. S., Kreisler, C., Parikh, R. B., Wang-Rodriguez, J., Klutts, J. S., Conlin, P., Pogach, L., Meerwijk, E., & Moy, E. (2023). Eliminating Algorithmic Racial Bias in Clinical Decision Support Algorithms: Use Cases from the Veterans Health Administration. Health Equity, 7(1), 809-816. https://doi.org/10.1089/heq.2023.0037

List, JM, Palevsky, P, Tamang, S, Crowley, S, Au, D, Yarbrough, WC, Navathe, AS, Kreisler, C, Parikh, RB, Wang-Rodriguez, J, Klutts, JS, Conlin, P, Pogach, L, Meerwijk, E & Moy, E 2023, 'Eliminating Algorithmic Racial Bias in Clinical Decision Support Algorithms: Use Cases from the Veterans Health Administration', Health Equity, vol. 7, no. 1, pp. 809-816. https://doi.org/10.1089/heq.2023.0037

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abstract = "The Veterans Health Administration uses equity- and evidence-based principles to examine, correct, and eliminate use of potentially biased clinical equations and predictive models. We discuss the processes, successes, challenges, and next steps in four examples. We detail elimination of the race modifier for estimated kidney function and discuss steps to achieve more equitable pulmonary function testing measurement. We detail the use of equity lenses in two predictive clinical modeling tools: Stratification Tool for Opioid Risk Mitigation (STORM) and Care Assessment Need (CAN) predictive models. We conclude with consideration of ways to advance racial health equity in clinical decision support algorithms.",

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Eliminating Algorithmic Racial Bias in Clinical Decision Support Algorithms: Use Cases from the Veterans Health Administration

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