Nature Medicine · 2023 · 271 citations · 37 references
ComputingHealth InformaticsHealth PolicyData EthicsHealth Data StandardsHealth EquityAlgorithmic FairnessArtificial Intelligence PolicyHealth Informatics StandardsHealthcare Data StandardsHealthcare StandardsAccountability In Health DataAlgorithmic BiasAlgorithmic Data BiasArtificial Intelligence TransparencyDataset CurationEquity In Data AccessHealth Ai GovernanceHealthcare Data Standardization
Artificial intelligence as a medical device is increasingly being applied to healthcare for diagnosis, risk stratification and resource allocation. However, a growing body of evidence has highlighted the risk of algorithmic bias, which may perpetuate existing health inequity. This problem arises in part because of systemic inequalities in dataset curation, unequal opportunity to participate in research and inequalities of access. This study aims to explore existing standards, frameworks and best practices for ensuring adequate data diversity in health datasets. Exploring the body of existing literature and expert views is an important step towards the development of consensus-based guidelines. The study comprises two parts: a systematic review of existing standards, frameworks and best practices for healthcare datasets; and a survey and thematic analysis of stakeholder views of bias, health equity and best practices for artificial intelligence as a medical device. We found that the need for dataset diversity was well described in literature, and experts generally favored the development of a robust set of guidelines, but there were mixed views about how these could be implemented practically. The outputs of this study will be used to inform the development of standards for transparency of data diversity in health datasets (the STANDING Together initiative).
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