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

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

Journal article

Open access

Peer reviewed

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, …

Health equity, Vol.7(1), pp.809-816

2023

DOI: 10.1089/heq.2023.0037

PMCID: PMC10698768

PMID: 38076213

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https://doi.org/10.1089/heq.2023.0037View

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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.

predictive models

health equity

Veterans Health Administration

clinical equations

racial bias

Details

Title: Subtitle: Eliminating Algorithmic Racial Bias in Clinical Decision Support Algorithms: Use Cases from the Veterans Health Administration
Creators: Justin M List - Yale School of Medicine
Paul Palevsky - University of Pittsburgh School of Medicine
Suzanne Tamang - Stanford University School of Medicine
Susan Crowley - VA Connecticut Healthcare System
David Au - VA Puget Sound Health Care System
William C Yarbrough - VA North Texas Health Care System, Dallas, Texas, USA
Amol S Navathe - University of Pennsylvania
Craig Kreisler - Veterans Health Administration
Ravi B Parikh - University of Pennsylvania
Jessica Wang-Rodriguez - University of California - San Diego School of Medicine
J Stacey Klutts - University of Iowa
Paul Conlin - Harvard Medical School
Leonard Pogach - Department of Veterans Affairs, New Jersey Health Care System, East Orange, New Jersey, USA
Esther Meerwijk - Department of Veterans Affairs, Palo Alto, California, USA
Ernest Moy - VA Office of Health Equity, Washington, District of Columbia, USA
Resource Type: Journal article
Publication Details: Health equity, Vol.7(1), pp.809-816
DOI: 10.1089/heq.2023.0037
PMID: 38076213
PMCID: PMC10698768
NLM abbreviation: Health Equity
eISSN: 2473-1242
Language: English
Date published: 2023
Academic Unit: Pathology
Record Identifier: 9984530375602771

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