机器学习算法中表示的人工智能模型是用于风险评估的有前途的工具,用于指导临床和其他医疗保健决策。机器学习算法,然而,可以容纳传播刻板印象的偏见,不平等,以及导致社会经济医疗保健差距的歧视。偏见包括与一些社会人口统计学特征相关的偏见,如种族,种族,性别,年龄,保险,使用错误的电子健康记录数据和社会经济地位。此外,人们担心大型语言模型中的训练数据和算法偏差会带来潜在的缺陷。这些偏见影响了美国和全球很大一部分人口的生活和生计。相关反弹的社会和经济后果不可低估。这里,我们概述了一些社会人口统计学,训练数据,和算法偏差,破坏健康护理风险评估和医疗决策,应在卫生保健系统中解决。我们按性别对这些偏见进行了透视和概述,种族,种族,年龄,历史上被边缘化的社区,算法偏差,有偏见的评价,隐性偏见,选择/采样偏差,社会经济地位偏见,有偏差的数据分布,文化偏见和保险地位偏见,构象偏向,信息偏差和锚定偏差,并提出改进大型语言模型训练数据的建议,包括去偏见技术,例如知识蒸馏过程中的反事实角色颠倒句子,微调,培训时的前缀附件,使用毒性分类器,检索增强生成和算法修改,以减轻前进的偏见。
Artificial intelligence models represented in machine learning algorithms are promising tools for risk assessment used to guide clinical and other health care decisions. Machine learning algorithms, however, may house biases that propagate stereotypes, inequities, and discrimination that contribute to socioeconomic health care disparities. The biases include those related to some sociodemographic characteristics such as race, ethnicity, gender, age, insurance, and socioeconomic status from the use of erroneous electronic health record data. Additionally, there is concern that training data and algorithmic biases in large language models pose potential drawbacks. These biases affect the lives and livelihoods of a significant percentage of the population in the United States and globally. The social and economic consequences of the associated backlash cannot be underestimated. Here, we outline some of the sociodemographic, training data, and algorithmic biases that undermine sound health care risk assessment and medical decision-making that should be addressed in the health care system. We present a perspective and overview of these biases by gender, race, ethnicity, age, historically marginalized communities, algorithmic bias, biased evaluations, implicit bias, selection/sampling bias, socioeconomic status biases, biased data distributions, cultural biases and insurance status bias, conformation bias, information bias and anchoring biases and make recommendations to improve large language model training data, including de-biasing techniques such as counterfactual role-reversed sentences during knowledge distillation, fine-tuning, prefix attachment at training time, the use of toxicity classifiers, retrieval augmented generation and algorithmic modification to mitigate the biases moving forward.