Weighing the benefits and risks of collecting race and ethnicity data in clinical settings for medical artificial intelligence.

Journal: The Lancet. Digital health
PMID:

Abstract

Many countries around the world do not collect race and ethnicity data in clinical settings. Without such identified data, it is difficult to identify biases in the training data or output of a given artificial intelligence (AI) algorithm, and to work towards medical AI tools that do not exclude or further harm marginalised groups. However, the collection of these data also poses specific risks to racially minoritised populations and other marginalised groups. This Viewpoint weighs the risks of collecting race and ethnicity data in clinical settings against the risks of not collecting those data. The collection of more comprehensive identified data (ie, data that include personal attributes such as race, ethnicity, and sex) has the possibility to benefit racially minoritised populations that have historically faced worse health outcomes and health-care access, and inadequate representation in research. However, the collection of extensive demographic data raises important concerns that include the construction of intersectional social categories (ie, race and its shifting meaning in different sociopolitical contexts), the risks of biological reductionism, and the potential for misuse, particularly in situations of historical exclusion, violence, conflict, genocide, and colonialism. Careful navigation of identified data collection is key to building better AI algorithms and to work towards medicine that does not exclude or harm marginalised groups.

Authors

  • Amelia Fiske
    Institute of History and Ethics in Medicine, Department of Preclinical Medicine, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany. a.fiske@tum.de.
  • Sarah Blacker
    Department of Social Science, York University, Toronto, ON, Canada.
  • Lester Darryl Geneviève
    Institute for Biomedical Ethics, University of Basel, Basel, Switzerland; VITAM, Centre de Recherche en Santé Durable, Quebec City, QC, Canada; Faculty of Medicine, Université Laval, Quebec City, QC, Canada.
  • Theresa Willem
    Institute of History and Ethics in Medicine, Department of Preclinical Medicine, TUM School of Medicine and Health, Technical University of Munich, Ismaninger Straße 22, 81675, Munich, Germany. theresa.willem@tum.de.
  • Marie-Christine Fritzsche
    Institute of History and Ethics in Medicine, Department of Preclinical Medicine, TUM School of Medicine and Health, Technical University of Munich, Ismaninger Straße 22, 81675, Munich, Germany.
  • Alena Buyx
    Institute for History and Ethics of Medicine, Technical University of Munich School of Medicine, Technical University of Munich, Munich, Germany.
  • Leo Anthony Celi
    Massachusetts Institute of Technology, Cambridge, MA, USA.
  • Stuart McLennan
    Technical University of Munich.