The value of standards for health datasets in artificial intelligence-based applications.

Journal: Nature medicine
PMID:

Abstract

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).

Authors

  • Anmol Arora
    School of Clinical Medicine, University of Cambridge, Cambridge, UK.
  • Joseph E Alderman
    University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
  • Joanne Palmer
    University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
  • Shaswath Ganapathi
    College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.
  • Elinor Laws
    Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.
  • Melissa D McCradden
    Division of Neurosurgery (McCradden, Baba, Saha, Boparai, Fadaiefard, Cusimano), St. Michael's Hospital, Unity Health Toronto; Dalla Lana School of Public Health (Cusimano), University of Toronto, Toronto, Ont. injuryprevention@smh.ca.
  • Lauren Oakden-Rayner
    School of Public Health, University of Adelaide, Adelaide, SA, Australia; Australian Institute for Machine Learning, University of Adelaide, Adelaide, SA, Australia. Electronic address: lauren.oakden-rayner@adelaide.edu.au.
  • Stephen R Pfohl
    Stanford Center for Biomedical Informatics Research, Stanford University, 1265 Welch Road, Stanford, CA 94305, United States of America. Electronic address: spfohl@stanford.edu.
  • Marzyeh Ghassemi
    Electrical Engineering and Computer Science, Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, United States.
  • Francis McKay
    The Ethox Centre and the Wellcome Centre for Ethics and Humanities, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
  • Darren Treanor
    Leeds Teaching Hospitals NHS Trust, Leeds, UK.
  • Negar Rostamzadeh
    Google Research, Montreal, Canada.
  • Bilal Mateen
    Wellcome Trust, London, UK.
  • Jacqui Gath
    Patient Partner, Birmingham, UK.
  • Adewole O Adebajo
    Patient and Public Involvement and Engagement (PPIE) Group, STANDING Together, Birmingham, UK.
  • Stephanie Kuku
    Institute of Women's Health, University College London, London, UK.
  • Rubeta Matin
    Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
  • Katherine Heller
    Department of Statistical Sciences.
  • Elizabeth Sapey
    University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
  • Neil J Sebire
    Health Data Research UK, London, UK.
  • Heather Cole-Lewis
    ICF International, Rockville, MD, United States.
  • Melanie Calvert
    Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham, UK.
  • Alastair Denniston
    Health Data Research UK, London, United Kingdom; Academic Unit of Ophthalmology, Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom; Department of Ophthalmology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom; Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham, United Kingdom; NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom.
  • Xiaoxuan Liu
    Birmingham Health Partners Centre for Regulatory Science and Innovation University of Birmingham Birmingham Reino Unido Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham, Reino Unido.