ArticleJAMIA open2022
A scoping review of ethics considerations in clinical natural language processing.
Article in JAMIA open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 23 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
23 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Clinical Decision Support and Natural Language Processing in Medicine: Systematic Literature Review.Journal of medical Internet research · 2024Pooled it
- Understanding Stigmatizing Language Lexicons: A Comparative Analysis in Clinical Contexts.AMIA ... Annual Symposium proceedings. AMIA Symposium · 2024Pooled it
- Natural language processing to enhance rheumatoid arthritis care in clinical studies: a scoping review of applications, data, approaches, challenges and future directions.Rheumatology international · 2026Article
- Strategies for mitigating artificial intelligence bias in healthcare: a systematic review.JAMIA open · 2026Review
- WiseMind: a knowledge-guided multi-agent framework for accurate and empathetic psychiatric diagnosis.NPJ digital medicine · 2026Article
- A scoping review of models to identify transgender patients in electronic health records.Journal of the American Medical Informatics Association : JAMIA · 2026Article
- A large language model-based approach to quantifying the effects of social determinants in liver transplant decisions.NPJ digital medicine · 2025Article
- Ethical and social considerations of applying artificial intelligence in healthcare-a two-pronged scoping review.BMC medical ethics · 2025Article
- Principles and implementation strategies for equitable and representative academic partnerships in global health informatics research.Journal of the American Medical Informatics Association : JAMIA · 2025Article
- Patient and clinician acceptability of automated extraction of social drivers of health from clinical notes in primary care.Journal of the American Medical Informatics Association : JAMIA · 2025Article
- The ethics of artificial intelligence systems in healthcare and medicine: from a local to a global perspective, and back.Pflugers Archiv : European journal of physiology · 2025Review
- From Serendipity to Precision: Integrating AI, Multi-Omics, and Human-Specific Models for Personalized Neuropsychiatric Care.Biomedicines · 2025Review
- Exploring ethical considerations in medical research: Harnessing pre-generated transformers for AI-powered ethics discussions.PloS one · 2025Article
- Article
- Natural Language Processing: Set to Transform Pediatric Research.Hospital pediatrics · 2025Article
- Large language model bias auditing for periodontal diagnosis using an ambiguity-probe methodology: a pilot study.Frontiers in digital health · 2025Article
- Opportunities for incorporating intersectionality into biomedical informatics.Journal of biomedical informatics · 2024Article
- Toward Fairness, Accountability, Transparency, and Ethics in AI for Social Media and Health Care: Scoping Review.JMIR medical informatics · 2024Article
- Machine learning data sources in pediatric sleep research: assessing racial/ethnic differences in electronic health record-based clinical notes prior to model training.Frontiers in sleep · 2024Article
- Mitigating Racial And Ethnic Bias And Advancing Health Equity In Clinical Algorithms: A Scoping Review.Health affairs (Project Hope) · 2023Article
Corrections and comments
- Erratum issued
Authors and funding
4 authors.
Funding
Abstract
Objectives: To review through an ethics lens the state of research in clinical natural language processing (NLP) for the study of bias and fairness, and to identify gaps in research. Methods: We queried PubMed and Google Scholar for articles published between 2015 and 2021 concerning clinical NLP, bias, and fairness. We analyzed articles using a framework that combines the machine learning (ML) development process (ie, design, data, algorithm, and critique) and bioethical concepts of beneficence, nonmaleficence, autonomy, justice, as well as explicability. Our approach further differentiated between biases of clinical text (eg, systemic or personal biases in clinical documentation towards patients) and biases in NLP applications. Results: Out of 1162 articles screened, 22 met criteria for full text review. We categorized articles based on the design ( Discussion: Clinical NLP can be used to study bias in applications reliant on clinical text data as well as explore biases in the healthcare setting. We identify 3 areas of active research that require unique ethical considerations about the potential for clinical NLP to address and/or perpetuate bias: (1) selecting metrics that interrogate bias in models; (2) opportunities and risks of identifying sensitive patient attributes; and (3) best practices in reconciling individual autonomy, leveraging patient data, and inferring and manipulating sensitive information of subgroups. Finally, we address the limitations of current ethical frameworks to fully address concerns of justice. Clinical NLP is a rapidly advancing field, and assessing current approaches against ethical considerations can help the discipline use clinical NLP to explore both healthcare biases and equitable NLP applications.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.