Evidence map›Paper›PMID 39475953›Full record

ArticlePLOS global public health2024

Racial differences in laboratory testing as a potential mechanism for bias in AI: A matched cohort analysis in emergency department visits.

Trenton Chang, Mark Nuppnau, Ying He, Keith E Kocher, Thomas S Valley, Michael W Sjoding, Jenna Wiens

Abstract read
In one paragraph

Article in PLOS global public health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Review
  3. Reaffirming DEI as a central value of JCM.Journal of clinical microbiology · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Trenton ChangDivision of Computer Science and Engineering, University of Michigan, Ann Arbor, Michigan, United States of America.ORCID https://orcid.org/0000-0003-4679-5841
Mark NuppnauDivision of Pulmonary and Critical Care, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, United States of America.
Ying HeDivision of Pulmonary and Critical Care, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, United States of America.ORCID https://orcid.org/0009-0005-4461-1596
Keith E KocherVA Center for Clinical Management Research, Ann Arbor, Michigan, United States of America.ORCID https://orcid.org/0000-0001-7256-8859
Thomas S ValleyDivision of Pulmonary and Critical Care, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, United States of America.ORCID https://orcid.org/0000-0002-5766-4970
Michael W SjodingDivision of Pulmonary and Critical Care, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, United States of America.
Jenna WiensDivision of Computer Science and Engineering, University of Michigan, Ann Arbor, Michigan, United States of America.ORCID https://orcid.org/0000-0002-1057-7722

Funding

Optimizing Clinician and AI Collaborations to Support Timely Management of Acute DyspneaR01HL158626 · NHLBI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI Michael William Sjoding, Jenna Wiens · 2021 to 2026
$3.8M
NHLBI NIH HHS R01 HL158626
6 · The paper itself

Abstract

AI models are often trained using available laboratory test results. Racial differences in laboratory testing may bias AI models for clinical decision support, amplifying existing inequities. This study aims to measure the extent of racial differences in laboratory testing in adult emergency department (ED) visits. We conducted a retrospective 1:1 exact-matched cohort study of Black and White adult patients seen in the ED, matching on age, biological sex, chief complaint, and ED triage score, using ED visits at two U.S. teaching hospitals: Michigan Medicine, Ann Arbor, MI (U-M, 2015-2022), and Beth Israel Deaconess Medical Center, Boston, MA (BIDMC, 2011-2019). Post-matching, White patients had significantly higher testing rates than Black patients for complete blood count (BIDMC difference: 1.7%, 95% CI: 1.1% to 2.4%, U-M difference: 2.0%, 95% CI: 1.6% to 2.5%), metabolic panel (BIDMC: 1.5%, 95% CI: 0.9% to 2.1%, U-M: 1.9%, 95% CI: 1.4% to 2.4%), and blood culture (BIDMC: 0.9%, 95% CI: 0.5% to 1.2%, U-M: 0.7%, 95% CI: 0.4% to 1.1%). Black patients had significantly higher testing rates for troponin than White patients (BIDMC: -2.1%, 95% CI: -2.6% to -1.6%, U-M: -2.2%, 95% CI: -2.7% to -1.8%). The observed racial testing differences may impact AI models trained using available laboratory results. The findings also motivate further study of how such differences arise and how to mitigate potential impacts on AI models.

Identifiers

PMID39475953
PMCPMC11524489

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Registered trials

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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.