Evidence map›Paper›PMID 40495929›Full record

ArticleFrontiers in artificial intelligence2025

Evaluating artificial intelligence bias in nephrology: the role of diversity, equity, and inclusion in AI-driven decision-making and ethical regulation.

Suryanarayanan Balakrishnan, Charat Thongprayoon, Wannasit Wathanavasin, Jing Miao, Michael A Mao, Iasmina M Craici, Wisit Cheungpasitporn

Abstract read
In one paragraph

Article in Frontiers in artificial intelligence, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing 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

5 citing papers in PubMed.

  1. Review
  2. Article
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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.

Suryanarayanan BalakrishnanDivision of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, MN, United States.
Charat ThongprayoonDivision of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, MN, United States.
Wannasit WathanavasinDivision of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, MN, United States.
Jing MiaoDivision of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, MN, United States.
Michael A MaoDivision of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Jacksonville, FL, United States.
Iasmina M CraiciDivision of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, MN, United States.
Wisit CheungpasitpornDivision of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, MN, United States.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: The integration of Artificial Intelligence (AI) in nephrology has raised concerns regarding bias, fairness, and ethical decision-making, particularly in the context of Diversity, Equity, and Inclusion (DEI). AI-driven models, including Large Language Models (LLMs) like ChatGPT, may unintentionally reinforce existing disparities in patient care and workforce recruitment. This study investigates how AI models (ChatGPT 3.5 and 4.0) handle DEI-related ethical considerations in nephrology, highlighting the need for improved regulatory oversight to ensure equitable AI deployment. Methods: The study was conducted in March 2024 using ChatGPT 3.5 and 4.0. Eighty simulated cases were developed to assess ChatGPT's decision-making across diverse nephrology topics. ChatGPT was instructed to respond to questions considering factors such as age, sex, gender identity, race, ethnicity, religion, cultural beliefs, socioeconomic status, education level, family structure, employment, insurance, geographic location, disability, mental health, language proficiency, and technology access. Results: ChatGPT 3.5 provided a response to all scenario questions and did not refuse to make decisions under any circumstances. This contradicts the essential DEI principle of avoiding decisions based on potentially discriminatory criteria. In contrast, ChatGPT 4.0 declined to make decisions based on potentially discriminatory criteria in 13 (16.3%) scenarios during the first round and in 5 (6.3%) during the second round. Conclusion: While ChatGPT 4.0 shows improvement in ethical AI decision-making, its limited recognition of bias and DEI considerations underscores the need for robust AI regulatory frameworks in nephrology. AI governance must incorporate structured DEI guidelines, ongoing bias detection mechanisms, and ethical oversight to prevent AI-driven disparities in clinical practice and workforce recruitment. This study emphasizes the importance of transparency, fairness, and inclusivity in AI development, calling for collaborative efforts between AI developers, nephrologists, policymakers, and patient communities to ensure AI serves as an equitable tool in nephrology.

Indexed as

artificial intelligencebias detectionChatGPTclinical implicationsdecision-makingdiversity, equity, and inclusionethical AI regulationnephrology

Identifiers

PMID40495929
PMCPMC12150873

What OpenQuestion holds

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LicenceCC BY
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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.