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Published in: Current Atherosclerosis Reports 4/2024

16-02-2024 | Artificial Intelligence | Review

Implications of Bias in Artificial Intelligence: Considerations for Cardiovascular Imaging

Authors: Marly van Assen, Ashley Beecy, Gabrielle Gershon, Janice Newsome, Hari Trivedi, Judy Gichoya

Published in: Current Atherosclerosis Reports | Issue 4/2024

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Abstract

Purpose of Review

Bias in artificial intelligence (AI) models can result in unintended consequences. In cardiovascular imaging, biased AI models used in clinical practice can negatively affect patient outcomes. Biased AI models result from decisions made when training and evaluating a model. This paper is a comprehensive guide for AI development teams to understand assumptions in datasets and chosen metrics for outcome/ground truth, and how this translates to real-world performance for cardiovascular disease (CVD).

Recent Findings

CVDs are the number one cause of mortality worldwide; however, the prevalence, burden, and outcomes of CVD vary across gender and race. Several biomarkers are also shown to vary among different populations and ethnic/racial groups. Inequalities in clinical trial inclusion, clinical presentation, diagnosis, and treatment are preserved in health data that is ultimately used to train AI algorithms, leading to potential biases in model performance. Despite the notion that AI models themselves are biased, AI can also help to mitigate bias (e.g., bias auditing tools).

Summary

In this review paper, we describe in detail implicit and explicit biases in the care of cardiovascular disease that may be present in existing datasets but are not obvious to model developers. We review disparities in CVD outcomes across different genders and race groups, differences in treatment of historically marginalized groups, and disparities in clinical trials for various cardiovascular diseases and outcomes. Thereafter, we summarize some CVD AI literature that shows bias in CVD AI as well as approaches that AI is being used to mitigate CVD bias.
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Metadata
Title
Implications of Bias in Artificial Intelligence: Considerations for Cardiovascular Imaging
Authors
Marly van Assen
Ashley Beecy
Gabrielle Gershon
Janice Newsome
Hari Trivedi
Judy Gichoya
Publication date
16-02-2024
Publisher
Springer US
Published in
Current Atherosclerosis Reports / Issue 4/2024
Print ISSN: 1523-3804
Electronic ISSN: 1534-6242
DOI
https://doi.org/10.1007/s11883-024-01190-x
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