4 ms·

Race and gender should be inputs then. The female part is actually a bit more surprising. Its easy to imagine a dataset not skewed towards black people. ~15% o

Race and gender should be inputs then. The female part is actually a bit more surprising. Its easy to imagine a dataset not skewed towards black people. ~15% of the population in North America, probably less in Europe, and way less in Asia. But female? Thats ~52% globally.

krapp 2y ago
Modern medicine has long operated under the assumption that whatever makes sense in a male body also makes sense in a female body, and womens' health concerns were often dismissed, misdiagnosed or misunderstood in patriarchal society. Women were rarely even included in medical trials prior to 1993. As a result, there is simply a dearth of medical research directly relevant to women for models to even train on.
- Avshalom 2y ago
  https://www.npr.org/2022/11/01/1133375223/the-first-female-crash-test-dummy-has-only-now-arrived https://www.npr.org/2022/11/01/1133375223/the-first-female-c... Twenty Twenty Two!
  - mrguyorama 2y ago
    Republicans early in this admin actually bitched in congress that we were "wasting" money on woman crash test dummies. https://www.foxnews.com/video/6325465806112 https://www.foxnews.com/video/6325465806112
- chrisgarand 2y ago
  I'm going to lay this out how I understand it: The NIH Revitalization Act of 1993 was supposed to bring women back into medical research. The reality was that women were always included, HOWEVER in 1977,(1) because of the outcomes from thalidomide (causing birth defects), "women of childbearing potential" were excluded from the phase 1, and early phase 2 trials (the highest risk trials). They're still generally generally excluded, even after the passage of the act. This was/is to protect the women, and potential children. According to Edward E. Bartlett in his meta data analysis from 2001, men have been routinely under-represented in NIH data (even before adjusting for men's mortality rates) between 1966-1990. (2) There's also routinely twice as much spent every year on women's health studies vs men's by the NIH. (3) It makes sense to me, but I'm biased. Logically, since men lead in 9 of the top 10 causes for death, that shows there's something missing in the equation of research. (4 - It's not a straight forward table, you can view the total deaths, and causes and compare the two for men, and women) With that being said, it doesn't tell us about the quality of the funding or research topics, maybe the money is going towards pointless goals, or unproductive researchers. Are there gaps in research? Most definitely, like women who are pregnant. This is put in place to avoid harm but that doesn't help them when they fall into them. Are there more? Definitely. I'm not educated enough in the nuances to go into them. If you have information that counters what I've posted, please share it, I would love know where these folks are blind so I can take a look at my bias. (1) https://petrieflom.law.harvard.edu/2021/04/16/pregnant-clinical-trials-safety-autonomy/ https://petrieflom.law.harvard.edu/2021/04/16/pregnant-clini... (2) https://journals.lww.com/epidem/fulltext/2001/09000/did_medical_research_routinely_exclude_women__an.20.aspx https://journals.lww.com/epidem/fulltext/2001/09000/did_medi... (3) https://jameslnuzzo.substack.com/p/nih-funding-of-mens-and-womens-health https://jameslnuzzo.substack.com/p/nih-funding-of-mens-and-w... < I spot checked a couple of the figures, and those lined up. I'm assuming the rest is accurate (4) https://www.cdc.gov/womens-health/lcod/index.html#:~:text=Overall%2C%20the%20leading%20cause%20of,%25%20for%20females)%20in%202021. https://www.cdc.gov/womens-health/lcod/index.html#:~:text=Ov...
Freak_NL 2y ago
Surprising? That's not a new realisation. It's a well known fact that women are affected by this in medicine. You can do a cursory search for the gender gap in medicine and get an endless amount of reporting on that topic.
- nonethewiser 2y ago
  That just makes it more surprising.
- appleorchard46 2y ago
  I learned about this recently! It's wild how big the difference is. Even though legal/practical barriers to gender equality in medicine and data collection have been virtually nonexistent for the past few decades the inertia from the decades before that (where women were often specifically excluded, among many other factors) still weigh heavily. To any women who happen to be reading this: if you can, please help fix this! Participate in studies, share your data when appropriate. If you see how a process can be improved to be more inclusive then please let it be known. Any (reasonable) male knows this is an issue and wants to see it fixed but it's not clear what should be done.
andsoitis 2y ago
> Its easy to imagine a dataset not skewed towards black people. ~15% of the population in North America, probably less in Europe, and way less in Asia. What about Africa?
- rafaelmn 2y ago
  How much medical data/papers do you think they generate in comparison to these three ?
- appleorchard46 2y ago
  That's not where most of the data is coming from. If it was we'd be seeing the opposite effect, presumably.
  - jsemrau 2y ago
    I suppose that's the problem I have with that study. T
- nonethewiser 2y ago
  The story is that there exists this model which poorly predicts for black (and female) patients. Given there are probably lots of datasets where black people are a vast minority makes this not surprising. For all I know there are millions of models with extremely poor accuracy based on African datasets. Wouldnt really change anything about the above though. I wouldnt expect that though and it would definitely be interesting.
orand 2y ago
Race and sex should be inputs. Giving any medical prominence to gender identity will result in people receiving wrong and potentially harmful treatment, or lack of treatment.
- lalaithion 2y ago
  Most trans people have undergone gender affirming medical care. A trans man who has had a hysterectomy and is on testosterone will have a very different medical baseline than a cis woman. A trans woman who has had an orchiectomy and is on estrogen will have a very different medical baseline than a cis man. It is literally throwing out relevant medical information to attempt to ignore this.
  - nonethewiser 2y ago
    How is that in any way in conflict with what he said? You're just making an argument for more inputs. Biological sex, hormone levels, etc.
    - matthewmacleod 2y ago
      The GP literally said “giving any medical prominence to gender identity will result in people receiving wrong and potentially harmful treatment” which is categorically false for the reasons the comment you replied to outlined. Sex assigned at birth is in many situations important medical information; the vast majority of trans people are very conscious of their health in this sense and happy to share that with their doctor.
      - nonethewiser 2y ago
        >Sex assigned at birth is in many situations important medical information Which is not gender identity. As a result of being trans there may be things like hormone levels that are different than what you'd expect based on biological sex, which is why I say hormone levels are important, but how you identify is in fact irrelevant.
XorNot 2y ago
Why not socioeconomic status or place of residence? Knowing mean yearly income will absolutely help an AI figure out statistically likely health outcomes.

krapp 2y ago

Modern medicine has long operated under the assumption that whatever makes sense in a male body also makes sense in a female body, and womens' health concerns were often dismissed, misdiagnosed or misunderstood in patriarchal society. Women were rarely even included in medical trials prior to 1993. As a result, there is simply a dearth of medical research directly relevant to women for models to even train on.

Avshalom 2y ago
https://www.npr.org/2022/11/01/1133375223/the-first-female-crash-test-dummy-has-only-now-arrived https://www.npr.org/2022/11/01/1133375223/the-first-female-c... Twenty Twenty Two!
- mrguyorama 2y ago
  Republicans early in this admin actually bitched in congress that we were "wasting" money on woman crash test dummies. https://www.foxnews.com/video/6325465806112 https://www.foxnews.com/video/6325465806112
chrisgarand 2y ago
I'm going to lay this out how I understand it: The NIH Revitalization Act of 1993 was supposed to bring women back into medical research. The reality was that women were always included, HOWEVER in 1977,(1) because of the outcomes from thalidomide (causing birth defects), "women of childbearing potential" were excluded from the phase 1, and early phase 2 trials (the highest risk trials). They're still generally generally excluded, even after the passage of the act. This was/is to protect the women, and potential children. According to Edward E. Bartlett in his meta data analysis from 2001, men have been routinely under-represented in NIH data (even before adjusting for men's mortality rates) between 1966-1990. (2) There's also routinely twice as much spent every year on women's health studies vs men's by the NIH. (3) It makes sense to me, but I'm biased. Logically, since men lead in 9 of the top 10 causes for death, that shows there's something missing in the equation of research. (4 - It's not a straight forward table, you can view the total deaths, and causes and compare the two for men, and women) With that being said, it doesn't tell us about the quality of the funding or research topics, maybe the money is going towards pointless goals, or unproductive researchers. Are there gaps in research? Most definitely, like women who are pregnant. This is put in place to avoid harm but that doesn't help them when they fall into them. Are there more? Definitely. I'm not educated enough in the nuances to go into them. If you have information that counters what I've posted, please share it, I would love know where these folks are blind so I can take a look at my bias. (1) https://petrieflom.law.harvard.edu/2021/04/16/pregnant-clinical-trials-safety-autonomy/ https://petrieflom.law.harvard.edu/2021/04/16/pregnant-clini... (2) https://journals.lww.com/epidem/fulltext/2001/09000/did_medical_research_routinely_exclude_women__an.20.aspx https://journals.lww.com/epidem/fulltext/2001/09000/did_medi... (3) https://jameslnuzzo.substack.com/p/nih-funding-of-mens-and-womens-health https://jameslnuzzo.substack.com/p/nih-funding-of-mens-and-w... < I spot checked a couple of the figures, and those lined up. I'm assuming the rest is accurate (4) https://www.cdc.gov/womens-health/lcod/index.html#:~:text=Overall%2C%20the%20leading%20cause%20of,%25%20for%20females)%20in%202021. https://www.cdc.gov/womens-health/lcod/index.html#:~:text=Ov...

Freak_NL 2y ago

Surprising? That's not a new realisation. It's a well known fact that women are affected by this in medicine. You can do a cursory search for the gender gap in medicine and get an endless amount of reporting on that topic.

nonethewiser 2y ago
That just makes it more surprising.
appleorchard46 2y ago
I learned about this recently! It's wild how big the difference is. Even though legal/practical barriers to gender equality in medicine and data collection have been virtually nonexistent for the past few decades the inertia from the decades before that (where women were often specifically excluded, among many other factors) still weigh heavily. To any women who happen to be reading this: if you can, please help fix this! Participate in studies, share your data when appropriate. If you see how a process can be improved to be more inclusive then please let it be known. Any (reasonable) male knows this is an issue and wants to see it fixed but it's not clear what should be done.

andsoitis 2y ago

> Its easy to imagine a dataset not skewed towards black people. ~15% of the population in North America, probably less in Europe, and way less in Asia. What about Africa?

rafaelmn 2y ago
How much medical data/papers do you think they generate in comparison to these three ?
appleorchard46 2y ago
That's not where most of the data is coming from. If it was we'd be seeing the opposite effect, presumably.
- jsemrau 2y ago
  I suppose that's the problem I have with that study. T
nonethewiser 2y ago
The story is that there exists this model which poorly predicts for black (and female) patients. Given there are probably lots of datasets where black people are a vast minority makes this not surprising. For all I know there are millions of models with extremely poor accuracy based on African datasets. Wouldnt really change anything about the above though. I wouldnt expect that though and it would definitely be interesting.

orand 2y ago

Race and sex should be inputs. Giving any medical prominence to gender identity will result in people receiving wrong and potentially harmful treatment, or lack of treatment.

lalaithion 2y ago
Most trans people have undergone gender affirming medical care. A trans man who has had a hysterectomy and is on testosterone will have a very different medical baseline than a cis woman. A trans woman who has had an orchiectomy and is on estrogen will have a very different medical baseline than a cis man. It is literally throwing out relevant medical information to attempt to ignore this.
- nonethewiser 2y ago
  How is that in any way in conflict with what he said? You're just making an argument for more inputs. Biological sex, hormone levels, etc.
  - matthewmacleod 2y ago
    The GP literally said “giving any medical prominence to gender identity will result in people receiving wrong and potentially harmful treatment” which is categorically false for the reasons the comment you replied to outlined. Sex assigned at birth is in many situations important medical information; the vast majority of trans people are very conscious of their health in this sense and happy to share that with their doctor.
    - nonethewiser 2y ago
      >Sex assigned at birth is in many situations important medical information Which is not gender identity. As a result of being trans there may be things like hormone levels that are different than what you'd expect based on biological sex, which is why I say hormone levels are important, but how you identify is in fact irrelevant.

XorNot 2y ago

Why not socioeconomic status or place of residence? Knowing mean yearly income will absolutely help an AI figure out statistically likely health outcomes.