4 ms·

One of the things that people I know in the medical field have mentioned is that there's racial and gender bias that goes through all levels and has a sort of f

One of the things that people I know in the medical field have mentioned is that there's racial and gender bias that goes through all levels and has a sort of feedback loop. A lot of medical knowledge is gained empirically, and historically that has meant that minorities and women tended to be underrepresented in western medical literature. That leads to new medical practitioners being less exposed to presentations of various ailments that may have variance due to gender or ethnicity. Basically, if most data is gathered from those who have the most access to medicine, there will be an inherent bias towards how various ailments present in those populations. So your base data set might be skewed from the very beginning. (This is mostly just to offer some food for thought, I haven't read the article in full so I don't want to comment on it specifically.)

belorn 2y ago
It is very true that a lot of medical knowledge is gained empirically, and there is also an additional aspect to it. The history of Medical research is generally studied on the demographics where such testing is cultural acceptable, and where the gains of such research has been mostly sought, which is young men drafted into wars. The second common demographic are medical students, which historically was biased towards men but are today biased towards women. So while access to medicine indeed one demographic, I would say that studies are more likely to target demographics which are convenient to test on.
- genocidicbunny 2y ago
  I think we're really talking about different aspects of the same issue. Everything you've described basically agrees with "those who have more access to medicine" because those are also the ones inherently more convenient to test/observe.
  - klipt 2y ago
    Like how the ones with the most access to medicine are mice, because they're convenient to experiment on.
    - genocidicbunny 2y ago
      And this is absolutely something one needs to consider when reading medical studies -- if they only use animal (usually mice) models, there's a decent chance the conclusions are not directly transferable to humans.
- gonzobonzo 2y ago
  > The history of Medical research is generally studied on the demographics where such testing is cultural acceptable, and where the gains of such research has been mostly sought, which is young men drafted into wars. Though in this study, the AI models were also biased against people under the age of 40. It is interesting that we're also seeing a lot of bias in the reporting and discussion of these results. The results tested three groups for bias, and found a bias in all three. Yet the headline only mentions the bias against two of the groups, and almost the entirety of the discussion here only talks about bias against two of the groups while ignoring the third group. If I test a system for bias, select three different groups to test for, and all three have a bias against them, my first reaction would be "there's a good chance that it's also biased against many other groups, I should test for those as well." It wouldn't be to pretend that there's only bias against the only three groups I actually bothered checking for. It definitely wouldn't be two ignore one of those groups, and pretend that there's only a bias against the other two.
QuarterReptile 2y ago
>women tended to be underrepresented in western medical literature. Is there some evidence of this? It's hard for me to picture that women see receive less medical attention than man: completely inconsistent with my culture and every doctor's office I've ever been to. It's more believable (still not very) that they disproportionately avoid studies.
- genocidicbunny 2y ago
  There's a few factors here: 1. We're talking about a span of 200 or so years. There is plenty of modern medicine that is still based on now century+ old knowledge. 2. The feedback loop. If you were learning medicine in the 1950's, you were probably learning from medical texts written in the 50 or so years before that, when it's not unreasonable to think women would have been less represented. Those same doctors from the 1950's would then have been teaching the next generation of doctors, and they carried those (intentional or not) biases forward. Of course there was new information, but you don't tend to have much time to explore novel medicine when you're in medical school or residency, so by the time you can integrate the new knowledge, some biases have already set in. Repeat for a few generations, and you tend to only get a dilution of those old ideas, not a wholesale replacement of them. 3. If you've been affected by such biases as a patient, you're less likely to trust and be willing to participate with medicine, once more reinforcing the feedback loop. I don't have any specific numbers or studies for you, but you could probably find more than a few that attest to this phenomenon. I hate to go with 'trust me bro' here, but my knowledge on this topic largely comes from knowing people that are either studying or practicing medicine currently, so it's anecdotal, but the anecdotes are from those in the field currently.
  - amy214 2y ago
    [flagged]
    - wegfawefgawefg 2y ago
      This is bait.
- 2y ago
searealist 2y ago
Women use far more medical care than men. Men's insurance premiums subsidize women's.
- genocidicbunny 2y ago
  Has this been consistently true for the past 200 or so years? Many medical texts are pretty old. And how much medical care they use does not necessarily correlate with how represented they are in the training data sets for AI.
  - searealist 2y ago
    The burden of proof is on you.
    - genocidicbunny 2y ago
      Proof that health insurance premiums for men have been consistently subsidizing women's health insurance premiums for the last 200 or so years? Perhaps the practical non-existence of health insurance until the latter half of the 20th's century? Pretty tough to subsidize something that doesn't exist. You also offered no evidence for your assertion in the first place.
      - searealist 2y ago
        The ACA bans health insurance companies from charging men and women different rates for the same coverage. Before this, Women would have higher premiums because, on average, they use their coverage more. This is very easy to look up. I can cite the ACA, but you can not cite anything that says AI training sets are biased against women.
        genocidicbunny 2y ago
        A few questions for you to think of then -- or rather a few things I think you should consider with your statements: 1. How does ACA affect the corpus of knowledge and medical practice gathered prior to the ACA being in effect? How does it affect late 19th, and early and mid 20th century medical knowledge and practice, which occurred prior to health insurance of any kind, nevermind ACA-compliant, being widespread? This corpus of knowledge and practice continues to propagate even now. I've read a handful of recently published medical textbooks and there are definitely parts that are pretty much the same as the textbooks of the early 20th century, just with slightly updated language. 2. What are the possible confounding factors in the use of health insurance by men vs women? For example, could men just be more hesitant to see a doctor, and thus less likely to make use of health insurance? Does the average life expectancy of women result in more use of health insurance later in life than for men? Are medical procedures that are specific to women that add to the cost of their care, such as mammograms, pap smears, etc? Seeings as how in the US health insurance is a practical requirement to getting medical care, and lack of it is punished financially in various ways from taxes to just having medical care be more expensive when you truly need it, means most people will try to have _some_ kind of health insurance, even if they don't think they need it for actual health reasons. So despite a perception of not needing health insurance, men are incentivized to have health insurance they don't use? 3. Does the ACA guarantee in any way that medical professionals no longer hold any bias due their previous training, especially if such training occurred prior to the introduction of the ACA? Does the ACA similarly guarantee that women and men are not only able, but choose to pursue medical care and participate in medical studies at percentages matching the general population? Your point about men subsidizing women with regard to health insurance premiums may be perfectly valid, I am not disputing you on that point. I am disputing that it is salient to the tradition and practice of medicine in the western world in the modern era, until very recently historically, and that these traditions and biases will affect data sets gathered from people who are directly affected by these biases and traditions to this day. We haven't eliminated them, because as I said in another comment, every generation just dilutes the old issues, it doesn't solve them. And while I could spend my evening finding studies from various countries that attest to my view on this, I have spent about as much time as I desire to on this, so I will grant you that my evidence is on the level of 'trust me bro' -- with the slight caveat that many people within just my family and close circle of friends are involved in the medical field and all largely agree to this, and they are not all based in the US (which by the way, your point is very specific to. ACA is a US thing, western medicine spans a bit more than that.) It is entirely fair for you to call out that I have offered no real peer-reviewed evidence for my statements. I intend to offer a viewpoint of someone who has had extensive peripheral experience with medical professionals and has discussed this topic with them, and to offer some avenues of thought on how and why the data sets might be biased.

belorn 2y ago

It is very true that a lot of medical knowledge is gained empirically, and there is also an additional aspect to it. The history of Medical research is generally studied on the demographics where such testing is cultural acceptable, and where the gains of such research has been mostly sought, which is young men drafted into wars. The second common demographic are medical students, which historically was biased towards men but are today biased towards women. So while access to medicine indeed one demographic, I would say that studies are more likely to target demographics which are convenient to test on.

genocidicbunny 2y ago
I think we're really talking about different aspects of the same issue. Everything you've described basically agrees with "those who have more access to medicine" because those are also the ones inherently more convenient to test/observe.
- klipt 2y ago
  Like how the ones with the most access to medicine are mice, because they're convenient to experiment on.
  - genocidicbunny 2y ago
    And this is absolutely something one needs to consider when reading medical studies -- if they only use animal (usually mice) models, there's a decent chance the conclusions are not directly transferable to humans.
gonzobonzo 2y ago
> The history of Medical research is generally studied on the demographics where such testing is cultural acceptable, and where the gains of such research has been mostly sought, which is young men drafted into wars. Though in this study, the AI models were also biased against people under the age of 40. It is interesting that we're also seeing a lot of bias in the reporting and discussion of these results. The results tested three groups for bias, and found a bias in all three. Yet the headline only mentions the bias against two of the groups, and almost the entirety of the discussion here only talks about bias against two of the groups while ignoring the third group. If I test a system for bias, select three different groups to test for, and all three have a bias against them, my first reaction would be "there's a good chance that it's also biased against many other groups, I should test for those as well." It wouldn't be to pretend that there's only bias against the only three groups I actually bothered checking for. It definitely wouldn't be two ignore one of those groups, and pretend that there's only a bias against the other two.

QuarterReptile 2y ago

>women tended to be underrepresented in western medical literature. Is there some evidence of this? It's hard for me to picture that women see receive less medical attention than man: completely inconsistent with my culture and every doctor's office I've ever been to. It's more believable (still not very) that they disproportionately avoid studies.

genocidicbunny 2y ago
There's a few factors here: 1. We're talking about a span of 200 or so years. There is plenty of modern medicine that is still based on now century+ old knowledge. 2. The feedback loop. If you were learning medicine in the 1950's, you were probably learning from medical texts written in the 50 or so years before that, when it's not unreasonable to think women would have been less represented. Those same doctors from the 1950's would then have been teaching the next generation of doctors, and they carried those (intentional or not) biases forward. Of course there was new information, but you don't tend to have much time to explore novel medicine when you're in medical school or residency, so by the time you can integrate the new knowledge, some biases have already set in. Repeat for a few generations, and you tend to only get a dilution of those old ideas, not a wholesale replacement of them. 3. If you've been affected by such biases as a patient, you're less likely to trust and be willing to participate with medicine, once more reinforcing the feedback loop. I don't have any specific numbers or studies for you, but you could probably find more than a few that attest to this phenomenon. I hate to go with 'trust me bro' here, but my knowledge on this topic largely comes from knowing people that are either studying or practicing medicine currently, so it's anecdotal, but the anecdotes are from those in the field currently.
- amy214 2y ago
  [flagged]
  - wegfawefgawefg 2y ago
    This is bait.
2y ago

searealist 2y ago

Women use far more medical care than men. Men's insurance premiums subsidize women's.

genocidicbunny 2y ago
Has this been consistently true for the past 200 or so years? Many medical texts are pretty old. And how much medical care they use does not necessarily correlate with how represented they are in the training data sets for AI.
- searealist 2y ago
  The burden of proof is on you.
  - genocidicbunny 2y ago
    Proof that health insurance premiums for men have been consistently subsidizing women's health insurance premiums for the last 200 or so years? Perhaps the practical non-existence of health insurance until the latter half of the 20th's century? Pretty tough to subsidize something that doesn't exist. You also offered no evidence for your assertion in the first place.
    - searealist 2y ago
      The ACA bans health insurance companies from charging men and women different rates for the same coverage. Before this, Women would have higher premiums because, on average, they use their coverage more. This is very easy to look up. I can cite the ACA, but you can not cite anything that says AI training sets are biased against women.
      - genocidicbunny 2y ago
        A few questions for you to think of then -- or rather a few things I think you should consider with your statements: 1. How does ACA affect the corpus of knowledge and medical practice gathered prior to the ACA being in effect? How does it affect late 19th, and early and mid 20th century medical knowledge and practice, which occurred prior to health insurance of any kind, nevermind ACA-compliant, being widespread? This corpus of knowledge and practice continues to propagate even now. I've read a handful of recently published medical textbooks and there are definitely parts that are pretty much the same as the textbooks of the early 20th century, just with slightly updated language. 2. What are the possible confounding factors in the use of health insurance by men vs women? For example, could men just be more hesitant to see a doctor, and thus less likely to make use of health insurance? Does the average life expectancy of women result in more use of health insurance later in life than for men? Are medical procedures that are specific to women that add to the cost of their care, such as mammograms, pap smears, etc? Seeings as how in the US health insurance is a practical requirement to getting medical care, and lack of it is punished financially in various ways from taxes to just having medical care be more expensive when you truly need it, means most people will try to have _some_ kind of health insurance, even if they don't think they need it for actual health reasons. So despite a perception of not needing health insurance, men are incentivized to have health insurance they don't use? 3. Does the ACA guarantee in any way that medical professionals no longer hold any bias due their previous training, especially if such training occurred prior to the introduction of the ACA? Does the ACA similarly guarantee that women and men are not only able, but choose to pursue medical care and participate in medical studies at percentages matching the general population? Your point about men subsidizing women with regard to health insurance premiums may be perfectly valid, I am not disputing you on that point. I am disputing that it is salient to the tradition and practice of medicine in the western world in the modern era, until very recently historically, and that these traditions and biases will affect data sets gathered from people who are directly affected by these biases and traditions to this day. We haven't eliminated them, because as I said in another comment, every generation just dilutes the old issues, it doesn't solve them. And while I could spend my evening finding studies from various countries that attest to my view on this, I have spent about as much time as I desire to on this, so I will grant you that my evidence is on the level of 'trust me bro' -- with the slight caveat that many people within just my family and close circle of friends are involved in the medical field and all largely agree to this, and they are not all based in the US (which by the way, your point is very specific to. ACA is a US thing, western medicine spans a bit more than that.) It is entirely fair for you to call out that I have offered no real peer-reviewed evidence for my statements. I intend to offer a viewpoint of someone who has had extensive peripheral experience with medical professionals and has discussed this topic with them, and to offer some avenues of thought on how and why the data sets might be biased.