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Libin A, Treitler JT, Vasaitis T, Shao Y. Evaluating and Reducing Subgroup Disparity in AI Models: An Analysis of Pediatric COVID-19 Test Outcomes. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.09.18.24313889. [PMID: 39371141 PMCID: PMC11451670 DOI: 10.1101/2024.09.18.24313889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 10/08/2024]
Abstract
Artificial Intelligence (AI) fairness in healthcare settings has attracted significant attention due to the concerns to propagate existing health disparities. Despite ongoing research, the frequency and extent of subgroup fairness have not been sufficiently studied. In this study, we extracted a nationally representative pediatric dataset (ages 0-17, n=9,935) from the US National Health Interview Survey (NHIS) concerning COVID-19 test outcomes. For subgroup disparity assessment, we trained 50 models using five machine learning algorithms. We assessed the models' area under the curve (AUC) on 12 small (<15% of the total n) subgroups defined using social economic factors versus the on the overall population. Our results show that subgroup disparities were prevalent (50.7%) in the models. Subgroup AUCs were generally lower, with a mean difference of 0.01, ranging from -0.29 to +0.41. Notably, the disparities were not always statistically significant, with four out of 12 subgroups having statistically significant disparities across models. Additionally, we explored the efficacy of synthetic data in mitigating identified disparities. The introduction of synthetic data enhanced subgroup disparity in 57.7% of the models. The mean AUC disparities for models with synthetic data decreased on average by 0.03 via resampling and 0.04 via generative adverbial network methods.
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Affiliation(s)
- Alexander Libin
- AIM AHEAD Consortium, Georgetown-Howard Universities Center for Clinical and Translational Science (GHUCCTS), Medstar Research Health Institute, Georgetown University, Washington, D.C., USA
| | - Jonah T. Treitler
- Thomas Jefferson High School for Science and Technology, Alexandria, Virginia, USA
| | - Tadas Vasaitis
- School of Pharmacy and Health Professions, University of Maryland Eastern Shore, Princess Anne, MD, USA
| | - Yijun Shao
- Biomedical Informatics Center, George Washington University, Washington, D.C., USA
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Kattih M, Lee H, Jo H, Jeong J, Kim H, Park J, Yang H, Nguyen A, Kim HJ, Lee H, Kim M, Lee M, Kwon R, Kim S, Koyanagi A, Kim MS, Rahmati M, López Sánchez GF, Dragioti E, Kim JH, Woo S, Cho SH, Smith L, Yon DK. National prevalence of atopic dermatitis in Korean adolescents from 2009 to 2022. Sci Rep 2024; 14:12391. [PMID: 38811655 PMCID: PMC11137070 DOI: 10.1038/s41598-024-62475-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 05/17/2024] [Indexed: 05/31/2024] Open
Abstract
Previous studies have examined the prevalence of allergic diseases in adolescents 1-2 years after the emergence of the COVID-19 pandemic. However, more data is needed to understand the long-term impact of COVID-19 on allergic diseases. Thus, we aimed to examine the trend of the atopic dermatitis prevalence in Korean adolescents before and during the COVID-19 pandemic across 14 years. Additionally, we analyze the risk factors of atopic dermatitis (AD) based on the results. The Korean Disease Control and Prevention Agency conducted the Korea Youth Risk Behavior Web-based Survey from 2009 to 2022, from which the data for this study were obtained. Prevalence trends were compared across subgroups, and the β difference (βdiff) was calculated. We computed odds ratios to examine changes in the disease prevalence before and during the pandemic. This study included a total of 917,461 participants from 2009 to 2022. The prevalence of atopic dermatitis increased from 6.79% (95% CI 6.66-6.91) in 2009-2011 to 6.89% (95% CI 6.72-7.05) in 2018-2019, then decreased slightly to 5.82% (95% CI 5.60-6.04) in 2022. Across the 14 years, middle school student status, low parent's highest education level, low household income, non-alcohol consumption, non-smoker smoking status, no suicidal thoughts, and no suicide attempts were associated with increased risk of atopic dermatitis, while female sex, rural residence, high BMI, low school performance, low household income, and no feelings of sadness and despair was associated with a small increase. This study examined the prevalence of atopic dermatitis across an 18-year, and found that the prevalence increased in the pre-pandemic then decreased during the start of the pandemic and remained constant throughout the pandemic. This trend could be explained mainly by the large scale social and political changes that occurred during the COVID-19 pandemic.
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Affiliation(s)
- Mafaz Kattih
- Department of Medicine, University of South Florida Morsani College of Medicine, Tampa, FL, USA
| | - Hojae Lee
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, South Korea
- Department of Regulatory Science, Kyung Hee University, Seoul, South Korea
| | - Hyesu Jo
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, South Korea
- Department of Regulatory Science, Kyung Hee University, Seoul, South Korea
| | - Jinyoung Jeong
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, South Korea
- Department of Medicine, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Hyejun Kim
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, South Korea
- Department of Applied Information Engineering, Yonsei University, Seoul, South Korea
| | - Jaeyu Park
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, South Korea
- Department of Regulatory Science, Kyung Hee University, Seoul, South Korea
| | - Hwi Yang
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, South Korea
- Department of Regulatory Science, Kyung Hee University, Seoul, South Korea
| | - Ann Nguyen
- Department of Medicine, University of South Florida Morsani College of Medicine, Tampa, FL, USA
| | - Hyeon Jin Kim
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, South Korea
- Department of Regulatory Science, Kyung Hee University, Seoul, South Korea
| | - Hyeri Lee
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, South Korea
- Department of Regulatory Science, Kyung Hee University, Seoul, South Korea
| | - Minji Kim
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, South Korea
- Department of Regulatory Science, Kyung Hee University, Seoul, South Korea
| | - Myeongcheol Lee
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, South Korea
- Department of Regulatory Science, Kyung Hee University, Seoul, South Korea
| | - Rosie Kwon
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, South Korea
- Department of Regulatory Science, Kyung Hee University, Seoul, South Korea
| | - Sunyoung Kim
- Department of Family Medicine, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Deu, Barcelona, Spain
| | - Min Seo Kim
- Cardiovascular Disease Initiative, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Masoud Rahmati
- Health Service Research and Quality of Life Center (CEReSS), Assistance Publique-Hôpitaux de Marseille, Aix-Marseille Université, Marseille, France
- Department of Physical Education and Sport Sciences, Faculty of Literature and Human Sciences, Lorestan University, Khoramabad, Iran
- Department of Physical Education and Sport Sciences, Faculty of Literature and Humanities, Vali-E-Asr University of Rafsanjan, Rafsanjan, Iran
| | - Guillermo F López Sánchez
- Division of Preventive Medicine and Public Health, Department of Public Health Sciences, School of Medicine, University of Murcia, Murcia, Spain
| | - Elena Dragioti
- Department of Medical and Health Sciences, Pain and Rehabilitation Centre, Linköping University, Linköping, Sweden
- Research Laboratory Psychology of Patients, Families, and Health Professionals, Department of Nursing, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Ju Hee Kim
- Department of Pediatrics, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, 23 Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447, South Korea
| | - Selin Woo
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Seong H Cho
- Department of Medicine, University of South Florida Morsani College of Medicine, Tampa, FL, USA.
- Division of Allergy and Immunology, Department of Internal Medicine, USF Morsani College of Medicine, Tampa, FL, USA.
| | - Lee Smith
- Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, CB1 1PT, UK.
| | - Dong Keon Yon
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, South Korea.
- Department of Regulatory Science, Kyung Hee University, Seoul, South Korea.
- Department of Medicine, Kyung Hee University College of Medicine, Seoul, South Korea.
- Department of Pediatrics, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, 23 Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447, South Korea.
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Huang X, Huang Z, Zhang J, Jiang Y. Maternal gestational diabetes mellitus and the childhood asthma in offspring: a meta-analysis. Ital J Pediatr 2023; 49:139. [PMID: 37840137 PMCID: PMC10577943 DOI: 10.1186/s13052-023-01532-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 09/14/2023] [Indexed: 10/17/2023] Open
Abstract
BACKGROUND Maternal diabetes might be related to a high risk of allergic disease in offspring. However, it remains unknown if maternal gestational diabetes mellitus (GDM) is also associated with a high incidence of childhood asthma in offspring. A systematic review and meta-analysis was performed to investigate the above association. METHODS Relevant observational studies were obtained by search of electronic databases including Medline, Embase, Cochrane Library, and Web of Science. A randomized-effects model was selected to pool the data by incorporating the influence of potential heterogeneity. The Newcastle-Ottawa Scale was used for study quality evaluation. Subgroup analyses were performed to evaluate the potential influences of study characteristics on the outcome. RESULTS Ten datasets from seven moderate to high quality cohort studies, involving 523,047 mother-child pairs were included in the meta-analysis. Overall, maternal GDM was associated with a higher risk of childhood asthma in offspring (risk ratio [RR]: 1.22, 95% confidence interval [CI]: 1.07 to 1.39, p = 0.003; I2 = 30%). Subgroup analyses showed that the association was not significantly affected by study design, validation methods for GDM, or diagnostic strategy for asthma (p for subgroup analyses all > 0.05). The association between maternal GDM and asthma in offspring was more remarkable after adjusting maternal body mass index in early pregnancy (RR: 1.50 versus 1.06, p < 0.001), but significantly weakened after adjusting hypertensive disorders during pregnancy (RR: 1.08 versus 1.50, p = 0.001). CONCLUSIONS Maternal GDM may be associated with an increased incidence of childhood asthma in offspring.
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Affiliation(s)
- Xufeng Huang
- Department of Pediatrics, Fuyang First People's Hospital, No. 429 Beihuan Road, Fuyang District, Hangzhou, 311400, China.
| | - Zhengguo Huang
- Department of Pediatrics, Fuyang First People's Hospital, No. 429 Beihuan Road, Fuyang District, Hangzhou, 311400, China
| | - Jing Zhang
- Department of Pediatrics, Fuyang First People's Hospital, No. 429 Beihuan Road, Fuyang District, Hangzhou, 311400, China
| | - You Jiang
- Department of Pediatrics, Fuyang First People's Hospital, No. 429 Beihuan Road, Fuyang District, Hangzhou, 311400, China
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