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Singh Ospina N, Diaz-Thomas A, McDonnell ME, Demay MB, Pittas AG, York E, Corrigan MD, Lash RW, Brito JP, Murad MH, McCartney CR. Navigating Complexities: Vitamin D, Skin Pigmentation, and Race. J Clin Endocrinol Metab 2024; 109:1955-1960. [PMID: 38828960 PMCID: PMC11244154 DOI: 10.1210/clinem/dgae314] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Indexed: 06/05/2024]
Abstract
Vitamin D plays a critical role in many physiological functions, including calcium metabolism and musculoskeletal health. This commentary aims to explore the intricate relationships among skin complexion, race, and 25-hydroxyvitamin D (25[OH]D) levels, focusing on challenges the Endocrine Society encountered during clinical practice guideline development. Given that increased melanin content reduces 25(OH)D production in the skin in response to UV light, the guideline development panel addressed the potential role for 25(OH)D screening in individuals with dark skin complexion. The panel discovered that no randomized clinical trials have directly assessed vitamin D related patient-important outcomes based on participants' skin pigmentation, although race and ethnicity often served as presumed proxies for skin pigmentation in the literature. In their deliberations, guideline panel members and selected Endocrine Society leaders underscored the critical need to distinguish between skin pigmentation as a biological variable and race and ethnicity as socially determined constructs. This differentiation is vital to maximize scientific rigor and, thus, the validity of resulting recommendations. Lessons learned from the guideline development process emphasize the necessity of clarity when incorporating race and ethnicity into clinical guidelines. Such clarity is an essential step toward improving health outcomes and ensuring equitable healthcare practices.
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Affiliation(s)
- Naykky Singh Ospina
- Division of Endocrinology, University of Florida, Gainesville, FL 32610, USA
| | - Alicia Diaz-Thomas
- Division of Pediatric Endocrinology, Department of Pediatrics, The University of Tennessee Health Science Center, Memphis, TN 38163, USA
| | - Marie E McDonnell
- Division of Endocrinology, Diabetes and Hypertension, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Marie B Demay
- Endocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Anastassios G Pittas
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Tufts Medical Center, Boston, MA 02111, USA
| | | | | | | | - Juan P Brito
- Division of Diabetes, Endocrinology, Metabolism, and Nutrition, Department of Medicine, Mayo Clinic, Rochester, MN 55905, USA
| | - M Hassan Murad
- Mayo Clinic, Evidence-Based Practice Center, Rochester, MN 55905, USA
| | - Christopher R McCartney
- Division of Endocrinology and Metabolism, Department of Medicine, West Virginia University, Morgantown, WV 26506, USA
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Wyatt KD, Alexander N, Hills GD, Liang WH, Kadauke S, Volchenboum SL, Mian A, Phillips CA. Making sense of artificial intelligence and large language models-including ChatGPT-in pediatric hematology/oncology. Pediatr Blood Cancer 2024:e31143. [PMID: 38924670 DOI: 10.1002/pbc.31143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Revised: 05/24/2024] [Accepted: 05/30/2024] [Indexed: 06/28/2024]
Abstract
ChatGPT and other artificial intelligence (AI) systems have captivated the attention of healthcare providers and researchers for their potential to improve care processes and outcomes. While these technologies hold promise to automate processes, increase efficiency, and reduce cognitive burden, their use also carries risks. In this commentary, we review basic concepts of AI, outline some of the capabilities and limitations of currently available tools, discuss current and future applications in pediatric hematology/oncology, and provide an evaluation and implementation framework that can be used by pediatric hematologist/oncologists considering the use of AI in clinical practice.
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Affiliation(s)
- Kirk D Wyatt
- Department of Pediatric Hematology/Oncology, Roger Maris Cancer Center, Fargo, North Dakota, USA
- Data for the Common Good, University of Chicago, Chicago, Illinois, USA
| | - Natasha Alexander
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Gerard D Hills
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana, USA
- Regenstrief Institute, Indianapolis, Indiana, USA
- Riley Children's Health at Indiana University Health, Indianapolis, Indiana, USA
| | - Wayne H Liang
- Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta and Emory University, Atlanta, Georgia, USA
| | - Stephan Kadauke
- Department of Pathology and Lab Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Cell and Gene Therapy Informatics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Samuel L Volchenboum
- Data for the Common Good, University of Chicago, Chicago, Illinois, USA
- Department of Pediatrics, University of Chicago, Chicago, Illinois, USA
| | - Amir Mian
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, Dell Children's Hospital, Austin, Texas, USA
- Dell Medical School, University of Texas at Austin, Austin, Texas, USA
| | - Charles A Phillips
- Department of Pediatrics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
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Powe NR. Race, Health Care Algorithms, and Precision Health Equity. Ann Intern Med 2024; 177:537-538. [PMID: 38466996 DOI: 10.7326/m24-0551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/13/2024] Open
Affiliation(s)
- Neil R Powe
- Priscilla Chan and Mark Zuckerberg San Francisco General Hospital and University of California San Francisco, San Francisco, California
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