Rosephine Del Fernandes, Ingrid de Vries, Laura McEwen, Steve Mann, Timothy Phillips, Boris Zevin
Evaluating the Quality of Narrative Feedback for Entrustable Professional Activities in a Surgery Residency Program
Annals of surgery
healthcare continues grapple persistent issue treatment disparities sparking concerns regarding equitable allocation treatments clinical practice various fairness metrics emerged assess fairness decisionmaking processes growing focus causalitybased fairness concepts due capacity mitigate confounding effects reason bias however application causal fairness notions evaluating fairness clinical decisionmaking electronic health record ehr data remains understudied domain study aims address methodological gap assessing causal fairness treatment allocation electronic health records data addition investigate impact social determinants health assessment causal fairness treatment allocation propose causal fairness algorithm assess fairness clinical decisionmaking algorithm accounts heterogeneity patient populations identifies potential unfairness treatment allocation conditioning patients likelihood benefit treatment apply framework patient cohort coronary artery disease derived ehr database evaluate fairness treatment decisions analysis reveals notable disparities coronary artery bypass grafting cabg allocation among different patient groups women found 4477 less likely receive cabg men two four treatment response strata similarly black african american patients 5487 less likely receive cabg others three four response strata results similar social determinants health insurance area deprivation index dropped algorithm findings highlight presence disparities treatment allocation among similar patients suggesting potential unfairness clinical decisionmaking process study introduces novel approach assessing fairness treatment allocation healthcare incorporating responses treatment fairness framework method explores potential quantifying fairness causal perspective using ehr data research advances methodological development fairness assessment healthcare highlight importance causality determining treatment fairness