论文标题

使用公平政策学习的临床试验网站与改善多样性的匹配

Clinical trial site matching with improved diversity using fair policy learning

论文作者

Srinivasa, Rakshith S, Qian, Cheng, Theodorou, Brandon, Spaeder, Jeffrey, Xiao, Cao, Glass, Lucas, Sun, Jimeng

论文摘要

持续的大流行强调了医疗保健中可靠有效的临床试验的重要性。进行试验的试验地点主要是基于医疗专业知识和与大量患者的可行性选择的。最近,临床试验中的多样性和包容性问题变得重要。不同的患者组可能会以不同的方式经历医疗药物/治疗的影响,因此需要包括在临床试验中。这些群体可以基于种族,合并症,年龄或经济因素。因此,设计一种既说明可行性和多样性的试验地点选择方法是一个至关重要且紧急的目标。在本文中,我们将此问题提出为排名问题,并具有公平性约束。使用机器学习中的公平原则,我们学习了一个模型,该模型将临床试验描述映射到了潜在试验地点的排名列表。与现有的公平框架不同,每个试验地点的小组成员资格是非二进制的:每个试验地点可能可以从多个组中访问患者。我们提出基于人口统计学奇偶校验的公平标准,以解决这种多组成员的情况。我们在480个现实世界临床试验中测试了我们的方法,并表明我们的模型会导致潜在试验地点列表,这些试验地点可访问各种患者,同时也随之而来的是大量的入学患者。

The ongoing pandemic has highlighted the importance of reliable and efficient clinical trials in healthcare. Trial sites, where the trials are conducted, are chosen mainly based on feasibility in terms of medical expertise and access to a large group of patients. More recently, the issue of diversity and inclusion in clinical trials is gaining importance. Different patient groups may experience the effects of a medical drug/ treatment differently and hence need to be included in the clinical trials. These groups could be based on ethnicity, co-morbidities, age, or economic factors. Thus, designing a method for trial site selection that accounts for both feasibility and diversity is a crucial and urgent goal. In this paper, we formulate this problem as a ranking problem with fairness constraints. Using principles of fairness in machine learning, we learn a model that maps a clinical trial description to a ranked list of potential trial sites. Unlike existing fairness frameworks, the group membership of each trial site is non-binary: each trial site may have access to patients from multiple groups. We propose fairness criteria based on demographic parity to address such a multi-group membership scenario. We test our method on 480 real-world clinical trials and show that our model results in a list of potential trial sites that provides access to a diverse set of patients while also ensuing a high number of enrolled patients.

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