npj Digital Medicine, PLOS Digital Health, Health Affairs, NEJM AI, Lancet Digital Health, Nature Medicine, ScienceSystematic review and narrative synthesis (multi-study scoping review incorporating systematic reviews, retrospective studies, and real-world evidence)
Cross-domain clinical AI — risk stratification, medical imaging (radiology AI, cardiac MRI), clinical NLP (mental health), scheduling algorithms, population health management, clinical decision supportA structured synthesis of how algorithmic bias originates and propagates through clinical AI systems, drawing on peer-reviewed evidence of disparate performance across care domains, three major audit frameworks operating at distinct governance levels, and technical and systemic mitigation strategies — with current U.S. regulatory context for health system leaders and researchers.
Key Metrics: Cardiac MRI DSC: 93.5% (White) vs. 84.5% (Black) pre-mitigation; 93.07% (Black) post-stratified sampling; Obermeyer recalibration: Black patient care management enrollment 17.7% → 46.5%; Scheduling disparity: 33% longer wait times for Black patients; 83% of neuroimaging AI studies rated high bias risk (PROBAST); 50% of sampled AI studies at high risk of bias (Kumar et al. 2023)
Funding: HEAAL (Kim et al.) co-designed with 10 US health systems; STANDING Together established via NHS AI Lab AI Ethics initiative; Hasanzadeh et al. and Abramoff et al. funding not specified in body; Cary et al. published via PMC (open access); industry conflicts of interest not reported in body for primary studies cited