Towards Fair Patient-Trial Matching via Patient-Criterion Level Fairness Constraint.

AMIA ... Annual Symposium proceedings. AMIA Symposium Pub Date : 2024-01-11 eCollection Date: 2023-01-01
Chia-Yuan Chang, Jiayi Yuan, Sirui Ding, Qiaoyu Tan, Kai Zhang, Xiaoqian Jiang, Xia Hu, Na Zou
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Abstract

Clinical trials are indispensable in developing new treatments, but they face obstacles in patient recruitment and retention, hindering the enrollment of necessary participants. To tackle these challenges, deep learning frameworks have been created to match patients to trials. These frameworks calculate the similarity between patients and clinical trial eligibility criteria, considering the discrepancy between inclusion and exclusion criteria. Recent studies have shown that these frameworks outperform earlier approaches. However, deep learning models may raise fairness issues in patient-trial matching when certain sensitive groups of individuals are underrepresented in clinical trials, leading to incomplete or inaccurate data and potential harm. To tackle the issue of fairness, this work proposes a fair patient-trial matching framework by generating a patient-criterion level fairness constraint. The proposed framework considers the inconsistency between the embedding of inclusion and exclusion criteria among patients of different sensitive groups. The experimental results on real-world patient-trial and patient-criterion matching tasks demonstrate that the proposed framework can successfully alleviate the predictions that tend to be biased.

通过患者-标准水平公平性约束实现公平的患者-试验匹配
临床试验在开发新的治疗方法中不可或缺,但在招募和留住患者方面却面临障碍,阻碍了必要参与者的注册。为了应对这些挑战,人们创建了深度学习框架,将患者与试验相匹配。这些框架考虑到纳入和排除标准之间的差异,计算患者与临床试验资格标准之间的相似度。最近的研究表明,这些框架优于早期的方法。然而,当某些敏感人群在临床试验中代表性不足时,深度学习模型可能会在患者-试验匹配中引发公平性问题,导致数据不完整或不准确,造成潜在伤害。为了解决公平性问题,本研究通过生成患者标准级别的公平性约束,提出了一种公平的患者-试验匹配框架。所提出的框架考虑了不同敏感群体患者之间纳入和排除标准嵌入的不一致性。在真实世界的患者试验和患者标准匹配任务中的实验结果表明,所提出的框架可以成功地缓解预测的偏差倾向。
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