
Contents
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Introduction Introduction
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Literature Review Literature Review
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How to Look at an AI System How to Look at an AI System
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What Kind of Audit? What Kind of System? What Kind of Audit? What Kind of System?
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System Comprehension and Reverse Engineering System Comprehension and Reverse Engineering
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What Are You Looking For? What Are You Looking For?
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What Harms Have People Experienced? What Harms Have People Experienced?
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Conclusion Conclusion
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References References
Auditing Algorithmic Medical Systems to Uncover AI Harms and Remedy Racial Injustice
Get accessArthur L. Carter Journalism Institute
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Published:20 March 2025
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Abstract
Algorithmic systems tend to perpetuate and amplify existing inequalities due to the ways in which they are designed and the data on which they are trained. This article explores how racism manifests inside medical technology systems, specifically those that use AI or algorithms. In order to intervene in and reduce the impact of historical injustice, I focus here on algorithmic auditing. Algorithmic auditing is a process by which researchers can examine algorithms to identify and mitigate bias. I outline a high-level method for algorithmic auditing, covering both the technical and social aspects of examining these systems. I include examples of how algorithmic bias has manifested in real-world medical contexts. These examples include situations where race correction has been applied in the past in order to mathematically disadvantage patients of colour. These situations include tests of pulmonary function, vaginal birth after caesarian determinations, and eligibility for kidney transplant based on estimated glomerular filtration rate calculation. I argue that interdisciplinary collaboration is necessary in order to understand the historical and social context in which algorithms are deployed. A comprehensive sociotechnical understanding of each individual medical system is important in addition to mathematical evaluation metrics in order to effectively address issues of algorithmic bias in healthcare.
Department of the History of Science
Schar School of Policy and Government
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