Javid orders review of medical device racial bias

[bitchstewie]

Good grief

You wouldn't even have thought this could be a "thing" with modern medicine and all of the research involved.

Covid: Javid orders review of medical device racial bias

Being discussed on Marr now.

[GranpaB]

Does this mean the devices are racist?

[andy43]

Vitamin D anybody? Oximeters may be wonky on darker skin but if everybody in those categories was checked for D there may not have been such a big disparity.

[voyds9]

There may indeed be a racial bias but perhaps that term has taken on a meaning that shouldn't be used here.

Someone will no doubt be offended that this is another systemic racism etc...

And it will be twisted to try to prove something that wasn't there

[bitchstewie]

I think the article explains it quite well and Javid is on Marr now explaining his concerns.

[21TonyK]

The oximeter issue is well known, its not new news.

[PurplePangolin]

anonymous said:

[redacted]

How long have these devices been used in medicine?

[JagLover]

anonymous said:

[redacted]

I would have thought a "Doctor" might be more careful about sweeping claims re Vitamin D and Covid

This is a virus we still seem to be learning more about. Certainly there have been studies showing links between Vitamin D deficiency and poor Covid outcomes.

As a "doctor" you are presumably aware as well of the past concerns about Vitamin D deficiency in a number of BAME communities.

[frisbee]

Racist medical devices and AIs, a dream diversionary tactic.

[Donbot]

JagLover said:

anonymous said:

[redacted]

I would have thought a "Doctor" might be more careful about sweeping claims re Vitamin D and Covid

This is a virus we still seem to be learning more about. Certainly there have been studies showing links between Vitamin D deficiency and poor Covid outcomes.

As a "doctor" you are presumably aware as well of the past concerns about Vitamin D deficiency in a number of BAME communities.

Give 'em time, the doc is still trying to figure out where the vaccine is supposed to go.

[Tuna]

voyds9 said:

There may indeed be a racial bias but perhaps that term has taken on a meaning that shouldn't be used here.

Someone will no doubt be offended that this is another systemic racism etc...

And it will be twisted to try to prove something that wasn't there

The 'r' word is a dog whistle for certain commentators, but more realistically the issue is that tests and devices tend to be biased towards the majority group, which in Europe and most of the West will be Caucasians. That's not to say they're biased against anyone, just that if your physiology is further from the 'norm', these devices tend to be less accurate/reliable/effective. That applies just as much to pregnant women and elderly patients as people with dark skin.

Of course it's not seen as offensive to say "do not use on pregnant women", whereas a device sold as "only for whites" would have people up in arms.

It is the job for medical approvals to identify the limitations of devices and tests, but actually getting appropriate groups together for trials is technically difficult, costly and time consuming. Many companies struggle to get large enough groups for effective testing, and when BAME groups are about 1/10th of the UK population that multiplies the problem by ten.

It's also the case that many companies would rather get a product out (and many doctors would rather have access to a product) that works for nine out of ten patients, than withhold that product until it is also characterised for the extra one tenth.

[croyde]

Some very good sensible replies in this thread.

Thank you.

[andy43]

Donbot said:

JagLover said:

anonymous said:

[redacted]

I would have thought a "Doctor" might be more careful about sweeping claims re Vitamin D and Covid

This is a virus we still seem to be learning more about. Certainly there have been studies showing links between Vitamin D deficiency and poor Covid outcomes.

As a "doctor" you are presumably aware as well of the past concerns about Vitamin D deficiency in a number of BAME communities.

Give 'em time, the doc is still trying to figure out where the vaccine is supposed to go.

All I'm suggesting is as above - maybe pennies-worth of vitamins doled out for everybody might be a better use of time and money.. then maybe those racist medical devices may not actually be needed.
Oddly there's no money to be made in promoting or trialing cheap vitamins...but hey what do I know, I've just been diagnosed as ignorant.

[Electro1980]

Tuna said:

The 'r' word is a dog whistle for certain commentators, but more realistically the issue is that tests and devices tend to be biased towards the majority group, which in Europe and most of the West will be Caucasians. That's not to say they're biased against anyone, just that if your physiology is further from the 'norm', these devices tend to be less accurate/reliable/effective. That applies just as much to pregnant women and elderly patients as people with dark skin.

Of course it's not seen as offensive to say "do not use on pregnant women", whereas a device sold as "only for whites" would have people up in arms.

It is the job for medical approvals to identify the limitations of devices and tests, but actually getting appropriate groups together for trials is technically difficult, costly and time consuming. Many companies struggle to get large enough groups for effective testing, and when BAME groups are about 1/10th of the UK population that multiplies the problem by ten.

It's also the case that many companies would rather get a product out (and many doctors would rather have access to a product) that works for nine out of ten patients, than withhold that product until it is also characterised for the extra one tenth.

I didn’t realise that oximeters were U.K. specific. I assumed that they would be used all over the world…

[Tuna]

andy43 said:

All I'm suggesting is as above - maybe pennies-worth of vitamins doled out for everybody might be a better use of time and money.. then maybe those racist medical devices may not actually be needed.
Oddly there's no money to be made in promoting or trialing cheap vitamins...but hey what do I know, I've just been diagnosed as ignorant.

Can we not turn this into another generic Covid thread?

[JagLover]

andy43 said:

All I'm suggesting is as above - maybe pennies-worth of vitamins doled out for everybody might be a better use of time and money.. then maybe those racist medical devices may not actually be needed.
Oddly there's no money to be made in promoting or trialing cheap vitamins...but hey what do I know, I've just been diagnosed as ignorant.

As a layperson (no Dr Jag here!) I think there are issues in absorbing sufficient Vitamin D from supplements alone

See this article on absorption

https://www.insider.com/vitamin-d-absorption

I think the best source of Vitamin D is sunlight during the relevant months, followed by sources in your diet and then the supplements.

[Tuna]

Electro1980 said:

I didn’t realise that oximeters were U.K. specific. I assumed that they would be used all over the world…

Go and look where they're developed and where those companies seek approvals and make the majority of their sale. Of course not UK specific, but you know what? The Western (dominant Caucasian) world has a huge medical industry that focuses first and foremost on the Western (dominant Caucasian) world - not through some conspiracy, but because that's where they plan to treat patients and sell products first.

(Daft attempt at point scoring, BTW)

[bitchstewie]

croyde said:

Some very good sensible replies in this thread.

Thank you.

Agreed and it's good to get feedback from people who presumably work in the medical field.

It's something I'd never have even thought about.

Javid seems to be keen on doing the right thing here.

[pquinn]

It has fk all to do with things being biased due to being developed in the 'western' world. It's a simple problem of a device that works by measuring light absorption being affected by different levels of light absorption in the skin.

If someone can work out a completely different way to make it work they're free to try.

It's the same stupid argument people make about stuff that works with cameras being 'biased' when it's a fundamental physical issue due to illumination and lack of contrast.

Or data being 'biased' because of a tiny set of data is available because, say, high levels of melanin significantly reduce the incidence of melanoma so there aren't a lot of images available.

But hey, whatever, medicine and physics are 'racist'.

[trashbat]

pquinn said:

It has fk all to do with things being biased due to being developed in the 'western' world. It's a simple problem of a device that works by measuring light absorption being affected by different levels of light absorption in the skin.

If someone can work out a completely different way to make it work they're free to try.

It's the same stupid argument people make about stuff that works with cameras being 'biased' when it's a fundamental physical issue due to illumination and lack of contrast.

Or data being 'biased' because of a tiny set of data is available because, say, high levels of melanin significantly reduce the incidence of melanoma so there aren't a lot of images available.

But hey, whatever, medicine and physics are 'racist'.

Healthcare is demonstrably biased in a variety of ways. For example, for a long time it's been biased against female patients who are regularly not believed in the same way that men are. This isn't malice but it is the biases of a system that has normalised certain factors and operating models like a largely male-dominated patronising/paternalistic and 'telling' relationship between GPs and patients.

Similarly, psychology and mental health therapy is dominated by a Western model and its foundations which in many ways originated with well-off men trying to devise treatment schemes to manage their wives. Modern practice doesn't visibly reflect that, of course, but once you dig a little much of the thinking still comes from those roots. By this I mean that if it had been developed from say, African perspectives, it would likely be a lot more group-based rather than an expert/subject client relationship. That this arrangement is lacking arguably under-serves people in general and also people from other cultures, so it's worth reflecting on such things.

Elsewhere, technology such as AI facial recognition has been shown to have racist outcomes not because of physics but because of the training data and who wrote it. Predominantly white software engineers (hello) and product teams would simply not have shipped something that fails to recognise black faces had they had better diversity within their ranks.

That these things hold true don't mean that it was designed this way on purpose to oppress people, or that people within these systems are even complacent never mind overtly racist. It's systemic and often accidental failings or harm rather than individual. It also doesn't mean that the things these problems manifest in need to be blown up or torn down in pursuit of fixing some imbalance.

However it does usually mean that a lot more can be done to accommodate all people; it's valuable to acknowledge that and think constructively about whether what we do can be more inclusive.

Edited by trashbat on Sunday 21st November 13:24