Cystatin C

• Health practitioners are increasingly concerned that because race is a social construct, and the biological mechanisms of how race affects clinical outcomes are often unknown, including race in predictive algorithms for clinical decision-making may worsen inequities.
• A higher eGFR value means better kidney health.
• My recently published research suggests that excluding race from certain diagnostic algorithms could worsen health inequities.

Different approaches to fairness

• Researchers use different economic frameworks to understand how society allocates resources.
• This approach allocates resources to those with the most opportunities to generate positive outcomes or mitigate negative ones.
• Although utilitarian approaches do not take fairness into account, an approach that does would ask two questions: How do we define fairness?
• Are there conditions when maximizing an algorithm’s prediction power and accuracy would not conflict with fairness?

Equality of opportunity

• There are two fundamental principles in equality of opportunity.
• However, differences in individual effort that occur because of circumstances, such as living in an area with limited access to healthy food, are not addressed under equality of opportunity.
• Equality of opportunity implies that if algorithms were to be used for clinical decision-making, then it is necessary to understand what causes variation in the predictions they make.

Evaluating clinical algorithms for fairness

• To hold machine learning and other artificial intelligence algorithms accountable to a standard of equity, I applied the principles of equality of opportunity to
  evaluate whether race should be included in clinical algorithms.
• The first, diagnostic algorithms, makes predictions based on outcomes that have already occurred at the time of decision-making.
• The second, prognostic algorithms, predicts future outcomes that have not yet occurred at the time of decision-making.
• For example, prognostic algorithms are used to predict whether a patient will live if they do or do not obtain a kidney transplant.

Unanswered questions and future work

• My colleagues and I are exploring many of these unanswered questions to reduce algorithmic discrimination.
• We believe our work will readily extend to other areas outside of health, including education, crime and labor markets.

• WASHINGTON, April 25, 2022 /PRNewswire/ -- A groundbreaking study published today in JAMA demonstrates significant inconsistencies with pediatric reference intervals, which are essential to high quality pediatric medical testing.
• Completed by AACC's laboratory medicine experts, this study identifies some of the most pressing issues in this area, thereby paving the way for the medical community to develop more reliable pediatric reference intervals and vastly improve children's medical care.
• For example, imprecise reference intervals can lead to a physician missing that a child has a serious medical condition and failing to administer treatment in time.
• From this, Vesper's team found that many of these pediatric reference intervals are inappropriate for assessing a child's health or monitoring treatment.

• NEW YORK, Feb. 3, 2022 /PRNewswire/ -- The National Kidney Foundation (NKF) is excited to celebrate Black History Month by highlighting the health equity initiatives accomplished throughout the year such as the formation of NKF's first-ever Health Equity Advisory Committee (HEAC) reaching its one-year anniversary and the recommendation for a race-free approach to eGFR (estimated glomerular filtration rate), which is an equation that determines a patient's level of kidney function.
• Kidney disease is a public health crisis that affects an estimated 37 million adults in the U.S. and can lead to life-threatening kidney failure .
• As the HEAC celebrates its one-year anniversary, this 13-member team continues to support, direct, and champion NKF's health equity initiatives, community health, and social justice efforts through research, education, and key partnerships.
• Join the conversation on social media during Black History Month by using the hashtag #blackhistorymonth.

• RARITAN, N.J., July 16, 2018 /PRNewswire/ --Ortho Clinical Diagnostics (Ortho), a global leader of in vitro diagnostics, in collaboration with Diazyme Laboratories, Inc. is offering three new Microtip Partnership Assays to their customers.
• Glycated Serum Protein (GSP), Lipoprotein (a) (Lp (a)), and Cystatin C assays allow Ortho to deepen offerings in key disease states: diabetes, cardiac and renal.
• "Ortho is a leader in testing in diabetes, cardiac and renal areas, and the three new assays we announce today further that position and commitment."
• Ortho Clinical Diagnostics is a global leader of in vitro diagnostics serving the clinical laboratory and immunohematology communities.