People Talking and AI Listening: How Stigmatizing Language in EHR Notes Affect AI Performance

Electronic health records (EHRs) serve as an essential data source for the envisioned artificial intelligence (AI)-driven transformation in healthcare. However, clinician biases reflected in EHR notes can lead to AI models inheriting and amplifying these biases, perpetuating health disparities. This study investigates the impact of stigmatizing language (SL) in EHR notes on mortality prediction using a Transformer-based deep learning model and explainable AI (XAI) techniques. Our findings demonstrate that SL written by clinicians adversely affects AI performance, particularly so for black patients, highlighting SL as a source of racial disparity in AI model development. To explore an operationally efficient way to mitigate SL's impact, we investigate patterns in the generation of SL through a clinicians' collaborative network, identifying central clinicians as having a stronger impact on racial disparity in the AI model. We find that removing SL written by central clinicians is a more efficient bias reduction strategy than eliminating all SL in the entire corpus of data. This study provides actionable insights for responsible AI development and contributes to understanding clinician behavior and EHR note writing in healthcare.

Sharp Threshold for Multivariate Multi-Response Linear Regression via Block Regularized Lasso

In this paper, we investigate a multivariate multi-response (MVMR) linear regression problem, which contains multiple linear regression models with differently distributed design matrices, and different regression and output vectors. The goal is to recover the support union of all regression vectors using $l_1/l_2$-regularized Lasso. We characterize sufficient and necessary conditions on sample complexity \emph{as a sharp threshold} to guarantee successful recovery of the support union. Namely, if the sample size is above the threshold, then $l_1/l_2$-regularized Lasso correctly recovers the support union; and if the sample size is below the threshold, $l_1/l_2$-regularized Lasso fails to recover the support union. In particular, the threshold precisely captures the impact of the sparsity of regression vectors and the statistical properties of the design matrices on sample complexity. Therefore, the threshold function also captures the advantages of joint support union recovery using multi-task Lasso over individual support recovery using single-task Lasso.