Transcript
Elizabeth McMahon
New Research delivers a warning about an FDA-approved test for Alzheimer's. A reminder about the importance of common sense when you're working with AI and how bias can creep into medical school exams. These stories and more next. This is Path News Network Daily Edition from the College of American Pathologists. I'm Elizabeth McMahon. It's Wednesday, July 8th. Researchers are warning that the first FDA-cleared blood test to detect the Hallmark amyloid plaque of Alzheimer's disease may produce false positive results. The Lumipulse blood test provides a less invasive and less expensive alternative to lumbar punctures and positron emission tomography or PET scans. Mayo clinic researchers tested the blood test in more than 350 participants who had undergone either a lumbar puncture or PET scan. They used FDA cleared cut points, or thresholds categorizing test results as normal or abnormal, to determine results. They then compared them to lumbar puncture or PET scan results. They found a high number of false positive and indeterminate results, attributing them to the test's reagents, which were different from those used in the clinical trials leading to FDA clearance. Investigating further, MAO researchers, whose own patients comprised one of two cohorts in the study, drew up their own cut points, which provided more accurate results. The authors published a research letter in JAMA Neurology, sharing the findings and urging cautious interpretation while new reagents are tested. Can race, gender, and sexual orientation details about hypothetical patients on standardized medical exams introduce bias? A new study explores the question using the patient vignettes medical trainees commonly encounter in multiple choice questions. Dr. Cullen Lilley, a resident at UCLA Health, led the study. He started thinking about the potential for hidden bias on exam questions when he was a medical student.
Dr. Cullen Lilley
And, you know, as we were really examining ourselves in medical school, I started to think about this and I was like, well, you know, how are these presented to us?
Elizabeth McMahon
To test for bias, researchers asked two groups of students to answer multiple choice questions containing clinical vignettes. Patient sociodemographic information was included in one group's vignettes and excluded in the other.
Dr. Cullen Lilley
All we really did was change one part of a question stem, and it did have an impact on how students answered the questions. The significant area that we saw were in questions that were trying to drive students to a common disease, but including a racial or sociodemographic uh identifier actually drove them to choose an incorrect answer.
Elizabeth McMahon
The study found significant discrepancies in questions related to homosexuality and sexually transmitted infection testing and sarcoidosis in black females, among others. Dr. Lilley is also chair of the CAP's Residence Forum Executive Committee. He says as the medical community continues to evaluate bias in medicine and patient care, it's also crucial to do so in medical curricula and exams. The study is in the latest edition of the Academic Pathology Journal. Speaking of test results that make you go, hmm, a new CAP podcast explores what can go wrong when you let automation bias or over-reliance on computer-generated results override your common sense. In the latest episode of Horror Stories in Pathology Informatics, Dr. Alexis Carter and Dr. Richard Davis of the CAP Informatics Committee discussed the case of an infant whose initial alarming blood test results sent the child to the oncology ward overnight. The next morning, his results were normal. So what happened? It's a story involving new reagents, a reformulated stain that caused an AI-enhanced digital analyzer to misclassify blood cells, and a distracted lab staffer who finalized a report that defied common sense. The case provides important lessons as AI becomes a mainstay in daily work, Dr.
Dr. Richard Davis
Davis says.org.
Elizabeth McMahon
We're back at 5 a.m. Eastern for another episode of the Daily Edition. I'm Elizabeth McMahon. Have a great day.