A scoping review and evidence gap analysis of clinical AI fairness
Abstract
The ethical integration of artificial intelligence (AI) in healthcare necessitates addressing fairness. AI fairness involves mitigating biases in AI and leveraging AI to promote equity. Despite advancements, significant disconnects persist between technical solutions and clinical applications. Through evidence gap analysis, this review systematically pinpoints the gaps at the intersection of healthcare contexts-including medical fields, healthcare datasets, and bias-relevant attributes (e.g., gender/sex)-and AI fairness techniques for bias detection, evaluation, and mitigation. We highlight the scarcity of AI fairness research in medical domains, the narrow focus on bias-relevant attributes, the dominance of group fairness centering on model performance equality, and the limited integration of clinician-in-the-loop to improve AI fairness. To bridge the gaps, we propose actionable strategies for future research to accelerate the development of AI fairness in healthcare, ultimately advancing equitable healthcare delivery.
Author
Liu, Mingxuan
Ning, Yilin
Teixayavong, Salinelat
Liu, Xiaoxuan
Mertens, Mayli
Shang, Yuqing
Li, Xin
Miao, Di
Liao, Jingchi
Xu, Jie
Ting, Daniel Shu Wei
Cheng, Lionel Tim-Ee
Ong, Jasmine Chiat Ling
Teo, Zhen Ling
Tan, Ting Fang
RaviChandran, Narrendar
Wang, Fei
Celi, Leo Anthony
Ong, Marcus Eng Hock
Liu, Nan
Ning, Yilin
Teixayavong, Salinelat
Liu, Xiaoxuan
Mertens, Mayli
Shang, Yuqing
Li, Xin
Miao, Di
Liao, Jingchi
Xu, Jie
Ting, Daniel Shu Wei
Cheng, Lionel Tim-Ee
Ong, Jasmine Chiat Ling
Teo, Zhen Ling
Tan, Ting Fang
RaviChandran, Narrendar
Wang, Fei
Celi, Leo Anthony
Ong, Marcus Eng Hock
Liu, Nan
Date
2025-06-14
Type
Article
Subject
Artificial intelligence, Ethics, Bias
Collections
Citation
Liu M, Ning Y, Teixayavong S, Liu X, Mertens M, Shang Y, Li X, Miao D, Liao J, Xu J, Ting DSW, Cheng LT, Ong JCL, Teo ZL, Tan TF, RaviChandran N, Wang F, Celi LA, Ong MEH, Liu N. A scoping review and evidence gap analysis of clinical AI fairness. NPJ Digit Med. 2025 Jun 14;8(1):360. doi: 10.1038/s41746-025-01667-2.
Journal / Source Title
NPJ digital medicine
DOI
10.1038/s41746-025-01667-2
PMID
40517148
Publisher
Nature Publishing Group
Publisher’s URL
https://www.nature.com/npjdigitalmed/