Abstract Details

Title Biased by Design: How Digital Health in Neurology Fails—and Can Serve—Marginalized Patients

Topic Practice, Policy, and Ethics

Presentation(s) P2 - Poster Session 2 (11:45 AM-12:45 PM)

Poster/Presentation
Number 14-006

Objective To examine how bias emerges within AI and digital health technologies across neurology and to propose an equity-centered framework to guide inclusive design and innovation.

Background Digital health technologies are rapidly transforming neurologic care, from wearable sensors to AI-based diagnostics. Yet many remain biased by design. Devices and algorithms that overlook phenotypic diversity or rely on exclusionary datasets can distort measurements, delay diagnoses, and widen disparities in brain health.

Design/Methods Representative examples from neurotechnology and clinical devices, including EEG, fNIRS, MRI, DBS, and AI-enabled cognitive tools, were analyzed to identify patterns of phenotypic, algorithmic, and structural bias. A conceptual synthesis was performed to derive actionable strategies for equitable innovation.

Results Biases were observed across the technology lifecycle: from data acquisition (hair- and skin-related measurement bias) to algorithm training (non-diverse datasets) and deployment (limited access in minority-serving settings). Five corrective strategies emerged: (1) diverse development teams; (2) inclusive datasets; (3) community co-design; (4) device and algorithm auditing across phenotypes; and (5) patient-centered inputs that prioritize lived experience over provider bias.

Conclusions Bias in digital health and AI is both a technical and moral failure. Embedding equity from concept to deployment can ensure that AI and digital health technologies serve every brain—not just some.

Authors/Disclosures
Victor Ekuta, MD PRESENTER	Dr. Ekuta has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Doximity. Dr. Ekuta has or had stock in Doximity.Dr. Ekuta has received research support from Rainwater Charitable Foundation. Dr. Ekuta has received research support from Cell Press, Elsevier, Cell Signaling Technologies. Dr. Ekuta has received research support from Rare Disease Diversity Coalition. Dr. Ekuta has received personal compensation in the range of $0-$499 for serving as a Contractor with ScaleAI. Dr. Ekuta has received personal compensation in the range of $500-$4,999 for serving as a Contractor with Mercor Labs. Dr. Ekuta has received personal compensation in the range of $500-$4,999 for serving as a ANA Futures Program Participant with American Neurological Association.

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