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May 2, 20260 citationsOpen Access

Why Clinical AI Will Keep Failing Women Until We Validate Across Hormonal States

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IRInna RytsarevaHarmonic Drive (Germany)

Key Result

A proposed hormonal-dynamic validation protocol and Endocrine Volatility Score aim to address structural bottlenecks in clinical AI fairness for women across different hormonal states.

Key Points

  • This research aims to investigate the impact of hormonal states on the fairness of clinical AI systems for women.
  • Proposed a tiered multi-modal data stack incorporating nocturnal basal heart rate variability and serum hormone assays.
  • Applied a longitudinal mixed-effects framework treating race as a moderator of hormonal transition slope.
  • Introduced the Endocrine Volatility Score (EVS) to quantify AI performance across hormonal states.
  • Establishment of the Endocrine Volatility Score (EVS) as a new metric for AI transparency.
  • Significant insights into how hormonal states affect AI efficacy in clinical settings for women.

PICO

P
Population
Clinical AI fairness in women
I
Intervention / Comparator
Hormonal-dynamic validation protocol

Abstract

We identify the absence of hormonal-dynamic validation as a structural bottleneck in clinical AI fairness and propose a concrete protocol to address it. The protocol centers on a tiered multi-modal data stack anchored by nocturnal basal heart rate variability, serum hormone assays, and STRAW+10 menopausal staging, applied within a longitudinal mixed-effects framework that treats race as a moderator of hormonal transition slope. We introduce the Endocrine Volatility Score (EVS), the coefficient of variation of a model’s true positive rate across hormonal states as a quantitative transparency metric for a public Hormonal Fidelity Index.

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Cite This Study

Inna Rytsareva (2026) studied Clinical AI fairness in women. Hormonal-dynamic validation protocol was evaluated. A proposed hormonal-dynamic validation protocol and Endocrine Volatility Score aim to address structural bottlenecks in clinical AI fairness for women across different hormonal states.

synapsesocial.com/papers/69f5947e71405d493afff3e7https://doi.org/10.5281/zenodo.19922856
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