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Outcomes Research

To Close Diversity Gaps in Transplant Care, Houston Methodist Aims Ahead

Amy Waterman, PhD, was awarded an NIH AIM-AHEAD grant to use artificial intelligence and machine learning to make recommendations on how to effectively reduce disparities and improve health outcomes in access to kidney transplantation.

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Health disparities in African American and Latinx communities often are the result of unequal distribution of social, political, economic and environmental resources, and result in poor health outcomes. For example, African American and Latinx patients are less likely to get life-saving organ transplants. There are many factors contributing to this, some are fixed, non-modifiable factors and some are modifiable, but determining the best strategies to reduce disparity and improve patient outcomes remains a challenge.
To tackle this critical need in healthcare, Houston Methodist’s Amy Waterman, PhD, professor in Outcomes Research in Surgery and the director of the Patient Engagement, Diversity, and Education Lab, was awarded a pilot grant from the NIH’s AIM-AHEAD program: Artificial Intelligence/Machine Learning Consortium to Advance Health Equity and Researcher Diversity. The funding from AIM-AHEAD allows Waterman and her team to use artificial intelligence (AI) and machine learning (ML) to analyze large data sets that include clinical factors using patient electronic health records and additional factors measuring social determinants of health geographically to make recommendations on how best to effectively reduce disparities and improve health outcomes in access to kidney transplantation.
Amy Waterman, PhD
AIM-AHEAD is a $50 million program funded by the National Institutes of Health that brings together experts in community engagement, AI/ML, health equity research, data science training and data infrastructure. The AI/ML field currently lacks diversity in researchers and in data, including electronic health records (EHRs). These diversity gaps perpetuate biases that impact how AI/ML is used and how data are interpreted and can increase health disparities for underrepresented communities. AIM-AHEAD was created to close those gaps by first identifying and understanding the trends involved in disparity perpetuation, then building the interventions needed.
Waterman’s project funded by AIM-AHEAD is titled: Using Artificial Intelligence to Improve Cardiometabolic Health: Validating a Kidney Transplant Derailers Index to Predict Transplant Drop-Out Risk for African American and Hispanic Patients. The project goals are to: Identify a set of clinical, socioeconomic and other variables correlated with a patient’s failure to complete transplant evaluation in a large, multiethnic population; Utilize machine learning to develop the Kidney Transplant Derailers Index (KTDI 2.0) incorporating novel clinical and community level variables; Validate the Index using a split sample technique for transplant candidates; and Identify a set of clinical interventions that could overcome barriers and better support those at higher risk for derailing.
“Here at Houston Methodist, we have such a rich dataset of diverse patients pursuing kidney transplantation. Our goal for this project is to understand trends ahead of time in who might be at higher risk of not finishing evaluation and to design care improvements to help more individuals get transplants,” Waterman said.
Waterman also served as a research advisor to the Mendez National Institute of Transplantation Foundation to produce an edutainment series called “Linked by Love” to help educate underserved communities about transplantation. The series shares a fictionalized story of a an African-American family having to make transplant decisions to educate those with risk factors for kidney disease. “Linked by Love” will premiere at Houston Methodist on April 14 in the John F. Bookout Auditorium. The series is available at
Heather Lander, PhD
April 2023
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