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EQUITRIAGE: A Fairness Audit of Gender Bias in LLM-Based Emergency Department Triage

L5 · ResearcherResearcharXiv· 5/5/2026

Essential for ML researchers and AI safety teams designing fairness audits, model evaluation frameworks, and bias mitigation strategies for high-stakes clinical AI systems.

AI Summary

EQUITRIAGE is a comprehensive fairness audit evaluating five LLMs (Gemini, DeepSeek, Mistral, Nemotron, GPT-4.1-Nano) on gender bias in emergency department triage decisions using 374,275 evaluations on clinical vignettes. The study finds all models exceed a 5% gender-flip threshold (9.9–43.8%), with DeepSeek and Gemini showing directional female undertriage, and demonstrates that demographic blinding and intervention effectiveness vary significantly by model. The research reveals that group parity, counterfactual invariance, and calibration are distinct fairness properties requiring per-model auditing before clinical deployment.

Excerpt

Emergency department triage assigns patients an acuity score that determines treatment priority, and clinical evidence documents persistent gender disparities in human acuity assessment. As hospitals pilot large language models (LLMs) as triage decision support, a critical question is whether these models reproduce or mitigate known biases. We present EQUITRIAGE, a fairness audit of LLM-based ESI assignment evaluating five models (Gemini-3-Flash, Nemotron-3-Super, DeepSeek-V3.1, Mistral-Small-3.

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