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Seyyed-Kalantari, L., Zhang, H., McDermott, M.B.A. et al. Reply to: ‘Potential sources of dataset bias complicate investigation of underdiagnosis by machine learning algorithms’ and ‘Confounding factors need to be accounted for in assessing bias by machine learning algorithms’. Nat Med 28, 1161–1162 (2022). https://doi.org/10.1038/s41591-022-01854-8