In chest X-ray (CXR) classification, acceptable ranking performance can still leave rare-positive patients below threshold, especially within subgroups. We study this pre-deployment fairness problem as an audit question: after a long-tailed multi-label CXR model is converted from scores into decisions, who is missed?
arXiv:2607. 28608v1 Announce Type: new Abstract: Clinical risk models routinely achieve strong aggregate performance while producing materially different error rates across patient subgroups.
By Sparsh Roy, Samuel Girmachew, Nishita Chavan
The paper introduces FRAME, a two‑step framework for auditing fairness claims in medical imaging. First, it derives a fair‑model reference distribution that captures the portion of subgroup performance differences attributable to sampling variation. Second, it tests the remaining difference using operators in representation space to assess whether demographic information or disease entanglement drives the bias. Across a large dataset of 702,206 images and 36 encoders, the reference explains a substantial median share of race and age differences, while interventions such as injecting demographic decodability or entangling disease direction have limited impact on the residual bias.
By Mahshad Lotfinia, Daniel Truhn, Andreas Maier, Soroosh Tayebi Arasteh
arXiv:2608. 14683v1 Announce Type: new Abstract: Given a patient's clinical findings, a diagnostic system ranks possible diseases and must decide when to endorse its first prediction or defer it for review.
By Zhaoyang Jiang, Zhizhong Fu, Yunsoo Kim, Zicheng Li, Xuanqi Peng, Fei Teng, Jiacong Mi, Honghan Wu
Subgroup performance differences are the standard evidence for fairness bias in medical imaging, and the usual response removes the demographic information that a model encodes. Here we introduce Fair...
Med-AR introduces two autoregressive vision‑language models, Med‑AR‑8B and Med‑AR‑2B, pretrained on structured radiology reports, abnormality‑focused text, and region annotations to address long‑tailed chest X‑ray classification. The models outperform existing contrastive, self‑supervised, and supervised encoders—including Med‑CLIP, CheXFound, EVA‑Base, ARK, and BioViL‑T—across PadChest, MIMIC‑CXR, and CheXpert, achieving higher mean AUROC and AUPRC for head, medium, and tail findings and lower excess area under the risk‑coverage curve. Med‑AR also demonstrates improved selective‑prediction performance, with Med‑AR‑8B raising tail‑label mean AUPRC on MIMIC‑CXR from 0.1033 to 0.1441 and Med‑AR‑2B delivering the strongest discrimination on PadChest.
By Janhavi Prabhu, Sahil, Akshay V, Shivam Shukla, Manoj Tadepalli, Preetham Putha
The study examines how three parameter‑efficient adaptation methods—linear heads on the raw CLS token, an MLP, and an attention‑pooling module—affect pathology classification accuracy and subgroup fairness when applied to a frozen Rad‑DINO chest X‑ray encoder. Using the MIMIC‑CXR dataset, the authors evaluate eight pathologies across race, sex, and imaging‑view subgroups, finding that attention pooling yields the best overall performance and encodes protected attributes most strongly, yet higher performance does not consistently reduce subgroup disparities. The results show that attribute encoding strength and layer choice do not reliably predict fairness outcomes, indicating that fairness must be assessed directly for each task.
By Dhruv Gupta, Emma A. M. Stanley, Fabio De Sousa Ribeiro, Sujal R. Desai, Ben Glocker
arXiv:2608. 10505v1 Announce Type: new Abstract: Automated radiology report generation is advancing rapidly in response to the shortage of radiologists, yet unlike a perception model, existing generation models offer no control over the sensitivity-specificity trade-off of their diagnostic content.
By Ying Jin, Noel C. F. Codella, John Corring, Mu Wei, Dinei Florencio, Eric Horvitz
arXiv:2608.30568v1 Announce Type: cross
Abstract: Background: Population level assessments of predictive artificial intelligence (AI) can conceal performance disparities across subgroups. Fairness ev...
By Jo\~ao Matos, Ben Van Calster, Richard D. Riley, Paula Dhiman, Gary S. Collins
Automated radiology report generation is advancing rapidly in response to the shortage of radiologists, yet unlike a perception model, existing generation models offer no control over the sensitivity-specificity trade-off of their diagnostic content. Such control is essential because clinical scenarios diverge: emergency triage prioritizes sensitivity to reduce missed findings, whereas confirmatory interpretation emphasizes specificity to limit unnecessary interventions.
arXiv:2608. 04025v1 Announce Type: cross Abstract: Whole-slide survival models commonly provide risk rankings without calibrated statements about individual event times.
By Mingi Hong
arXiv:2509. 19671v3 Announce Type: replace Abstract: Public datasets of Chest X-Rays (CXRs) have long been a popular benchmark for developing machine learning (ML) computer vision models in healthcare.
By Andrew Wang, Jiashuo Zhang, Michael Oberst