arXiv Machine Learning
Aug 27

FRAME: separating sampling variation from representational cause in medical imaging fairness

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 Machine Learning
Oct 3

Beyond Demographic Balance: Multi-Metric and Intersectional Evaluation of Fairness in MIMIC-IV Mortality Prediction

The paper examines how fairness conclusions in ICU mortality prediction using MIMIC-IV depend on the choice of metrics and the granularity of demographic analysis. It compares predictive-utility and subgroup-error metrics across various fairness interventions and introduces a lightweight adaptation strategy that balances ethnicity, gender, and insurance representation without conditioning on mortality outcomes. The study finds that different interventions can be evaluated differently across accuracy, sensitivity, and false-positive rate, and that marginal demographic summaries may hide heterogeneous error patterns within intersectional subgroups.

By Abdullah Al Noman, Fahmid Al Rifat, Tahrima Hashem, Syed Muhammad Ibne Zulfiker, Rishov Paul, Tanzima HAshem
arXiv AI
Aug 20

Beyond Predictive Fairness: Quantifying Attribution Consistency Across Demographic Groups in Diabetic Retinopathy Screening

The paper introduces the Explanation Consistency Score (ECS), a fairness‑aware metric that uses Jensen‑Shannon divergence to measure how similar attribution maps are across demographic subgroups. Applied to diabetic retinopathy screening, ECS is evaluated both overall and within disease severity levels. Results show that although predictive performance varies among ethnic groups, explanation consistency remains high and is not significantly linked to performance disparities, indicating that predictive fairness and explanation consistency assess different aspects of model behavior.

By Kerol Djoumessi, Philipp Berens
arXiv AI
Jul 17

Demographically-Conditioned Synthetic Medical Images for Bias Mitigation and Bias Detection in Disease Classifiers

arXiv:2607. 14984v1 Announce Type: new Abstract: Per-subgroup fairness audits of medical image classifiers face a sample-size problem: minority subgroups in held-out test sets have so few samples that the resulting confidence intervals on per-subgroup performance are wider than the bias the audit is meant to detect.

By Mahmoud Ibrahim, Bart Elen, Chang Sun, Gokhan Ertaylan, Michel Dumontier
arXiv Computer Vision
Sep 4

Subgroup performance analysis of adaptation strategies for chest X-ray foundation models

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