FRAME: separating sampling variation from representational cause in medical imaging fairness
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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.
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.
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.
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.
arXiv:2607. 07852v1 Announce Type: cross Abstract: Automated segmentation of cervical-spine MRI is increasingly used in clinical workflows, yet no fairness audit exists for this anatomy.
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.