用对比学习消除医疗模型中的性别和种族偏见,提升公平性且不损失预测精度。
Debias-CLR: A Contrastive Learning Based Debiasing Method for Algorithmic Fairness in Healthcare Applications
- 通过对比学习框架分别对性别和种族进行隐式去偏处理。
- 去偏后嵌入空间的SC-WEAT效应量下降,公平性显著提升。
- 保持预测准确率,适合医疗场景中需兼顾公平与性能的部署。
基于临床记录训练的人工智能预测模型可能存在人口统计学偏见,导致患者住院时长等结果预测出现健康差异。为缓解此类偏差,本文提出一种隐式内处理去偏方法Debias-CLR,针对性别、种族等敏感属性引发的差别对待问题。利用心衰患者病历中的诊断编码、操作报告和生理指标,结合Clinical BERT提取诊断与操作文本特征,使用LSTM自编码器处理生理信号,分别构建针对性别和种族的对比学习框架,生成去偏表示。基于先前研究识别的临床表型,通过单类别词嵌入关联测试(SC-WEAT)评估公平性,结果显示去偏后效应量降低。同时,在预测住院时长等下游任务上,模型精度未下降,表明Debias-CLR在保障公平性的同时维持了良好性能,可有效减少医疗决策中的不公平现象。
原文摘要 · Abstract (English)
Artificial intelligence based predictive models trained on the clinical notes can be demographically biased. This could lead to adverse healthcare disparities in predicting outcomes like length of stay of the patients. Thus, it is necessary to mitigate the demographic biases within these models. We proposed an implicit in-processing debiasing method to combat disparate treatment which occurs when the machine learning model predict different outcomes for individuals based on the sensitive attributes like gender, ethnicity, race, and likewise. For this purpose, we used clinical notes of heart failure patients and used diagnostic codes, procedure reports and physiological vitals of the patients. We used Clinical BERT to obtain feature embeddings within the diagnostic codes and procedure reports, and LSTM autoencoders to obtain feature embeddings within the physiological vitals. Then, we trained two separate deep learning contrastive learning frameworks, one for gender and the other for ethnicity to obtain debiased representations within those demographic traits. We called this debiasing framework Debias-CLR. We leveraged clinical phenotypes of the patients identified in the diagnostic codes and procedure reports in the previous study to measure fairness statistically. We found that Debias-CLR was able to reduce the Single-Category Word Embedding Association Test (SC-WEAT) effect size score when debiasing for gender and ethnicity. We further found that to obtain fair representations in the embedding space using Debias-CLR, the accuracy of the predictive models on downstream tasks like predicting length of stay of the patients did not get reduced as compared to using the un-debiased counterparts for training the predictive models. Hence, we conclude that our proposed approach, Debias-CLR is fair and representative in mitigating demographic biases and can reduce health disparities.
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