arXiv:2412.00606cs.AI2024-12被引 6

针对医疗影像与电子病历中的多重身份偏见,提出针对性缓解方案。

Fairness at Every Intersection: Uncovering and Mitigating Intersectional Biases in Multimodal Clinical Predictions

  • 基于多模态数据构建统一文本表征,识别交叉群体偏差
  • 在MIMIC-Eye1与MIMIC-IV ED上验证方法有效性
  • 适合关注医疗公平性与模型可解释性的研究者

基于电子健康记录(EHR)的自动化临床决策存在显著偏见,导致患者诊疗差异。传统方法仅关注单一属性(如性别或种族)的偏见缓解,忽视了多种属性交叉形成的子群体(如黑人女性、亚裔男性等)的复杂偏见模式。由于这些交叉子群体在不同模态(文本、时间序列、表格、事件、图像)中的分布与偏差特征各异,单一属性的缓解策略往往失效。本文利用多模态数据集MIMIC-Eye1和MIMIC-IV ED,通过MedBERT、Clinical BERT和Clinical BioBERT等预训练临床语言模型,学习统一文本表示,首次系统揭示多模态临床预测中的交叉偏见,并在多个数据集与嵌入方法上验证了子群体特异性缓解策略的有效性,证明其在跨数据集、跨子群体及多嵌入下的鲁棒性。

原文摘要 · Abstract (English)

Biases in automated clinical decision-making using Electronic Healthcare Records (EHR) impose significant disparities in patient care and treatment outcomes. Conventional approaches have primarily focused on bias mitigation strategies stemming from single attributes, overlooking intersectional subgroups -- groups formed across various demographic intersections (such as race, gender, ethnicity, etc.). Rendering single-attribute mitigation strategies to intersectional subgroups becomes statistically irrelevant due to the varying distribution and bias patterns across these subgroups. The multimodal nature of EHR -- data from various sources such as combinations of text, time series, tabular, events, and images -- adds another layer of complexity as the influence on minority groups may fluctuate across modalities. In this paper, we take the initial steps to uncover potential intersectional biases in predictions by sourcing extensive multimodal datasets, MIMIC-Eye1 and MIMIC-IV ED, and propose mitigation at the intersectional subgroup level. We perform and benchmark downstream tasks and bias evaluation on the datasets by learning a unified text representation from multimodal sources, harnessing the enormous capabilities of the pre-trained clinical Language Models (LM), MedBERT, Clinical BERT, and Clinical BioBERT. Our findings indicate that the proposed sub-group-specific bias mitigation is robust across different datasets, subgroups, and embeddings, demonstrating effectiveness in addressing intersectional biases in multimodal settings.

医疗AI交叉偏见多模态公平性

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