arXiv:2510.10822cs.CVcs.AI2025-10被引 2

用轻量级方法提升胸片诊断模型的公平性,减少性别年龄种族差异。

From Detection to Mitigation: Addressing Bias in Deep Learning Models for Chest X-Ray Diagnosis

  • 用XGBoost替代CNN最后一层,实现公平性提升。
  • 在CheXpert和MIMIC数据集上显著降低各群体偏差。
  • 计算成本低,适合临床部署,尤其适合资源有限场景。

深度学习在胸片诊断中展现潜力,但可能因性能在不同人口群体间差异而加剧医疗不公。本文提出一个针对性别、年龄和种族差异的偏见检测与缓解框架。通过扩展现有CNN-XGBoost流水线支持多标签分类,在四种疾病任务上评估其表现。结果表明,用eXtreme Gradient Boosting(XGBoost)替换CNN末层,可在保持或提升整体预测性能的同时改善子群体公平性。该方法在DenseNet-121和ResNet-50等不同主干网络上均取得一致的强性能与公平性结果,验证其模型无关性。相比对抗训练、重加权、数据增强和主动学习等传统方法,本方法以极低计算成本实现相当或更优的偏见缓解效果。进一步发现,将XGBoost重训练与主动学习结合,可在分布内和分布外数据上对所有人口子群体实现最大偏见降低,为临床放射学中可公平部署的深度学习提供可行路径。

原文摘要 · Abstract (English)

Deep learning models have shown promise in improving diagnostic accuracy from chest X-rays, but they also risk perpetuating healthcare disparities when performance varies across demographic groups. In this work, we present a comprehensive bias detection and mitigation framework targeting sex, age, and race-based disparities when performing diagnostic tasks with chest X-rays. We extend a recent CNN-XGBoost pipeline to support multi-label classification and evaluate its performance across four medical conditions. We show that replacing the final layer of CNN with an eXtreme Gradient Boosting classifier improves the fairness of the subgroup while maintaining or improving the overall predictive performance. To validate its generalizability, we apply the method to different backbones, namely DenseNet-121 and ResNet-50, and achieve similarly strong performance and fairness outcomes, confirming its model-agnostic design. We further compare this lightweight adapter training method with traditional full-model training bias mitigation techniques, including adversarial training, reweighting, data augmentation, and active learning, and find that our approach offers competitive or superior bias reduction at a fraction of the computational cost. Finally, we show that combining eXtreme Gradient Boosting retraining with active learning yields the largest reduction in bias across all demographic subgroups, both in and out of distribution on the CheXpert and MIMIC datasets, establishing a practical and effective path toward equitable deep learning deployment in clinical radiology.

医疗AI公平性模型优化

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