让医疗AI根据患者特征动态调整诊断,提升小群体准确性。
Patient-Conditioned Adaptive Offsets for Reliable Diagnosis across Subgroups
- 用患者特征生成微调参数,动态调整模型但不改变主干结构。
- 在PAD-UFES-20数据集上,小群体召回率提升4.1%,F1提升4.4%。
- 适合关注医疗公平性、需兼顾准确与群体差异的临床场景。
医学诊断中的AI模型常因疾病流行率、影像表现和临床风险差异,在不同患者群体中表现不均。现有算法公平性方法通常通过抑制敏感属性来减少差异,但在医疗场景中,这些属性往往携带关键诊断信息,移除会降低准确性和可靠性。相比之下,临床决策明确结合患者背景解读诊断证据,提示应设计更适应子群的模型。本文提出HyperAdapt,一种患者条件自适应框架,可在保持共享诊断模型的同时提升子群可靠性。将年龄、性别等临床相关属性编码为紧凑嵌入,输入超网络式模块,生成选定骨干层的小型残差调节参数。该设计保留骨干模型的通用医学知识,同时实现反映个体差异的精准调整。通过低秩与瓶颈化参数化约束,保障效率与鲁棒性。在多个公开医学影像基准测试中,本方法持续提升子群性能,未牺牲整体准确率。在PAD-UFES-20数据集上,相较最强基线,召回率提升4.1%,F1得分提升4.4%,对代表性不足群体增益更大。
原文摘要 · Abstract (English)
AI models for medical diagnosis often exhibit uneven performance across patient populations due to heterogeneity in disease prevalence, imaging appearance, and clinical risk profiles. Existing algorithmic fairness approaches typically seek to reduce such disparities by suppressing sensitive attributes. However, in medical settings these attributes often carry essential diagnostic information, and removing them can degrade accuracy and reliability, particularly in high-stakes applications. In contrast, clinical decision making explicitly incorporates patient context when interpreting diagnostic evidence, suggesting a different design direction for subgroup-aware models. In this paper, we introduce HyperAdapt, a patient-conditioned adaptation framework that improves subgroup reliability while maintaining a shared diagnostic model. Clinically relevant attributes such as age and sex are encoded into a compact embedding and used to condition a hypernetwork-style module, which generates small residual modulation parameters for selected layers of a shared backbone. This design preserves the general medical knowledge learned by the backbone while enabling targeted adjustments that reflect patient-specific variability. To ensure efficiency and robustness, adaptations are constrained through low-rank and bottlenecked parameterizations, limiting both model complexity and computational overhead. Experiments across multiple public medical imaging benchmarks demonstrate that the proposed approach consistently improves subgroup-level performance without sacrificing overall accuracy. On the PAD-UFES-20 dataset, our method outperforms the strongest competing baseline by 4.1% in recall and 4.4% in F1 score, with larger gains observed for underrepresented patient populations.
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