arXiv:2605.11362cs.LGcs.AI2026-05

提出因果公平框架,解析重症患者生存差异的成因路径。

Causal Fairness for Survival Analysis

论文配图:Causal Fairness for Survival Analysis
图 1 · 摘自论文原文
  • 用图模型构建因果假设,分解生存差异的直接、间接和虚假路径。
  • 在ICU数据上发现种族差异随时间演变,其中30%由非因果因素导致。
  • 适合关注医疗决策公平性的研究人员和临床系统设计者。

在数据驱动时代,机器学习与人工智能被广泛用于医疗、就业和司法等高风险领域,引发对系统公平性的担忧。现有公平学习研究多聚焦静态任务,而时间序列型生存分析中的公平性问题仍缺乏深入探索。当前方法依赖统计公平定义,即便数据无限也无法剥离导致差异的因果机制。为此,本文提出一种生存分析的因果公平框架,可将生存差异分解为直接、间接和虚假路径的贡献,提供人类可理解的差异成因解释。该非参数方法包含四步:(1)基于图模型形式化删失与无混杂假设;(2)恢复给定协变量的条件生存函数;(3)应用因果归约定理重构问题以支持路径分解;(4)高效估计效应。最终应用于重症监护室(ICU)患者入院后结果的种族差异分析,揭示差异随时间演变特征。

原文摘要 · Abstract (English)

In the data-driven era, large-scale datasets are routinely collected and analyzed using machine learning (ML) and artificial intelligence (AI) to inform decisions in high-stakes domains such as healthcare, employment, and criminal justice, raising concerns about the fairness behavior of these systems. Existing works in fair ML cover tasks such as bias detection, fair prediction, and fair decision-making, but largely focus on static settings. At the same time, fairness in temporal contexts, particularly survival/time-to-event (TTE) analysis, remains relatively underexplored, with current approaches to fair survival analysis adopting statistical fairness definitions, which, even with unlimited data, cannot disentangle the causal mechanisms that generate disparities. To address this gap, we develop a causal framework for fairness in TTE analysis, enabling the decomposition of disparities in survival into contributions from direct, indirect, and spurious pathways. This provides a human-understandable explanation of why disparities arise and how they evolve over time. Our non-parametric approach proceeds in four steps: (1) formalizing the necessary assumptions about censoring and lack of confounding using a graphical model; (2) recovering the conditional survival function given covariates; (3) applying the Causal Reduction Theorem to reframe the problem in a form amenable to causal pathway decomposition; (4) estimating the effects efficiently. Finally, our approach is used to analyze the temporal evolution of racial disparities in outcome after admission to an intensive care unit (ICU).

因果公平生存分析医疗公平

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