通过解耦样本难度与年龄关联,缓解医学影像诊断中的年龄偏差问题。
Robust Mitigation of Age-Dependent Confounding Effects via Sample-Difficulty Decorrelation

- 基于样本难度建模,用鲁棒权重解耦年龄与诊断趋势。
- 在两个放射科数据集上显著降低年龄相关的假阳性/真阳性差异。
- 适合关注临床公平性且需保留非线性年龄信息的研究者。
医学图像分类中年龄依赖的性能差异常源于年龄作为混杂因子,将影像形态与疾病流行率相联系。实际中,高患病率年龄组易出现过度诊断,低患病率年龄组则易漏诊,且在训练测试年龄分布偏移时问题加剧。传统方法强制年龄不变性可能抑制年龄中蕴含的诊断有意义信息。为此,我们提出一种稳健框架,通过消除虚假的年龄相关趋势而非强制不变性来缓解年龄混杂。经过预热阶段后,我们以标签条件化方式刻画样本难度及其年龄依赖趋势,并使用鲁棒的Huber加权亲和权重解耦年龄与主导难度趋势,削弱混杂驱动的捷径学习,同时保留临床相关的非线性年龄信息。进一步引入年龄覆盖得分,按小批量年龄方差缩放解耦惩罚,确保在年龄多样性有限时优化稳定。在两个放射科数据集上,该方法有效降低年龄相关的真阳性和假阳性差异,对AUC影响极小,并在训练测试年龄分布偏移增大时仍保持鲁棒性。
原文摘要 · Abstract (English)
Age dependent performance disparities in medical image classification often arise because age acts as a confounder, linking imaging morphology with disease prevalence. In practice, disparities can manifest as overdiagnosis at ages where disease prevalence is higher and underdiagnosis at ages where prevalence is lower, and can worsen under train test shifts in the age distribution. Conventional mitigation approaches that enforce strict age invariance may suppress diagnostically meaningful information encoded in age. We therefore propose a robust framework that mitigates the effects of age-dependent confounding by targeting spurious age linked trends rather than enforcing invariance. Following a warm-up phase, we characterize sample difficulty and model its age-dependent trends in a label-conditioned manner. We decorrelate age from dominant age difficulty trends using robust, Huber weighted affinity weights, attenuating confounding-driven shortcuts while preserving clinically meaningful, nonlinear age information. We further introduce an Age Coverage Score that scales the decorrelation penalty by minibatch age variance to ensure stable optimization under limited age diversity. Across two radiology datasets, our approach reduces age dependent true and false positive disparities with minimal AUC impact and remains robust to increasing train test age distribution shifts.
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