通过重分布神经元激活,解决医疗影像模型对不同人群的诊断偏差问题。
Neuron Incidence Redistribution for Fairness in Medical Image Classification

- 基于潜表示机制,调整模型在不同人群中的神经元激活分布。
- 在哈姆10000数据集上,年龄和性别差异分别从10.81%、12.04%降至0.93%、0.74%。
- 无需标注人群属性,适用于缺乏敏感信息的医疗场景。
医学图像分类的深度学习模型在年龄、性别、种族等人口统计特征上存在子群体性能差异。我们发现其潜在表征机制:在迁移学习模型中,正向预测时主导的倒数第二层激活通道同时被疾病阳性样本与优势群体(男性、年长患者)激活,导致过度诊断;负向预测时主导通道则被弱势群体(女性、年轻患者)激活,引发系统性漏诊。为此,提出轻量级正则化方法Neuron Incidence Redistribution(NIR),惩罚预测概率加权后的神经元均值激活方差,训练时不需人群标签。在HAM10000数据集上,年龄组的真阳性率(TPR)差异从10.81%降至0.93%,性别差异从12.04%降至0.74%,仅损失0.51点AUC。在Harvard OCT-RNFL数据集上,种族的假阳性率(FPR)差异从15.68%降至10.66%,年龄差异从12.69%降至1.80%,表明将潜在疾病证据均匀分布于倒数第二层是提升医疗AI公平性的有效策略。
原文摘要 · Abstract (English)
Deep learning models for medical image classification are susceptible to subgroup performance disparities across demographic attributes such as age, gender, and race. We identify a latent representational mechanism underlying these disparities: in transfer-learned models, the dominant penultimate-layer activation channel under positive predictions is co-activated by both disease-positive samples and privileged demographic groups (male, older patients), producing over-diagnosis; conversely, the dominant channel under negative predictions is co-activated by disadvantaged groups (female, younger patients), producing systematic under-diagnosis. To address this, we propose Neuron Incidence Redistribution (NIR), a lightweight regularization method that penalizes the variance of predicted-probability-weighted mean activations across penultimate-layer neurons, requiring no demographic labels at training time. On HAM10000, TPR disparity drops from 10.81% to 0.93% across age groups and from 12.04% to 0.74% across gender, with a marginal AUC improvement of 0.51 points. On Harvard OCT-RNFL, NIR reduces FPR disparity for race (from 15.68% to 10.66%) and age (from 12.69% to 1.80%), demonstrating that distributing latent disease evidence across the full penultimate layer is a principled and effective strategy for improving demographic fairness in medical AI.
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