用生成模型合成带人口统计信息的医学图像,解决少数群体数据少导致的公平性评估难题。
Demographically-Conditioned Synthetic Medical Images for Bias Mitigation and Bias Detection in Disease Classifiers

- 基于人口统计信息生成合成医学图像,分阶段预训练优于联合增强。
- 合成数据使模型在仅1/100真实数据下仍超越全真实数据基准。
- 合成数据可精准检测少数群体偏差,尤其适合小样本公平性审计。
医疗图像分类器的分组公平性审计面临样本量不足问题:测试集中少数群体样本过少,导致各组性能置信区间过宽,无法有效检测偏差。本文提出,基于人口统计信息的合成图像生成器可同时实现偏差缓解与检测。在新冠胸部CT分类任务中,采用端到端微调的Stable Diffusion 2.1生成器,发现:在训练阶段,均衡人口统计的合成数据作为预训练先验最有效,顺序预训练+微调显著优于联合增强,在相同数据量下实现约100倍真实数据效率提升;在评估阶段,五组合成少数群体与五种子随机分类器下,合成估计器与高功率真实基准(真实黄金标准)的子组排名完全一致(斯皮尔曼ρ=1.00,以MCC和召回率衡量),且在真实小样本测试集耗尽时仍提供更可靠的单元估计。因此,合成数据在公平性审计关注的核心区域,既是偏差修复工具,也是可靠测量手段。
原文摘要 · Abstract (English)
Per-subgroup fairness audits of medical image classifiers face a sample-size problem: minority subgroups in held-out test sets have so few samples that the resulting confidence intervals on per-subgroup performance are wider than the bias the audit is meant to detect. We argue that a demographically-conditioned synthetic generator can do both: mitigate bias on the training side and detect bias on the evaluation side. Working on COVID-19 chest CT classification with an end-to-end fine-tuned Stable Diffusion 2.1 generator, we make two findings. For bias mitigation (training), a demographically-balanced synthetic cohort is most useful as a pretraining prior, not as joint augmentation: with the same fixed data, sequential pretraining followed by fine-tuning substantially outperforms joint augmentation, and the resulting classifier surpasses the full-real baseline at $\sim$$100\times$ real-data efficiency. For bias detection (evaluation), across five synthetic minority cohorts and five classifier seeds, the synthetic estimator reproduces the subgroup ranking of a well-powered real oracle (Spearman $ρ= 1.00$ on MCC and Recall) and gives the more reliable per-cell estimate where the small real test set runs out of samples. The synthetic cohort is therefore most useful in exactly the cells that fairness audits care about, as both a fix for and a measure of subgroup bias.
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