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Comprehensive Study on Fairness of 3D Medical Imaging Models and Proposal of Fair Identity Scaling Method


Core Concepts
Comprehensive investigation of fairness in 3D medical imaging models across multiple protected attributes, including race, gender, and ethnicity, and proposal of a novel Fair Identity Scaling (FIS) method to improve both overall performance and fairness.
Abstract
This study conducts the first comprehensive investigation of fairness in 3D medical imaging diagnosis models across multiple protected attributes, including race, gender, and ethnicity. The authors analyze fairness across 2D and 3D models, 5 different architectures, and 3 common eye diseases - age-related macular degeneration (AMD), diabetic retinopathy (DR), and glaucoma. The results reveal significant biases across demographic subgroups. For example, the White subgroup exhibits improved performance on AMD and DR detection, while the Asian subgroup shows better performance on Glaucoma detection. The Female subgroup exhibits improved performance on AMD detection, while the Male subgroup shows better performance on Glaucoma detection. The non-Hispanic subgroup exhibits improved performance on AMD and Glaucoma detection, while the Hispanic subgroup shows better performance on DR detection. To address these biases, the authors propose a novel Fair Identity Scaling (FIS) method that incorporates both individual scaling and group scaling to determine loss weights during training. FIS improves both overall performance and fairness, outperforming various state-of-the-art fairness methods. Additionally, the authors introduce Harvard-FairVision, the first large-scale medical fairness dataset with 30,000 subjects and six demographic identity attributes for eye disease screening, covering three major eye disorders affecting about 380 million people worldwide.
Stats
The dataset includes 10,000 samples for each of the three major eye diseases - age-related macular degeneration (AMD), diabetic retinopathy (DR), and glaucoma, totaling 30,000 subjects. The proportions of the four AMD classes are: normal (64.3%), early AMD (8.9%), intermediate AMD (12.0%), and late AMD (14.8%). The proportion of vision-threatening DR is 9.1% compared with 90.9% non-vision-threatening DR. The proportion of glaucoma is 48.7% compared with 51.3% normal.
Quotes
"Equity in AI for healthcare is crucial due to its direct impact on human well-being." "Since 3D imaging surpasses 2D imaging in SOTA clinical care, it is critical to understand the fairness of these 3D models." "The undiagnosed eye disease issue is even more severe in minority subgroups. For instance, it has been reported that Black patients have 4.4 times greater odds of having undiagnosed and untreated Glaucoma than White patients."

Deeper Inquiries

How can the proposed Fair Identity Scaling (FIS) method be extended to other medical imaging tasks beyond eye disease detection

The Fair Identity Scaling (FIS) method proposed in the study can be extended to other medical imaging tasks beyond eye disease detection by adapting the concept of fairness learning to different healthcare domains. One way to extend FIS is to apply it to tasks such as cancer detection, organ segmentation, or anomaly detection in medical imaging. By incorporating demographic identity attributes and implementing individual and group scaling mechanisms, FIS can help address biases and disparities in these areas as well. For example, in cancer detection, FIS can be used to ensure that the model's predictions are fair across different demographic groups, such as race, gender, or ethnicity. This can help improve the overall performance and equity of the AI system in diagnosing various types of cancer accurately and fairly.

What are the potential limitations of the Harvard-FairVision dataset, and how can it be further expanded to address these limitations

The Harvard-FairVision dataset, while comprehensive and valuable for studying fairness in eye disease detection, may have some limitations that could be addressed to enhance its utility. One potential limitation is the focus on a specific set of eye diseases, namely AMD, DR, and glaucoma. To address this limitation, the dataset could be further expanded to include a wider range of eye diseases, such as cataracts, retinal detachment, or diabetic macular edema. Additionally, the dataset could benefit from including more diverse demographic attributes beyond age, gender, race, ethnicity, preferred language, and marital status. Adding socioeconomic status, education level, or access to healthcare information could provide a more comprehensive understanding of fairness in medical imaging. Furthermore, increasing the sample size and diversity of the dataset, including more rare cases and underrepresented groups, would improve the generalizability and robustness of the fairness analysis.

How can the insights from this study on fairness in 3D medical imaging models inform the development of more equitable AI systems in other healthcare domains

The insights gained from the study on fairness in 3D medical imaging models can inform the development of more equitable AI systems in other healthcare domains by highlighting the importance of considering demographic attributes in model training and evaluation. By understanding the biases and disparities present in AI models, developers can implement strategies like Fair Identity Scaling (FIS) to mitigate these issues and promote fairness in healthcare AI applications. The study's emphasis on fairness across multiple protected attributes, such as race, gender, and ethnicity, can serve as a blueprint for ensuring equity in various medical imaging tasks beyond eye disease screening. By incorporating fairness metrics and techniques from this study, developers can create AI systems that are not only accurate but also unbiased and inclusive, ultimately improving healthcare outcomes for all patient populations.
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