Daily Papers

Achieving robust performance and fairness across diverse patient populations remains a challenge in developing clinically deployable deep learning models for diagnostic imaging. Synthetic data generation has emerged as a promising strategy to address limitations in dataset scale and diversity. We introduce RoentGen-v2, a text-to-image diffusion model for chest radiographs that enables fine-grained control over both radiographic findings and patient demographic attributes, including sex, age, and race/ethnicity. RoentGen-v2 is the first model to generate clinically plausible images with demographic conditioning, facilitating the creation of a large, demographically balanced synthetic dataset comprising over 565,000 images. We use this large synthetic dataset to evaluate optimal training pipelines for downstream disease classification models. In contrast to prior work that combines real and synthetic data naively, we propose an improved training strategy that leverages synthetic data for supervised pretraining, followed by fine-tuning on real data. Through extensive evaluation on over 137,000 chest radiographs from five institutions, we demonstrate that synthetic pretraining consistently improves model performance, generalization to out-of-distribution settings, and fairness across demographic subgroups. Across datasets, synthetic pretraining led to a 6.5% accuracy increase in the performance of downstream classification models, compared to a modest 2.7% increase when naively combining real and synthetic data. We observe this performance improvement simultaneously with the reduction of the underdiagnosis fairness gap by 19.3%. These results highlight the potential of synthetic imaging to advance equitable and generalizable medical deep learning under real-world data constraints. We open source our code, trained models, and synthetic dataset at https://github.com/StanfordMIMI/RoentGen-v2 .

Fairness or equity in machine learning is profoundly important for societal well-being, but limited public datasets hinder its progress, especially in the area of medicine. It is undeniable that fairness in medicine is one of the most important areas for fairness learning's applications. Currently, no large-scale public medical datasets with 3D imaging data for fairness learning are available, while 3D imaging data in modern clinics are standard tests for disease diagnosis. In addition, existing medical fairness datasets are actually repurposed datasets, and therefore they typically have limited demographic identity attributes with at most three identity attributes of age, gender, and race for fairness modeling. To address this gap, we introduce our Eye Fairness dataset with 30,000 subjects (Harvard-EF) covering three major eye diseases including age-related macular degeneration, diabetic retinopathy, and glaucoma affecting 380 million patients globally. Our Harvard-EF dataset includes both 2D fundus photos and 3D optical coherence tomography scans with six demographic identity attributes including age, gender, race, ethnicity, preferred language, and marital status. We also propose a fair identity scaling (FIS) approach combining group and individual scaling together to improve model fairness. Our FIS approach is compared with various state-of-the-art fairness learning methods with superior performance in the racial, gender, and ethnicity fairness tasks with 2D and 3D imaging data, which demonstrate the utilities of our Harvard-EF dataset for fairness learning. To facilitate fairness comparisons between different models, we propose performance-scaled disparity measures, which can be used to compare model fairness accounting for overall performance levels. The dataset and code are publicly accessible via https://ophai.hms.harvard.edu/datasets/harvard-ef30k.

Training models with robust group fairness properties is crucial in ethically sensitive application areas such as medical diagnosis. Despite the growing body of work aiming to minimise demographic bias in AI, this problem remains challenging. A key reason for this challenge is the fairness generalisation gap: High-capacity deep learning models can fit all training data nearly perfectly, and thus also exhibit perfect fairness during training. In this case, bias emerges only during testing when generalisation performance differs across subgroups. This motivates us to take a bi-level optimisation perspective on fair learning: Optimising the learning strategy based on validation fairness. Specifically, we consider the highly effective workflow of adapting pre-trained models to downstream medical imaging tasks using parameter-efficient fine-tuning (PEFT) techniques. There is a trade-off between updating more parameters, enabling a better fit to the task of interest vs. fewer parameters, potentially reducing the generalisation gap. To manage this tradeoff, we propose FairTune, a framework to optimise the choice of PEFT parameters with respect to fairness. We demonstrate empirically that FairTune leads to improved fairness on a range of medical imaging datasets. The code is available at https://github.com/Raman1121/FairTune

Fairness in artificial intelligence models has gained significantly more attention in recent years, especially in the area of medicine, as fairness in medical models is critical to people's well-being and lives. High-quality medical fairness datasets are needed to promote fairness learning research. Existing medical fairness datasets are all for classification tasks, and no fairness datasets are available for medical segmentation, while medical segmentation is an equally important clinical task as classifications, which can provide detailed spatial information on organ abnormalities ready to be assessed by clinicians. In this paper, we propose the first fairness dataset for medical segmentation named Harvard-FairSeg with 10,000 subject samples. In addition, we propose a fair error-bound scaling approach to reweight the loss function with the upper error-bound in each identity group, using the segment anything model (SAM). We anticipate that the segmentation performance equity can be improved by explicitly tackling the hard cases with high training errors in each identity group. To facilitate fair comparisons, we utilize a novel equity-scaled segmentation performance metric to compare segmentation metrics in the context of fairness, such as the equity-scaled Dice coefficient. Through comprehensive experiments, we demonstrate that our fair error-bound scaling approach either has superior or comparable fairness performance to the state-of-the-art fairness learning models. The dataset and code are publicly accessible via https://ophai.hms.harvard.edu/datasets/harvard-fairseg10k.

Diabetic retinopathy (DR) is a leading cause of vision loss in working-age adults. While screening reduces the risk of blindness, traditional imaging is often costly and inaccessible. Artificial intelligence (AI) algorithms present a scalable diagnostic solution, but concerns regarding fairness and generalization persist. This work evaluates the fairness and performance of image-trained models in DR prediction, as well as the impact of disentanglement as a bias mitigation technique, using the diverse mBRSET fundus dataset. Three models, ConvNeXt V2, DINOv2, and Swin V2, were trained on macula images to predict DR and sensitive attributes (SAs) (e.g., age and gender/sex). Fairness was assessed between subgroups of SAs, and disentanglement was applied to reduce bias. All models achieved high DR prediction performance in diagnosing (up to 94% AUROC) and could reasonably predict age and gender/sex (91% and 77% AUROC, respectively). Fairness assessment suggests disparities, such as a 10% AUROC gap between age groups in DINOv2. Disentangling SAs from DR prediction had varying results, depending on the model selected. Disentanglement improved DINOv2 performance (2% AUROC gain), but led to performance drops in ConvNeXt V2 and Swin V2 (7% and 3%, respectively). These findings highlight the complexity of disentangling fine-grained features in fundus imaging and emphasize the importance of fairness in medical imaging AI to ensure equitable and reliable healthcare solutions.

Predictive artificial intelligence (AI) offers an opportunity to improve clinical practice and patient outcomes, but risks perpetuating biases if fairness is inadequately addressed. However, the definition of "fairness" remains unclear. We conducted a scoping review to identify and critically appraise fairness metrics for clinical predictive AI. We defined a "fairness metric" as a measure quantifying whether a model discriminates (societally) against individuals or groups defined by sensitive attributes. We searched five databases (2014-2024), screening 820 records, to include 41 studies, and extracted 62 fairness metrics. Metrics were classified by performance-dependency, model output level, and base performance metric, revealing a fragmented landscape with limited clinical validation and overreliance on threshold-dependent measures. Eighteen metrics were explicitly developed for healthcare, including only one clinical utility metric. Our findings highlight conceptual challenges in defining and quantifying fairness and identify gaps in uncertainty quantification, intersectionality, and real-world applicability. Future work should prioritise clinically meaningful metrics.

Advances in artificial intelligence (AI) have achieved expert-level performance in medical imaging applications. Notably, self-supervised vision-language foundation models can detect a broad spectrum of pathologies without relying on explicit training annotations. However, it is crucial to ensure that these AI models do not mirror or amplify human biases, thereby disadvantaging historically marginalized groups such as females or Black patients. The manifestation of such biases could systematically delay essential medical care for certain patient subgroups. In this study, we investigate the algorithmic fairness of state-of-the-art vision-language foundation models in chest X-ray diagnosis across five globally-sourced datasets. Our findings reveal that compared to board-certified radiologists, these foundation models consistently underdiagnose marginalized groups, with even higher rates seen in intersectional subgroups, such as Black female patients. Such demographic biases present over a wide range of pathologies and demographic attributes. Further analysis of the model embedding uncovers its significant encoding of demographic information. Deploying AI systems with these biases in medical imaging can intensify pre-existing care disparities, posing potential challenges to equitable healthcare access and raising ethical questions about their clinical application.

In critical decision-making scenarios, optimizing accuracy can lead to a biased classifier, hence past work recommends enforcing group-based fairness metrics in addition to maximizing accuracy. However, doing so exposes the classifier to another kind of bias called infra-marginality. This refers to individual-level bias where some individuals/subgroups can be worse off than under simply optimizing for accuracy. For instance, a classifier implementing race-based parity may significantly disadvantage women of the advantaged race. To quantify this bias, we propose a general notion of eta-infra-marginality that can be used to evaluate the extent of this bias. We prove theoretically that, unlike other fairness metrics, infra-marginality does not have a trade-off with accuracy: high accuracy directly leads to low infra-marginality. This observation is confirmed through empirical analysis on multiple simulated and real-world datasets. Further, we find that maximizing group fairness often increases infra-marginality, suggesting the consideration of both group-level fairness and individual-level infra-marginality. However, measuring infra-marginality requires knowledge of the true distribution of individual-level outcomes correctly and explicitly. We propose a practical method to measure infra-marginality, and a simple algorithm to maximize group-wise accuracy and avoid infra-marginality.

Fairness for machine learning predictions is widely required in practice for legal, ethical, and societal reasons. Existing work typically focuses on settings without unobserved confounding, even though unobserved confounding can lead to severe violations of causal fairness and, thus, unfair predictions. In this work, we analyze the sensitivity of causal fairness to unobserved confounding. Our contributions are three-fold. First, we derive bounds for causal fairness metrics under different sources of unobserved confounding. This enables practitioners to examine the sensitivity of their machine learning models to unobserved confounding in fairness-critical applications. Second, we propose a novel neural framework for learning fair predictions, which allows us to offer worst-case guarantees of the extent to which causal fairness can be violated due to unobserved confounding. Third, we demonstrate the effectiveness of our framework in a series of experiments, including a real-world case study about predicting prison sentences. To the best of our knowledge, ours is the first work to study causal fairness under unobserved confounding. To this end, our work is of direct practical value as a refutation strategy to ensure the fairness of predictions in high-stakes applications.

Motivated by the strong performance of CLIP-based models in natural image-text domains, recent efforts have adapted these architectures to medical tasks, particularly in radiology, where large paired datasets of images and reports, such as chest X-rays, are available. While these models have shown encouraging results in terms of accuracy and discriminative performance, their fairness and robustness in the different clinical tasks remain largely underexplored. In this study, we extensively evaluate six widely used CLIP-based models on chest X-ray classification using three publicly available datasets: MIMIC-CXR, NIH-CXR14, and NEATX. We assess the models fairness across six conditions and patient subgroups based on age, sex, and race. Additionally, we assess the robustness to shortcut learning by evaluating performance on pneumothorax cases with and without chest drains. Our results indicate performance gaps between patients of different ages, but more equitable results for the other attributes. Moreover, all models exhibit lower performance on images without chest drains, suggesting reliance on spurious correlations. We further complement the performance analysis with a study of the embeddings generated by the models. While the sensitive attributes could be classified from the embeddings, we do not see such patterns using PCA, showing the limitations of these visualisation techniques when assessing models. Our code is available at https://github.com/TheoSourget/clip_cxr_fairness

Fair machine learning aims to prevent discrimination against individuals or sub-populations based on sensitive attributes such as gender and race. In recent years, causal inference methods have been increasingly used in fair machine learning to measure unfairness by causal effects. However, current methods assume that the true causal graph is given, which is often not true in real-world applications. To address this limitation, this paper proposes a framework for achieving causal fairness based on the notion of interventions when the true causal graph is partially known. The proposed approach involves modeling fair prediction using a Partially Directed Acyclic Graph (PDAG), specifically, a class of causal DAGs that can be learned from observational data combined with domain knowledge. The PDAG is used to measure causal fairness, and a constrained optimization problem is formulated to balance between fairness and accuracy. Results on both simulated and real-world datasets demonstrate the effectiveness of this method.

When the performance of a machine learning model varies over groups defined by sensitive attributes (e.g., gender or ethnicity), the performance disparity can be expressed in terms of the probability distributions of the input and output variables over each group. In this paper, we exploit this fact to reduce the disparate impact of a fixed classification model over a population of interest. Given a black-box classifier, we aim to eliminate the performance gap by perturbing the distribution of input variables for the disadvantaged group. We refer to the perturbed distribution as a counterfactual distribution, and characterize its properties for common fairness criteria. We introduce a descent algorithm to learn a counterfactual distribution from data. We then discuss how the estimated distribution can be used to build a data preprocessor that can reduce disparate impact without training a new model. We validate our approach through experiments on real-world datasets, showing that it can repair different forms of disparity without a significant drop in accuracy.

Algorithmic fairness has conventionally adopted the mathematically convenient perspective of racial color-blindness (i.e., difference unaware treatment). However, we contend that in a range of important settings, group difference awareness matters. For example, differentiating between groups may be necessary in legal contexts (e.g., the U.S. compulsory draft applies to men but not women) and harm assessments (e.g., referring to girls as ``terrorists'' may be less harmful than referring to Muslim people as such). Thus, in contrast to most fairness work, we study fairness through the perspective of treating people differently -- when it is contextually appropriate to. We first introduce an important distinction between descriptive (fact-based), normative (value-based), and correlation (association-based) benchmarks. This distinction is significant because each category requires separate interpretation and mitigation tailored to its specific characteristics. Then, we present a benchmark suite composed of eight different scenarios for a total of 16k questions that enables us to assess difference awareness. Finally, we show results across ten models that demonstrate difference awareness is a distinct dimension to fairness where existing bias mitigation strategies may backfire.

Fairness remains a critical concern in healthcare, where unequal access to services and treatment outcomes can adversely affect patient health. While Federated Learning (FL) presents a collaborative and privacy-preserving approach to model training, ensuring fairness is challenging due to heterogeneous data across institutions, and current research primarily addresses non-medical applications. To fill this gap, we establish the first experimental benchmark for fairness in medical FL, evaluating six representative FL methods across diverse demographic attributes and imaging modalities. We introduce FairFedMed, the first medical FL dataset specifically designed to study group fairness (i.e., demographics). It comprises two parts: FairFedMed-Oph, featuring 2D fundus and 3D OCT ophthalmology samples with six demographic attributes; and FairFedMed-Chest, which simulates real cross-institutional FL using subsets of CheXpert and MIMIC-CXR. Together, they support both simulated and real-world FL across diverse medical modalities and demographic groups. Existing FL models often underperform on medical images and overlook fairness across demographic groups. To address this, we propose FairLoRA, a fairness-aware FL framework based on SVD-based low-rank approximation. It customizes singular value matrices per demographic group while sharing singular vectors, ensuring both fairness and efficiency. Experimental results on the FairFedMed dataset demonstrate that FairLoRA not only achieves state-of-the-art performance in medical image classification but also significantly improves fairness across diverse populations. Our code and dataset can be accessible via link: https://wang.hms.harvard.edu/fairfedmed/.

Benchmarking competitions are central to the development of artificial intelligence (AI) in medical imaging, defining performance standards and shaping methodological progress. However, it remains unclear whether these benchmarks provide data that are sufficiently representative, accessible, and reusable to support clinically meaningful AI. In this work, we assess fairness along two complementary dimensions: (1) whether challenge datasets are representative of real-world clinical diversity, and (2) whether they are accessible and legally reusable in line with the FAIR principles. To address this question, we conducted a large-scale systematic study of 241 biomedical image analysis challenges comprising 458 tasks across 19 imaging modalities. Our findings show substantial biases in dataset composition, including geographic location, modality-, and problem type-related biases, indicating that current benchmarks do not adequately reflect real-world clinical diversity. Despite their widespread influence, challenge datasets were frequently constrained by restrictive or ambiguous access conditions, inconsistent or non-compliant licensing practices, and incomplete documentation, limiting reproducibility and long-term reuse. Together, these shortcomings expose foundational fairness limitations in our benchmarking ecosystem and highlight a disconnect between leaderboard success and clinical relevance.

The growing capability and accessibility of machine learning has led to its application to many real-world domains and data about people. Despite the benefits algorithmic systems may bring, models can reflect, inject, or exacerbate implicit and explicit societal biases into their outputs, disadvantaging certain demographic subgroups. Discovering which biases a machine learning model has introduced is a great challenge, due to the numerous definitions of fairness and the large number of potentially impacted subgroups. We present FairVis, a mixed-initiative visual analytics system that integrates a novel subgroup discovery technique for users to audit the fairness of machine learning models. Through FairVis, users can apply domain knowledge to generate and investigate known subgroups, and explore suggested and similar subgroups. FairVis' coordinated views enable users to explore a high-level overview of subgroup performance and subsequently drill down into detailed investigation of specific subgroups. We show how FairVis helps to discover biases in two real datasets used in predicting income and recidivism. As a visual analytics system devoted to discovering bias in machine learning, FairVis demonstrates how interactive visualization may help data scientists and the general public understand and create more equitable algorithmic systems.

Addressing fairness in artificial intelligence (AI), particularly in medical AI, is crucial for ensuring equitable healthcare outcomes. Recent efforts to enhance fairness have introduced new methodologies and datasets in medical AI. However, the fairness issue under the setting of domain transfer is almost unexplored, while it is common that clinics rely on different imaging technologies (e.g., different retinal imaging modalities) for patient diagnosis. This paper presents FairDomain, a pioneering systemic study into algorithmic fairness under domain shifts, employing state-of-the-art domain adaptation (DA) and generalization (DG) algorithms for both medical segmentation and classification tasks to understand how biases are transferred between different domains. We also introduce a novel plug-and-play fair identity attention (FIA) module that adapts to various DA and DG algorithms to improve fairness by using self-attention to adjust feature importance based on demographic attributes. Additionally, we curate the first fairness-focused dataset with two paired imaging modalities for the same patient cohort on medical segmentation and classification tasks, to rigorously assess fairness in domain-shift scenarios. Excluding the confounding impact of demographic distribution variation between source and target domains will allow clearer quantification of the performance of domain transfer models. Our extensive evaluations reveal that the proposed FIA significantly enhances both model performance accounted for fairness across all domain shift settings (i.e., DA and DG) with respect to different demographics, which outperforms existing methods on both segmentation and classification. The code and data can be accessed at https://ophai.hms.harvard.edu/datasets/harvard-fairdomain20k.

Large language models (LLMs) hold immense promise to serve complex health information needs but also have the potential to introduce harm and exacerbate health disparities. Reliably evaluating equity-related model failures is a critical step toward developing systems that promote health equity. In this work, we present resources and methodologies for surfacing biases with potential to precipitate equity-related harms in long-form, LLM-generated answers to medical questions and then conduct an empirical case study with Med-PaLM 2, resulting in the largest human evaluation study in this area to date. Our contributions include a multifactorial framework for human assessment of LLM-generated answers for biases, and EquityMedQA, a collection of seven newly-released datasets comprising both manually-curated and LLM-generated questions enriched for adversarial queries. Both our human assessment framework and dataset design process are grounded in an iterative participatory approach and review of possible biases in Med-PaLM 2 answers to adversarial queries. Through our empirical study, we find that the use of a collection of datasets curated through a variety of methodologies, coupled with a thorough evaluation protocol that leverages multiple assessment rubric designs and diverse rater groups, surfaces biases that may be missed via narrower evaluation approaches. Our experience underscores the importance of using diverse assessment methodologies and involving raters of varying backgrounds and expertise. We emphasize that while our framework can identify specific forms of bias, it is not sufficient to holistically assess whether the deployment of an AI system promotes equitable health outcomes. We hope the broader community leverages and builds on these tools and methods towards realizing a shared goal of LLMs that promote accessible and equitable healthcare for all.

In recent years, multiple notions of algorithmic fairness have arisen. One such notion is individual fairness (IF), which requires that individuals who are similar receive similar treatment. In parallel, matrix estimation (ME) has emerged as a natural paradigm for handling noisy data with missing values. In this work, we connect the two concepts. We show that pre-processing data using ME can improve an algorithm's IF without sacrificing performance. Specifically, we show that using a popular ME method known as singular value thresholding (SVT) to pre-process the data provides a strong IF guarantee under appropriate conditions. We then show that, under analogous conditions, SVT pre-processing also yields estimates that are consistent and approximately minimax optimal. As such, the ME pre-processing step does not, under the stated conditions, increase the prediction error of the base algorithm, i.e., does not impose a fairness-performance trade-off. We verify these results on synthetic and real data.

Unfair treatment and discrimination are critical ethical concerns in AI systems, particularly as their adoption expands across diverse domains. Addressing these challenges, the recent introduction of the EU AI Act establishes a unified legal framework to ensure legal certainty for AI innovation and investment while safeguarding public interests, such as health, safety, fundamental rights, democracy, and the rule of law (Recital 8). The Act encourages stakeholders to initiate dialogue on existing AI fairness notions to address discriminatory outcomes of AI systems. However, these notions often overlook the critical role of Socio-Economic Status (SES), inadvertently perpetuating biases that favour the economically advantaged. This is concerning, given that principles of equalization advocate for equalizing resources or opportunities to mitigate disadvantages beyond an individual's control. While provisions for discrimination are laid down in the AI Act, specialized directions should be broadened, particularly in addressing economic disparities perpetuated by AI systems. In this work, we explore the limitations of popular AI fairness notions using a real-world dataset (Adult), highlighting their inability to address SES-driven disparities. To fill this gap, we propose a novel fairness notion, Socio-Economic Parity (SEP), which incorporates SES and promotes positive actions for underprivileged groups while accounting for factors within an individual's control, such as working hours, which can serve as a proxy for effort. We define a corresponding fairness measure and optimize a model constrained by SEP to demonstrate practical utility. Our results show the effectiveness of SEP in mitigating SES-driven biases. By analyzing the AI Act alongside our method, we lay a foundation for aligning AI fairness with SES factors while ensuring legal compliance.

Differential privacy (DP) is a key technique for protecting sensitive patient data in medical deep learning (DL). As clinical models grow more data-dependent, balancing privacy with utility and fairness has become a critical challenge. This scoping review synthesizes recent developments in applying DP to medical DL, with a particular focus on DP-SGD and alternative mechanisms across centralized and federated settings. Using a structured search strategy, we identified 74 studies published up to March 2025. Our analysis spans diverse data modalities, training setups, and downstream tasks, and highlights the tradeoffs between privacy guarantees, model accuracy, and subgroup fairness. We find that while DP-especially at strong privacy budgets-can preserve performance in well-structured imaging tasks, severe degradation often occurs under strict privacy, particularly in underrepresented or complex modalities. Furthermore, privacy-induced performance gaps disproportionately affect demographic subgroups, with fairness impacts varying by data type and task. A small subset of studies explicitly addresses these tradeoffs through subgroup analysis or fairness metrics, but most omit them entirely. Beyond DP-SGD, emerging approaches leverage alternative mechanisms, generative models, and hybrid federated designs, though reporting remains inconsistent. We conclude by outlining key gaps in fairness auditing, standardization, and evaluation protocols, offering guidance for future work toward equitable and clinically robust privacy-preserving DL systems in medicine.

While research on applications and evaluations of explanation methods continues to expand, fairness of the explanation methods concerning disparities in their performance across subgroups remains an often overlooked aspect. In this paper, we address this gap by showing that, across three tasks and five language models, widely used post-hoc feature attribution methods exhibit significant gender disparity with respect to their faithfulness, robustness, and complexity. These disparities persist even when the models are pre-trained or fine-tuned on particularly unbiased datasets, indicating that the disparities we observe are not merely consequences of biased training data. Our results highlight the importance of addressing disparities in explanations when developing and applying explainability methods, as these can lead to biased outcomes against certain subgroups, with particularly critical implications in high-stakes contexts. Furthermore, our findings underscore the importance of incorporating the fairness of explanations, alongside overall model fairness and explainability, as a requirement in regulatory frameworks.

Recent failures such as Google Gemini generating people of color in Nazi-era uniforms illustrate how AI outputs can be factually plausible yet socially harmful. AI models are increasingly evaluated for "fairness," yet existing benchmarks often conflate two fundamentally different dimensions: factual correctness and normative fairness. A model may generate responses that are factually accurate but socially unfair, or conversely, appear fair while distorting factual reality. We argue that identifying the boundary between fact and fair is essential for meaningful fairness evaluation. We introduce Fact-or-Fair, a benchmark with (i) objective queries aligned with descriptive, fact-based judgments, and (ii) subjective queries aligned with normative, fairness-based judgments. Our queries are constructed from 19 statistics and are grounded in cognitive psychology, drawing on representativeness bias, attribution bias, and ingroup-outgroup bias to explain why models often misalign fact and fairness. Experiments across ten frontier models reveal different levels of fact-fair trade-offs. By reframing fairness evaluation, we provide both a new theoretical lens and a practical benchmark to advance the responsible model assessments. Our test suite is publicly available at https://github.com/uclanlp/Fact-or-Fair.

Ensuring equitable treatment (fairness) across protected attributes (such as gender or ethnicity) is a critical issue in machine learning. Most existing literature focuses on binary classification, but achieving fairness in regression tasks-such as insurance pricing or hiring score assessments-is equally important. Moreover, anti-discrimination laws also apply to continuous attributes, such as age, for which many existing methods are not applicable. In practice, multiple protected attributes can exist simultaneously; however, methods targeting fairness across several attributes often overlook so-called "fairness gerrymandering", thereby ignoring disparities among intersectional subgroups (e.g., African-American women or Hispanic men). In this paper, we propose a distance covariance regularisation framework that mitigates the association between model predictions and protected attributes, in line with the fairness definition of demographic parity, and that captures both linear and nonlinear dependencies. To enhance applicability in the presence of multiple protected attributes, we extend our framework by incorporating two multivariate dependence measures based on distance covariance: the previously proposed joint distance covariance (JdCov) and our novel concatenated distance covariance (CCdCov), which effectively address fairness gerrymandering in both regression and classification tasks involving protected attributes of various types. We discuss and illustrate how to calibrate regularisation strength, including a method based on Jensen-Shannon divergence, which quantifies dissimilarities in prediction distributions across groups. We apply our framework to the COMPAS recidivism dataset and a large motor insurance claims dataset.

This paper investigates algorithmic bias in language-based models for automated depression detection, focusing on socio-demographic disparities related to gender and race/ethnicity. Models trained using deep neural networks (DNN) based embeddings are compared to few-shot learning approaches with large language models (LLMs), evaluating both performance and fairness on clinical interview transcripts from the Distress Analysis Interview Corpus/Wizard-of-Oz (DAIC-WOZ). To mitigate bias, fairness-aware loss functions are applied to DNN-based models, while in-context learning with varied prompt framing and shot counts is explored for LLMs. Results indicate that LLMs outperform DNN-based models in depression classification, particularly for underrepresented groups such as Hispanic participants. LLMs also exhibit reduced gender bias compared to DNN-based embeddings, though racial disparities persist. Among fairness-aware techniques for mitigating bias in DNN-based embeddings, the worst-group loss, which is designed to minimize loss for the worst-performing demographic group, achieves a better balance between performance and fairness. In contrast, the fairness-regularized loss minimizes loss across all groups but performs less effectively. In LLMs, guided prompting with ethical framing helps mitigate gender bias in the 1-shot setting. However, increasing the number of shots does not lead to further reductions in disparities. For race/ethnicity, neither prompting strategy nor increasing N in N-shot learning effectively reduces disparities.

Algorithmic decision-making has become deeply ingrained in many domains, yet biases in machine learning models can still produce discriminatory outcomes, often harming unprivileged groups. Achieving fair classification is inherently challenging, requiring a careful balance between predictive performance and ethical considerations. We present FairTTTS, a novel post-processing bias mitigation method inspired by the Tree Test Time Simulation (TTTS) method. Originally developed to enhance accuracy and robustness against adversarial inputs through probabilistic decision-path adjustments, TTTS serves as the foundation for FairTTTS. By building on this accuracy-enhancing technique, FairTTTS mitigates bias and improves predictive performance. FairTTTS uses a distance-based heuristic to adjust decisions at protected attribute nodes, ensuring fairness for unprivileged samples. This fairness-oriented adjustment occurs as a post-processing step, allowing FairTTTS to be applied to pre-trained models, diverse datasets, and various fairness metrics without retraining. Extensive evaluation on seven benchmark datasets shows that FairTTTS outperforms traditional methods in fairness improvement, achieving a 20.96% average increase over the baseline compared to 18.78% for related work, and further enhances accuracy by 0.55%. In contrast, competing methods typically reduce accuracy by 0.42%. These results confirm that FairTTTS effectively promotes more equitable decision-making while simultaneously improving predictive performance.

Fair machine learning seeks to identify and mitigate biases in predictions against unfavorable populations characterized by demographic attributes, such as race and gender. Recently, a few works have extended fairness to graph data, such as social networks, but most of them neglect the causal relationships among data instances. This paper addresses the prevalent challenge in fairness-aware ML algorithms, which typically assume Independent and Identically Distributed (IID) data. We tackle the overlooked domain of non-IID, graph-based settings where data instances are interconnected, influencing the outcomes of fairness interventions. We base our research on the Network Structural Causal Model (NSCM) framework and posit two main assumptions: Decomposability and Graph Independence, which enable the computation of interventional distributions in non-IID settings using the do-calculus. Based on that, we develop the Message Passing Variational Autoencoder for Causal Inference (MPVA) to compute interventional distributions and facilitate causally fair node classification through estimated interventional distributions. Empirical evaluations on semi-synthetic and real-world datasets demonstrate that MPVA outperforms conventional methods by effectively approximating interventional distributions and mitigating bias. The implications of our findings underscore the potential of causality-based fairness in complex ML applications, setting the stage for further research into relaxing the initial assumptions to enhance model fairness.

Unfairness in mortgage lending has created generational inequality among racial and ethnic groups in the US. Many studies address this problem, but most existing work focuses on correlation-based techniques. In our work, we use the framework of counterfactual fairness to train fair machine learning models. We propose a new causal graph for the variables available in the Home Mortgage Disclosure Act (HMDA) data. We use a matching-based approach instead of the latent variable modeling approach, because the former approach does not rely on any modeling assumptions. Furthermore, matching provides us with counterfactual pairs in which the race variable is isolated. We first demonstrate the unfairness in mortgage approval and interest rates between African-American and non-Hispanic White sub-populations. Then, we show that having balanced data using matching does not guarantee perfect counterfactual fairness of the machine learning models.

The popularity of machine learning has increased the risk of unfair models getting deployed in high-stake applications, such as justice system, drug/vaccination design, and medical diagnosis. Although there are effective methods to train fair models from scratch, how to automatically reveal and explain the unfairness of a trained model remains a challenging task. Revealing unfairness of machine learning models in interpretable fashion is a critical step towards fair and trustworthy AI. In this paper, we systematically tackle the novel task of revealing unfair models by mining interpretable evidence (RUMIE). The key idea is to find solid evidence in the form of a group of data instances discriminated most by the model. To make the evidence interpretable, we also find a set of human-understandable key attributes and decision rules that characterize the discriminated data instances and distinguish them from the other non-discriminated data. As demonstrated by extensive experiments on many real-world data sets, our method finds highly interpretable and solid evidence to effectively reveal the unfairness of trained models. Moreover, it is much more scalable than all of the baseline methods.

Artificial intelligence is revealing what medicine never intended to encode. Deep vision models, trained on chest X-rays, can now detect not only disease but also invisible traces of social inequality. In this study, we show that state-of-the-art architectures (DenseNet121, SwinV2-B, MedMamba) can predict a patient's health insurance type, a strong proxy for socioeconomic status, from normal chest X-rays with significant accuracy (AUC around 0.70 on MIMIC-CXR-JPG, 0.68 on CheXpert). The signal was unlikely contributed by demographic features by our machine learning study combining age, race, and sex labels to predict health insurance types; it also remains detectable when the model is trained exclusively on a single racial group. Patch-based occlusion reveals that the signal is diffuse rather than localized, embedded in the upper and mid-thoracic regions. This suggests that deep networks may be internalizing subtle traces of clinical environments, equipment differences, or care pathways; learning socioeconomic segregation itself. These findings challenge the assumption that medical images are neutral biological data. By uncovering how models perceive and exploit these hidden social signatures, this work reframes fairness in medical AI: the goal is no longer only to balance datasets or adjust thresholds, but to interrogate and disentangle the social fingerprints embedded in clinical data itself.

This thesis explores open-sourced machine learning (ML) model explanation tools to understand whether these tools can allow a layman to visualize, understand, and suggest intuitive remedies to unfairness in ML-based decision-support systems. Machine learning models trained on datasets biased against minority groups are increasingly used to guide life-altering social decisions, prompting the urgent need to study their logic for unfairness. Due to this problem's impact on vast populations of the general public, it is critical for the layperson -- not just subject matter experts in social justice or machine learning experts -- to understand the nature of unfairness within these algorithms and the potential trade-offs. Existing research on fairness in machine learning focuses mostly on the mathematical definitions and tools to understand and remedy unfair models, with some directly citing user-interactive tools as necessary for future work. This thesis presents FairLay-ML, a proof-of-concept GUI integrating some of the most promising tools to provide intuitive explanations for unfair logic in ML models by integrating existing research tools (e.g. Local Interpretable Model-Agnostic Explanations) with existing ML-focused GUI (e.g. Python Streamlit). We test FairLay-ML using models of various accuracy and fairness generated by an unfairness detector tool, Parfait-ML, and validate our results using Themis. Our study finds that the technology stack used for FairLay-ML makes it easy to install and provides real-time black-box explanations of pre-trained models to users. Furthermore, the explanations provided translate to actionable remedies.

Fairness in image restoration tasks is the desire to treat different sub-groups of images equally well. Existing definitions of fairness in image restoration are highly restrictive. They consider a reconstruction to be a correct outcome for a group (e.g., women) only if it falls within the group's set of ground truth images (e.g., natural images of women); otherwise, it is considered entirely incorrect. Consequently, such definitions are prone to controversy, as errors in image restoration can manifest in various ways. In this work we offer an alternative approach towards fairness in image restoration, by considering the Group Perceptual Index (GPI), which we define as the statistical distance between the distribution of the group's ground truth images and the distribution of their reconstructions. We assess the fairness of an algorithm by comparing the GPI of different groups, and say that it achieves perfect Perceptual Fairness (PF) if the GPIs of all groups are identical. We motivate and theoretically study our new notion of fairness, draw its connection to previous ones, and demonstrate its utility on state-of-the-art face image super-resolution algorithms.

Synthetic data generation offers a promising solution to enhance the usefulness of Electronic Healthcare Records (EHR) by generating realistic de-identified data. However, the existing literature primarily focuses on the quality of synthetic health data, neglecting the crucial aspect of fairness in downstream predictions. Consequently, models trained on synthetic EHR have faced criticism for producing biased outcomes in target tasks. These biases can arise from either spurious correlations between features or the failure of models to accurately represent sub-groups. To address these concerns, we present Bias-transforming Generative Adversarial Networks (Bt-GAN), a GAN-based synthetic data generator specifically designed for the healthcare domain. In order to tackle spurious correlations (i), we propose an information-constrained Data Generation Process that enables the generator to learn a fair deterministic transformation based on a well-defined notion of algorithmic fairness. To overcome the challenge of capturing exact sub-group representations (ii), we incentivize the generator to preserve sub-group densities through score-based weighted sampling. This approach compels the generator to learn from underrepresented regions of the data manifold. We conduct extensive experiments using the MIMIC-III database. Our results demonstrate that Bt-GAN achieves SOTA accuracy while significantly improving fairness and minimizing bias amplification. We also perform an in-depth explainability analysis to provide additional evidence supporting the validity of our study. In conclusion, our research introduces a novel and professional approach to addressing the limitations of synthetic data generation in the healthcare domain. By incorporating fairness considerations and leveraging advanced techniques such as GANs, we pave the way for more reliable and unbiased predictions in healthcare applications.

Magnetic resonance imaging (MRI) is the gold standard for brain imaging. Deep learning (DL) algorithms have been proposed to aid in the diagnosis of diseases such as Alzheimer's disease (AD) from MRI scans. However, DL algorithms can suffer from shortcut learning, in which spurious features, not directly related to the output label, are used for prediction. When these features are related to protected attributes, they can lead to performance bias against underrepresented protected groups, such as those defined by race and sex. In this work, we explore the potential for shortcut learning and demographic bias in DL based AD diagnosis from MRI. We first investigate if DL algorithms can identify race or sex from 3D brain MRI scans to establish the presence or otherwise of race and sex based distributional shifts. Next, we investigate whether training set imbalance by race or sex can cause a drop in model performance, indicating shortcut learning and bias. Finally, we conduct a quantitative and qualitative analysis of feature attributions in different brain regions for both the protected attribute and AD classification tasks. Through these experiments, and using multiple datasets and DL models (ResNet and SwinTransformer), we demonstrate the existence of both race and sex based shortcut learning and bias in DL based AD classification. Our work lays the foundation for fairer DL diagnostic tools in brain MRI. The code is provided at https://github.com/acharaakshit/ShortMR

State-of-the-art question answering (QA) models exhibit a variety of social biases (e.g., with respect to sex or race), generally explained by similar issues in their training data. However, what has been overlooked so far is that in the critical domain of biomedicine, any unjustified change in model output due to patient demographics is problematic: it results in the unfair treatment of patients. Selecting only questions on biomedical topics whose answers do not depend on ethnicity, sex, or sexual orientation, we ask the following research questions: (RQ1) Do the answers of QA models change when being provided with irrelevant demographic information? (RQ2) Does the answer of RQ1 differ between knowledge graph (KG)-grounded and text-based QA systems? We find that irrelevant demographic information change up to 15% of the answers of a KG-grounded system and up to 23% of the answers of a text-based system, including changes that affect accuracy. We conclude that unjustified answer changes caused by patient demographics are a frequent phenomenon, which raises fairness concerns and should be paid more attention to.

This paper introduces the Fair Fairness Benchmark (FFB), a benchmarking framework for in-processing group fairness methods. Ensuring fairness in machine learning is critical for ethical and legal compliance. However, there exist challenges in comparing and developing of fairness methods due to inconsistencies in experimental settings, lack of accessible algorithmic implementations, and limited extensibility of current fairness packages and tools. To address these issues, we introduce an open-source, standardized benchmark for evaluating in-processing group fairness methods and provide a comprehensive analysis of state-of-the-art methods to ensure different notions of group fairness. This work offers the following key contributions: the provision of flexible, extensible, minimalistic, and research-oriented open-source code; the establishment of unified fairness method benchmarking pipelines; and extensive benchmarking, which yields key insights from 45,079 experiments. We believe our work will significantly facilitate the growth and development of the fairness research community. The benchmark, including code and running logs, is available at https://github.com/ahxt/fair_fairness_benchmark

Addressing fairness in lesion classification from dermatological images is crucial due to variations in how skin diseases manifest across skin tones. However, the absence of skin tone labels in public datasets hinders building a fair classifier. To date, such skin tone labels have been estimated prior to fairness analysis in independent studies using the Individual Typology Angle (ITA). Briefly, ITA calculates an angle based on pixels extracted from skin images taking into account the lightness and yellow-blue tints. These angles are then categorised into skin tones that are subsequently used to analyse fairness in skin cancer classification. In this work, we review and compare four ITA-based approaches of skin tone classification on the ISIC18 dataset, a common benchmark for assessing skin cancer classification fairness in the literature. Our analyses reveal a high disagreement among previously published studies demonstrating the risks of ITA-based skin tone estimation methods. Moreover, we investigate the causes of such large discrepancy among these approaches and find that the lack of diversity in the ISIC18 dataset limits its use as a testbed for fairness analysis. Finally, we recommend further research on robust ITA estimation and diverse dataset acquisition with skin tone annotation to facilitate conclusive fairness assessments of artificial intelligence tools in dermatology. Our code is available at https://github.com/tkalbl/RevisitingSkinToneFairness.

We introduce Metric-Fair Prompting, a fairness-aware prompting framework that guides large language models (LLMs) to make decisions under metric-fairness constraints. In the application of multiple-choice medical question answering, each {(question, option)} pair is treated as a binary instance with label +1 (correct) or -1 (incorrect). To promote {individual fairness}~--~treating similar instances similarly~--~we compute question similarity using NLP embeddings and solve items in joint pairs of similar questions rather than in isolation. The prompt enforces a global decision protocol: extract decisive clinical features, map each \((question, option)\) to a score f(x) that acts as confidence, and impose a Lipschitz-style constraint so that similar inputs receive similar scores and, hence, consistent outputs. Evaluated on the {MedQA (US)} benchmark, Metric-Fair Prompting is shown to improve performance over standard single-item prompting, demonstrating that fairness-guided, confidence-oriented reasoning can enhance LLM accuracy on high-stakes clinical multiple-choice questions.

Ensuring equitable Artificial Intelligence (AI) in healthcare demands systems that make unbiased decisions across all demographic groups, bridging technical innovation with ethical principles. Foundation Models (FMs), trained on vast datasets through self-supervised learning, enable efficient adaptation across medical imaging tasks while reducing dependency on labeled data. These models demonstrate potential for enhancing fairness, though significant challenges remain in achieving consistent performance across demographic groups. Our review indicates that effective bias mitigation in FMs requires systematic interventions throughout all stages of development. While previous approaches focused primarily on model-level bias mitigation, our analysis reveals that fairness in FMs requires integrated interventions throughout the development pipeline, from data documentation to deployment protocols. This comprehensive framework advances current knowledge by demonstrating how systematic bias mitigation, combined with policy engagement, can effectively address both technical and institutional barriers to equitable AI in healthcare. The development of equitable FMs represents a critical step toward democratizing advanced healthcare technologies, particularly for underserved populations and regions with limited medical infrastructure and computational resources.

Current tools for machine learning fairness only admit a limited range of fairness definitions and have seen little integration with automatic differentiation libraries, despite the central role these libraries play in modern machine learning pipelines. We introduce a framework of fairness regularization terms (fairrets) which quantify bias as modular objectives that are easily integrated in automatic differentiation pipelines. By employing a general definition of fairness in terms of linear-fractional statistics, a wide class of fairrets can be computed efficiently. Experiments show the behavior of their gradients and their utility in enforcing fairness with minimal loss of predictive power compared to baselines. Our contribution includes a PyTorch implementation of the fairret framework.

Urban assessments often compress diverse needs into single scores, which can obscure minority perspectives. We present a community-centered study in Montreal (n=35; wheelchair users, seniors, LGBTQIA2+ residents, and immigrants). Participants rated 20 streets (accessibility, inclusivity, aesthetics, practicality) and ranked 7 images on 12 interview-elicited criteria. Disagreement patterns were systematic in our sample: wheelchair users diverged most on accessibility and practicality; LGBTQIA2+ participants emphasized inclusion and liveliness; seniors prioritized security. Group discussion reduced information gaps but not value conflicts; ratings conveyed intensity, while rankings forced trade-offs. We then formalize negotiative alignment, a transparent, budget-aware bargaining procedure, and pilot it with role-played stakeholder agents plus a neutral mediator. Relative to the best base design under the same public rubric, the negotiated package increased total utility (21.10 to 24.55), raised the worst-group utility (3.20 to 3.90), improved twentieth percentile satisfaction (0.86 to 1.00; min-max normalized within the scenario), and reduced inequality (Gini 0.036 to 0.025). Treating disagreement as signal and reporting worst-group outcomes alongside totals may help planners and AI practitioners surface trade-offs and preserve minority priorities while maintaining efficiency.

Large Language Models (LLMs) are increasingly used for toxicity assessment in online moderation systems, where fairness across demographic groups is essential for equitable treatment. However, LLMs often produce inconsistent toxicity judgements for subtle expressions, particularly those involving implicit hate speech, revealing underlying biases that are difficult to correct through standard training. This raises a key question that existing approaches often overlook: when should corrective mechanisms be invoked to ensure fair and reliable assessments? To address this, we propose FairToT, an inference-time framework that enhances LLM fairness through prompt-guided toxicity assessment. FairToT identifies cases where demographic-related variation is likely to occur and determines when additional assessment should be applied. In addition, we introduce two interpretable fairness indicators that detect such cases and improve inference consistency without modifying model parameters. Experiments on benchmark datasets show that FairToT reduces group-level disparities while maintaining stable and reliable toxicity predictions, demonstrating that inference-time refinement offers an effective and practical approach for fairness improvement in LLM-based toxicity assessment systems. The source code can be found at https://aisuko.github.io/fair-tot/.

The growing importance of understanding and addressing algorithmic bias in artificial intelligence (AI) has led to a surge in research on AI fairness, which often assumes that the underlying data is independent and identically distributed (IID). However, real-world data frequently exists in non-IID graph structures that capture connections among individual units. To effectively mitigate bias in AI systems, it is essential to bridge the gap between traditional fairness literature, designed for IID data, and the prevalence of non-IID graph data. This survey reviews recent advancements in fairness amidst non-IID graph data, including the newly introduced fair graph generation and the commonly studied fair graph classification. In addition, available datasets and evaluation metrics for future research are identified, the limitations of existing work are highlighted, and promising future directions are proposed.

Recognizing the prevalence of domain shift as a common challenge in machine learning, various domain generalization (DG) techniques have been developed to enhance the performance of machine learning systems when dealing with out-of-distribution (OOD) data. Furthermore, in real-world scenarios, data distributions can gradually change across a sequence of sequential domains. While current methodologies primarily focus on improving model effectiveness within these new domains, they often overlook fairness issues throughout the learning process. In response, we introduce an innovative framework called Counterfactual Fairness-Aware Domain Generalization with Sequential Autoencoder (CDSAE). This approach effectively separates environmental information and sensitive attributes from the embedded representation of classification features. This concurrent separation not only greatly improves model generalization across diverse and unfamiliar domains but also effectively addresses challenges related to unfair classification. Our strategy is rooted in the principles of causal inference to tackle these dual issues. To examine the intricate relationship between semantic information, sensitive attributes, and environmental cues, we systematically categorize exogenous uncertainty factors into four latent variables: 1) semantic information influenced by sensitive attributes, 2) semantic information unaffected by sensitive attributes, 3) environmental cues influenced by sensitive attributes, and 4) environmental cues unaffected by sensitive attributes. By incorporating fairness regularization, we exclusively employ semantic information for classification purposes. Empirical validation on synthetic and real-world datasets substantiates the effectiveness of our approach, demonstrating improved accuracy levels while ensuring the preservation of fairness in the evolving landscape of continuous domains.

While deep learning based approaches have demonstrated expert-level performance in dermatological diagnosis tasks, they have also been shown to exhibit biases toward certain demographic attributes, particularly skin types (e.g., light versus dark), a fairness concern that must be addressed. We propose CIRCLe, a skin color invariant deep representation learning method for improving fairness in skin lesion classification. CIRCLe is trained to classify images by utilizing a regularization loss that encourages images with the same diagnosis but different skin types to have similar latent representations. Through extensive evaluation and ablation studies, we demonstrate CIRCLe's superior performance over the state-of-the-art when evaluated on 16k+ images spanning 6 Fitzpatrick skin types and 114 diseases, using classification accuracy, equal opportunity difference (for light versus dark groups), and normalized accuracy range, a new measure we propose to assess fairness on multiple skin type groups.

In domains ranging from computer vision to natural language processing, machine learning models have been shown to exhibit stark disparities, often performing worse for members of traditionally underserved groups. One factor contributing to these performance gaps is a lack of representation in the data the models are trained on. It is often unclear, however, how to operationalize representativeness in specific applications. Here we formalize the problem of creating equitable training datasets, and propose a statistical framework for addressing this problem. We consider a setting where a model builder must decide how to allocate a fixed data collection budget to gather training data from different subgroups. We then frame dataset creation as a constrained optimization problem, in which one maximizes a function of group-specific performance metrics based on (estimated) group-specific learning rates and costs per sample. This flexible approach incorporates preferences of model-builders and other stakeholders, as well as the statistical properties of the learning task. When data collection decisions are made sequentially, we show that under certain conditions this optimization problem can be efficiently solved even without prior knowledge of the learning rates. To illustrate our approach, we conduct a simulation study of polygenic risk scores on synthetic genomic data -- an application domain that often suffers from non-representative data collection. We find that our adaptive sampling strategy outperforms several common data collection heuristics, including equal and proportional sampling, demonstrating the value of strategic dataset design for building equitable models.

In the field of algorithmic fairness, significant attention has been put on group fairness criteria, such as Demographic Parity and Equalized Odds. Nevertheless, these objectives, measured as global averages, have raised concerns about persistent local disparities between sensitive groups. In this work, we address the problem of local fairness, which ensures that the predictor is unbiased not only in terms of expectations over the whole population, but also within any subregion of the feature space, unknown at training time. To enforce this objective, we introduce ROAD, a novel approach that leverages the Distributionally Robust Optimization (DRO) framework within a fair adversarial learning objective, where an adversary tries to infer the sensitive attribute from the predictions. Using an instance-level re-weighting strategy, ROAD is designed to prioritize inputs that are likely to be locally unfair, i.e. where the adversary faces the least difficulty in reconstructing the sensitive attribute. Numerical experiments demonstrate the effectiveness of our method: it achieves Pareto dominance with respect to local fairness and accuracy for a given global fairness level across three standard datasets, and also enhances fairness generalization under distribution shift.

Developing models with robust group fairness properties is paramount, particularly in ethically sensitive domains such as medical diagnosis. Recent approaches to achieving fairness in machine learning require a substantial amount of training data and depend on model retraining, which may not be practical in real-world scenarios. To mitigate these challenges, we propose Bias-based Weight Masking Fine-Tuning (BMFT), a novel post-processing method that enhances the fairness of a trained model in significantly fewer epochs without requiring access to the original training data. BMFT produces a mask over model parameters, which efficiently identifies the weights contributing the most towards biased predictions. Furthermore, we propose a two-step debiasing strategy, wherein the feature extractor undergoes initial fine-tuning on the identified bias-influenced weights, succeeded by a fine-tuning phase on a reinitialised classification layer to uphold discriminative performance. Extensive experiments across four dermatological datasets and two sensitive attributes demonstrate that BMFT outperforms existing state-of-the-art (SOTA) techniques in both diagnostic accuracy and fairness metrics. Our findings underscore the efficacy and robustness of BMFT in advancing fairness across various out-of-distribution (OOD) settings. Our code is available at: https://github.com/vios-s/BMFT

Fairness in recommender systems (RSs) is commonly categorised into group fairness and individual fairness. However, there is no established scientific understanding of the relationship between the two fairness types, as prior work on both types has used different evaluation measures or evaluation objectives for each fairness type, thereby not allowing for a proper comparison of the two. As a result, it is currently not known how increasing one type of fairness may affect the other. To fill this gap, we study the relationship of group and individual fairness through a comprehensive comparison of evaluation measures that can be used for both fairness types. Our experiments with 8 runs across 3 datasets show that recommendations that are highly fair for groups can be very unfair for individuals. Our finding is novel and useful for RS practitioners aiming to improve the fairness of their systems. Our code is available at: https://github.com/theresiavr/stairway-to-fairness.

Computer vision models have known performance disparities across attributes such as gender and skin tone. This means during tasks such as classification and detection, model performance differs for certain classes based on the demographics of the people in the image. These disparities have been shown to exist, but until now there has not been a unified approach to measure these differences for common use-cases of computer vision models. We present a new benchmark named FACET (FAirness in Computer Vision EvaluaTion), a large, publicly available evaluation set of 32k images for some of the most common vision tasks - image classification, object detection and segmentation. For every image in FACET, we hired expert reviewers to manually annotate person-related attributes such as perceived skin tone and hair type, manually draw bounding boxes and label fine-grained person-related classes such as disk jockey or guitarist. In addition, we use FACET to benchmark state-of-the-art vision models and present a deeper understanding of potential performance disparities and challenges across sensitive demographic attributes. With the exhaustive annotations collected, we probe models using single demographics attributes as well as multiple attributes using an intersectional approach (e.g. hair color and perceived skin tone). Our results show that classification, detection, segmentation, and visual grounding models exhibit performance disparities across demographic attributes and intersections of attributes. These harms suggest that not all people represented in datasets receive fair and equitable treatment in these vision tasks. We hope current and future results using our benchmark will contribute to fairer, more robust vision models. FACET is available publicly at https://facet.metademolab.com/

Unintended bias in Machine Learning can manifest as systemic differences in performance for different demographic groups, potentially compounding existing challenges to fairness in society at large. In this paper, we introduce a suite of threshold-agnostic metrics that provide a nuanced view of this unintended bias, by considering the various ways that a classifier's score distribution can vary across designated groups. We also introduce a large new test set of online comments with crowd-sourced annotations for identity references. We use this to show how our metrics can be used to find new and potentially subtle unintended bias in existing public models.

Speech models may be affected by performance imbalance in different population subgroups, raising concerns about fair treatment across these groups. Prior attempts to mitigate unfairness either focus on user-defined subgroups, potentially overlooking other affected subgroups, or do not explicitly improve the internal representation at the subgroup level. This paper proposes the first adoption of contrastive learning to mitigate speech model bias in underperforming subgroups. We employ a three-level learning technique that guides the model in focusing on different scopes for the contrastive loss, i.e., task, subgroup, and the errors within subgroups. The experiments on two spoken language understanding datasets and two languages demonstrate that our approach improves internal subgroup representations, thus reducing model bias and enhancing performance.

Skin diseases affect millions of people worldwide, across all ethnicities. Increasing diagnosis accessibility requires fair and accurate segmentation and classification of dermatology images. However, the scarcity of annotated medical images, especially for rare diseases and underrepresented skin tones, poses a challenge to the development of fair and accurate models. In this study, we introduce a Fair, Efficient, and Diverse Diffusion-based framework for skin lesion segmentation and malignancy classification. FEDD leverages semantically meaningful feature embeddings learned through a denoising diffusion probabilistic backbone and processes them via linear probes to achieve state-of-the-art performance on Diverse Dermatology Images (DDI). We achieve an improvement in intersection over union of 0.18, 0.13, 0.06, and 0.07 while using only 5%, 10%, 15%, and 20% labeled samples, respectively. Additionally, FEDD trained on 10% of DDI demonstrates malignancy classification accuracy of 81%, 14% higher compared to the state-of-the-art. We showcase high efficiency in data-constrained scenarios while providing fair performance for diverse skin tones and rare malignancy conditions. Our newly annotated DDI segmentation masks and training code can be found on https://github.com/hectorcarrion/fedd.

This paper uses the MIMIC-IV dataset to examine the fairness and bias in an XGBoost binary classification model predicting the Intensive Care Unit (ICU) length of stay (LOS). Highlighting the critical role of the ICU in managing critically ill patients, the study addresses the growing strain on ICU capacity. It emphasizes the significance of LOS prediction for resource allocation. The research reveals class imbalances in the dataset across demographic attributes and employs data preprocessing and feature extraction. While the XGBoost model performs well overall, disparities across race and insurance attributes reflect the need for tailored assessments and continuous monitoring. The paper concludes with recommendations for fairness-aware machine learning techniques for mitigating biases and the need for collaborative efforts among healthcare professionals and data scientists.

Background: Health datasets from clinical sources do not reflect the breadth and diversity of disease in the real world, impacting research, medical education, and artificial intelligence (AI) tool development. Dermatology is a suitable area to develop and test a new and scalable method to create representative health datasets. Methods: We used Google Search advertisements to invite contributions to an open access dataset of images of dermatology conditions, demographic and symptom information. With informed contributor consent, we describe and release this dataset containing 10,408 images from 5,033 contributions from internet users in the United States over 8 months starting March 2023. The dataset includes dermatologist condition labels as well as estimated Fitzpatrick Skin Type (eFST) and Monk Skin Tone (eMST) labels for the images. Results: We received a median of 22 submissions/day (IQR 14-30). Female (66.72%) and younger (52% < age 40) contributors had a higher representation in the dataset compared to the US population, and 32.6% of contributors reported a non-White racial or ethnic identity. Over 97.5% of contributions were genuine images of skin conditions. Dermatologist confidence in assigning a differential diagnosis increased with the number of available variables, and showed a weaker correlation with image sharpness (Spearman's P values <0.001 and 0.01 respectively). Most contributions were short-duration (54% with onset < 7 days ago ) and 89% were allergic, infectious, or inflammatory conditions. eFST and eMST distributions reflected the geographical origin of the dataset. The dataset is available at github.com/google-research-datasets/scin . Conclusion: Search ads are effective at crowdsourcing images of health conditions. The SCIN dataset bridges important gaps in the availability of representative images of common skin conditions.

The acceleration in the adoption of AI-based automated decision-making systems poses a challenge for evaluating the fairness of algorithmic decisions, especially in the absence of ground truth. When designing interventions, uplift modeling is used extensively to identify candidates that are likely to benefit from treatment. However, these models remain particularly susceptible to fairness evaluation due to the lack of ground truth on the outcome measure since a candidate cannot be in both treatment and control simultaneously. In this article, we propose a framework that overcomes the missing ground truth problem by generating surrogates to serve as a proxy for counterfactual labels of uplift modeling campaigns. We then leverage the surrogate ground truth to conduct a more comprehensive binary fairness evaluation. We show how to apply the approach in a comprehensive study from a real-world marketing campaign for promotional offers and demonstrate its enhancement for fairness evaluation.

It has recently been shown that deep learning models for anatomical segmentation in medical images can exhibit biases against certain sub-populations defined in terms of protected attributes like sex or ethnicity. In this context, auditing fairness of deep segmentation models becomes crucial. However, such audit process generally requires access to ground-truth segmentation masks for the target population, which may not always be available, especially when going from development to deployment. Here we propose a new method to anticipate model biases in biomedical image segmentation in the absence of ground-truth annotations. Our unsupervised bias discovery method leverages the reverse classification accuracy framework to estimate segmentation quality. Through numerical experiments in synthetic and realistic scenarios we show how our method is able to successfully anticipate fairness issues in the absence of ground-truth labels, constituting a novel and valuable tool in this field.

The Fair Graph Anomaly Detection (FairGAD) problem aims to accurately detect anomalous nodes in an input graph while ensuring fairness and avoiding biased predictions against individuals from sensitive subgroups such as gender or political leanings. Fairness in graphs is particularly crucial in anomaly detection areas such as misinformation detection in search/ranking systems, where decision outcomes can significantly affect individuals. However, the current literature does not comprehensively discuss this problem, nor does it provide realistic datasets that encompass actual graph structures, anomaly labels, and sensitive attributes for research in FairGAD. To bridge this gap, we introduce a formal definition of the FairGAD problem and present two novel graph datasets constructed from the globally prominent social media platforms Reddit and Twitter. These datasets comprise 1.2 million and 400,000 edges associated with 9,000 and 47,000 nodes, respectively, and leverage political leanings as sensitive attributes and misinformation spreaders as anomaly labels. We demonstrate that our FairGAD datasets significantly differ from the synthetic datasets used currently by the research community. These new datasets offer significant values for FairGAD by providing realistic data that captures the intricacies of social networks. Using our datasets, we investigate the performance-fairness trade-off in eleven existing GAD and non-graph AD methods on five state-of-the-art fairness methods, which sheds light on their effectiveness and limitations in addressing the FairGAD problem.

Graph anomaly detection (GAD) has become an increasingly important task across various domains. With the rapid development of graph neural networks (GNNs), GAD methods have achieved significant performance improvements. However, fairness considerations in GAD remain largely underexplored. Indeed, GNN-based GAD models can inherit and amplify biases present in training data, potentially leading to unfair outcomes. While existing efforts have focused on developing fair GNNs, most approaches target node classification tasks, where models often rely on simple layer architectures rather than autoencoder-based structures, which are the most widely used architecturs for anomaly detection. To address fairness in autoencoder-based GAD models, we propose DisEntangled Counterfactual Adversarial Fair (DECAF)-GAD, a framework that alleviates bias while preserving GAD performance. Specifically, we introduce a structural causal model (SCM) to disentangle sensitive attributes from learned representations. Based on this causal framework, we formulate a specialized autoencoder architecture along with a fairness-guided loss function. Through extensive experiments on both synthetic and real-world datasets, we demonstrate that DECAF-GAD not only achieves competitive anomaly detection performance but also significantly enhances fairness metrics compared to baseline GAD methods. Our code is available at https://github.com/Tlhey/decaf_code.

Organizations cannot address demographic disparities that they cannot see. Recent research on machine learning and fairness has emphasized that awareness of sensitive attributes, such as race and sex, is critical to the development of interventions. However, on the ground, the existence of these data cannot be taken for granted. This paper uses the domains of employment, credit, and healthcare in the United States to surface conditions that have shaped the availability of sensitive attribute data. For each domain, we describe how and when private companies collect or infer sensitive attribute data for antidiscrimination purposes. An inconsistent story emerges: Some companies are required by law to collect sensitive attribute data, while others are prohibited from doing so. Still others, in the absence of legal mandates, have determined that collection and imputation of these data are appropriate to address disparities. This story has important implications for fairness research and its future applications. If companies that mediate access to life opportunities are unable or hesitant to collect or infer sensitive attribute data, then proposed techniques to detect and mitigate bias in machine learning models might never be implemented outside the lab. We conclude that today's legal requirements and corporate practices, while highly inconsistent across domains, offer lessons for how to approach the collection and inference of sensitive data in appropriate circumstances. We urge stakeholders, including machine learning practitioners, to actively help chart a path forward that takes both policy goals and technical needs into account.

Debiasing methods in NLP models traditionally focus on isolating information related to a sensitive attribute (e.g., gender or race). We instead argue that a favorable debiasing method should use sensitive information 'fairly,' with explanations, rather than blindly eliminating it. This fair balance is often subjective and can be challenging to achieve algorithmically. We explore two interactive setups with a frozen predictive model and show that users able to provide feedback can achieve a better and fairer balance between task performance and bias mitigation. In one setup, users, by interacting with test examples, further decreased bias in the explanations (5-8%) while maintaining the same prediction accuracy. In the other setup, human feedback was able to disentangle associated bias and predictive information from the input leading to superior bias mitigation and improved task performance (4-5%) simultaneously.

Speech patterns have been identified as potential diagnostic markers for neuropsychiatric conditions. However, most studies only compare a single clinical group to healthy controls, whereas clinical practice often requires differentiating between multiple potential diagnoses (multiclass settings). To address this, we assembled a dataset of repeated recordings from 420 participants (67 with major depressive disorder, 106 with schizophrenia and 46 with autism, as well as matched controls), and tested the performance of a range of conventional machine learning models and advanced Transformer models on both binary and multiclass classification, based on voice and text features. While binary models performed comparably to previous research (F1 scores between 0.54-0.75 for autism spectrum disorder, ASD; 0.67-0.92 for major depressive disorder, MDD; and 0.71-0.83 for schizophrenia); when differentiating between multiple diagnostic groups performance decreased markedly (F1 scores between 0.35-0.44 for ASD, 0.57-0.75 for MDD, 0.15-0.66 for schizophrenia, and 0.38-0.52 macro F1). Combining voice and text-based models yielded increased performance, suggesting that they capture complementary diagnostic information. Our results indicate that models trained on binary classification may learn to rely on markers of generic differences between clinical and non-clinical populations, or markers of clinical features that overlap across conditions, rather than identifying markers specific to individual conditions. We provide recommendations for future research in the field, suggesting increased focus on developing larger transdiagnostic datasets that include more fine-grained clinical features, and that can support the development of models that better capture the complexity of neuropsychiatric conditions and naturalistic diagnostic assessment.

Fairness has been a critical issue that affects the adoption of deep learning models in real practice. To improve model fairness, many existing methods have been proposed and evaluated to be effective in their own contexts. However, there is still no systematic evaluation among them for a comprehensive comparison under the same context, which makes it hard to understand the performance distinction among them, hindering the research progress and practical adoption of them. To fill this gap, this paper endeavours to conduct the first large-scale empirical study to comprehensively compare the performance of existing state-of-the-art fairness improving techniques. Specifically, we target the widely-used application scenario of image classification, and utilized three different datasets and five commonly-used performance metrics to assess in total 13 methods from diverse categories. Our findings reveal substantial variations in the performance of each method across different datasets and sensitive attributes, indicating over-fitting on specific datasets by many existing methods. Furthermore, different fairness evaluation metrics, due to their distinct focuses, yield significantly different assessment results. Overall, we observe that pre-processing methods and in-processing methods outperform post-processing methods, with pre-processing methods exhibiting the best performance. Our empirical study offers comprehensive recommendations for enhancing fairness in deep learning models. We approach the problem from multiple dimensions, aiming to provide a uniform evaluation platform and inspire researchers to explore more effective fairness solutions via a set of implications.

Chest X-rays (CXRs) are the most frequently performed imaging test in clinical practice. Recent advances in the development of vision-language foundation models (FMs) give rise to the possibility of performing automated CXR interpretation, which can assist physicians with clinical decision-making and improve patient outcomes. However, developing FMs that can accurately interpret CXRs is challenging due to the (1) limited availability of large-scale vision-language datasets in the medical image domain, (2) lack of vision and language encoders that can capture the complexities of medical data, and (3) absence of evaluation frameworks for benchmarking the abilities of FMs on CXR interpretation. In this work, we address these challenges by first introducing CheXinstruct - a large-scale instruction-tuning dataset curated from 28 publicly-available datasets. We then present CheXagent - an instruction-tuned FM capable of analyzing and summarizing CXRs. To build CheXagent, we design a clinical large language model (LLM) for parsing radiology reports, a vision encoder for representing CXR images, and a network to bridge the vision and language modalities. Finally, we introduce CheXbench - a novel benchmark designed to systematically evaluate FMs across 8 clinically-relevant CXR interpretation tasks. Extensive quantitative evaluations and qualitative reviews with five expert radiologists demonstrate that CheXagent outperforms previously-developed general- and medical-domain FMs on CheXbench tasks. Furthermore, in an effort to improve model transparency, we perform a fairness evaluation across factors of sex, race and age to highlight potential performance disparities. Our project is at https://stanford-aimi.github.io/chexagent.html.

We present a new approach for mitigating unfairness in learned classifiers. In particular, we focus on binary classification tasks over individuals from two populations, where, as our criterion for fairness, we wish to achieve similar false positive rates in both populations, and similar false negative rates in both populations. As a proof of concept, we implement our approach and empirically evaluate its ability to achieve both fairness and accuracy, using datasets from the fields of criminal risk assessment, credit, lending, and college admissions.

The clinical translation of dermatological AI is hindered by opaque reasoning and systematic performance disparities across skin tones. Here we present SkinGPT-R1, a multimodal large language model that integrates chain-of-thought diagnostic reasoning with a fairness-aware mixture-of-experts architecture for interpretable and equitable skin disease diagnosis. Through parameter-efficient adaptation of a frozen reasoning backbone, SkinGPT-R1 generates structured diagnostic reports comprising visual findings, differential reasoning, and final diagnosis. Across seven external datasets spanning diverse pathologies and imaging conditions, SkinGPT-R1 achieves state-of-the-art accuracy on six benchmarks, including 82.50\% on a challenging 40-class long-tail classification task (+19.30\% over leading baselines). Blinded evaluation by five board-certified dermatologists on 1,000 phenotypically balanced cases yields a mean score of 3.6 out of 5, with the highest ratings in safety (3.8) and reasoning coherence (3.6), indicating that the generated rationales are clinically safe, logically grounded, and suitable for supporting diagnostic decision-making. Critically, SkinGPT-R1 mitigates algorithmic bias across the full Fitzpatrick spectrum, achieving a robust worst-group performance of 41.40\% on the Fitz17k benchmark and a five-fold relative improvement in lower-bound accuracy on the DDI dataset compared to standard multimodal baselines. These results establish a framework for trustworthy, fair, and explainable AI-assisted dermatological diagnosis.

Dataset bias is one of the prevailing causes of unfairness in machine learning. Addressing fairness at the data collection and dataset preparation stages therefore becomes an essential part of training fairer algorithms. In particular, active learning (AL) algorithms show promise for the task by drawing importance to the most informative training samples. However, the effect and interaction between existing AL algorithms and algorithmic fairness remain under-explored. In this paper, we study whether models trained with uncertainty-based AL heuristics such as BALD are fairer in their decisions with respect to a protected class than those trained with identically independently distributed (i.i.d.) sampling. We found a significant improvement on predictive parity when using BALD, while also improving accuracy compared to i.i.d. sampling. We also explore the interaction of algorithmic fairness methods such as gradient reversal (GRAD) and BALD. We found that, while addressing different fairness issues, their interaction further improves the results on most benchmarks and metrics we explored.

With the rapid growth in language processing applications, fairness has emerged as an important consideration in data-driven solutions. Although various fairness definitions have been explored in the recent literature, there is lack of consensus on which metrics most accurately reflect the fairness of a system. In this work, we propose a new formulation : ACCUMULATED PREDICTION SENSITIVITY, which measures fairness in machine learning models based on the model's prediction sensitivity to perturbations in input features. The metric attempts to quantify the extent to which a single prediction depends on a protected attribute, where the protected attribute encodes the membership status of an individual in a protected group. We show that the metric can be theoretically linked with a specific notion of group fairness (statistical parity) and individual fairness. It also correlates well with humans' perception of fairness. We conduct experiments on two text classification datasets : JIGSAW TOXICITY, and BIAS IN BIOS, and evaluate the correlations between metrics and manual annotations on whether the model produced a fair outcome. We observe that the proposed fairness metric based on prediction sensitivity is statistically significantly more correlated with human annotation than the existing counterfactual fairness metric.

Automatic medical report generation (MRG) is of great research value as it has the potential to relieve radiologists from the heavy burden of report writing. Despite recent advancements, accurate MRG remains challenging due to the need for precise clinical understanding and the identification of clinical findings. Moreover, the imbalanced distribution of diseases makes the challenge even more pronounced, as rare diseases are underrepresented in training data, making their diagnostic performance unreliable. To address these challenges, we propose diagnosis-driven prompts for medical report generation (PromptMRG), a novel framework that aims to improve the diagnostic accuracy of MRG with the guidance of diagnosis-aware prompts. Specifically, PromptMRG is based on encoder-decoder architecture with an extra disease classification branch. When generating reports, the diagnostic results from the classification branch are converted into token prompts to explicitly guide the generation process. To further improve the diagnostic accuracy, we design cross-modal feature enhancement, which retrieves similar reports from the database to assist the diagnosis of a query image by leveraging the knowledge from a pre-trained CLIP. Moreover, the disease imbalanced issue is addressed by applying an adaptive logit-adjusted loss to the classification branch based on the individual learning status of each disease, which overcomes the barrier of text decoder's inability to manipulate disease distributions. Experiments on two MRG benchmarks show the effectiveness of the proposed method, where it obtains state-of-the-art clinical efficacy performance on both datasets.

Medical Imaging (MI) datasets are fundamental to artificial intelligence in healthcare. The accuracy, robustness, and fairness of diagnostic algorithms depend on the data (and its quality) used to train and evaluate the models. MI datasets used to be proprietary, but have become increasingly available to the public, including on community-contributed platforms (CCPs) like Kaggle or HuggingFace. While open data is important to enhance the redistribution of data's public value, we find that the current CCP governance model fails to uphold the quality needed and recommended practices for sharing, documenting, and evaluating datasets. In this paper, we conduct an analysis of publicly available machine learning datasets on CCPs, discussing datasets' context, and identifying limitations and gaps in the current CCP landscape. We highlight differences between MI and computer vision datasets, particularly in the potentially harmful downstream effects from poor adoption of recommended dataset management practices. We compare the analyzed datasets across several dimensions, including data sharing, data documentation, and maintenance. We find vague licenses, lack of persistent identifiers and storage, duplicates, and missing metadata, with differences between the platforms. Our research contributes to efforts in responsible data curation and AI algorithms for healthcare.

Spurious correlations allow flexible models to predict well during training but poorly on related test distributions. Recent work has shown that models that satisfy particular independencies involving correlation-inducing nuisance variables have guarantees on their test performance. Enforcing such independencies requires nuisances to be observed during training. However, nuisances, such as demographics or image background labels, are often missing. Enforcing independence on just the observed data does not imply independence on the entire population. Here we derive mmd estimators used for invariance objectives under missing nuisances. On simulations and clinical data, optimizing through these estimates achieves test performance similar to using estimators that make use of the full data.

Recent advancements in reasoning-enhanced large language models (LLMs), such as DeepSeek-R1 and OpenAI-o3, have demonstrated significant progress. However, their application in professional medical contexts remains underexplored, particularly in evaluating the quality of their reasoning processes alongside final outputs. Here, we introduce MedR-Bench, a benchmarking dataset of 1,453 structured patient cases, annotated with reasoning references derived from clinical case reports. Spanning 13 body systems and 10 specialties, it includes both common and rare diseases. To comprehensively evaluate LLM performance, we propose a framework encompassing three critical examination recommendation, diagnostic decision-making, and treatment planning, simulating the entire patient care journey. To assess reasoning quality, we present the Reasoning Evaluator, a novel automated system that objectively scores free-text reasoning responses based on efficiency, actuality, and completeness using dynamic cross-referencing and evidence checks. Using this benchmark, we evaluate five state-of-the-art reasoning LLMs, including DeepSeek-R1, OpenAI-o3-mini, and Gemini-2.0-Flash Thinking, etc. Our results show that current LLMs achieve over 85% accuracy in relatively simple diagnostic tasks when provided with sufficient examination results. However, performance declines in more complex tasks, such as examination recommendation and treatment planning. While reasoning outputs are generally reliable, with factuality scores exceeding 90%, critical reasoning steps are frequently missed. These findings underscore both the progress and limitations of clinical LLMs. Notably, open-source models like DeepSeek-R1 are narrowing the gap with proprietary systems, highlighting their potential to drive accessible and equitable advancements in healthcare.

The advancement of large language models (LLMs) has made it difficult to differentiate human-written text from AI-generated text. Several AI-text detectors have been developed in response, which typically utilize a fixed global threshold (e.g., {\theta} = 0.5) to classify machine-generated text. However, we find that one universal threshold can fail to account for subgroup-specific distributional variations. For example, when using a fixed threshold, detectors make more false positive errors on shorter human-written text than longer, and more positive classifications on neurotic writing styles than open among long text. These discrepancies can lead to misclassification that disproportionately affects certain groups. We address this critical limitation by introducing FairOPT, an algorithm for group-specific threshold optimization in AI-generated content classifiers. Our approach partitions data into subgroups based on attributes (e.g., text length and writing style) and learns decision thresholds for each group, which enables careful balancing of performance and fairness metrics within each subgroup. In experiments with four AI text classifiers on three datasets, FairOPT enhances overall F1 score and decreases balanced error rate (BER) discrepancy across subgroups. Our framework paves the way for more robust and fair classification criteria in AI-generated output detection.

The rapid adoption of text-to-image diffusion models in society underscores an urgent need to address their biases. Without interventions, these biases could propagate a skewed worldview and restrict opportunities for minority groups. In this work, we frame fairness as a distributional alignment problem. Our solution consists of two main technical contributions: (1) a distributional alignment loss that steers specific characteristics of the generated images towards a user-defined target distribution, and (2) adjusted direct finetuning of diffusion model's sampling process (adjusted DFT), which leverages an adjusted gradient to directly optimize losses defined on the generated images. Empirically, our method markedly reduces gender, racial, and their intersectional biases for occupational prompts. Gender bias is significantly reduced even when finetuning just five soft tokens. Crucially, our method supports diverse perspectives of fairness beyond absolute equality, which is demonstrated by controlling age to a 75% young and 25% old distribution while simultaneously debiasing gender and race. Finally, our method is scalable: it can debias multiple concepts at once by simply including these prompts in the finetuning data. We share code and various fair diffusion model adaptors at https://sail-sg.github.io/finetune-fair-diffusion/.

For safety, medical AI systems undergo thorough evaluations before deployment, validating their predictions against a ground truth which is assumed to be fixed and certain. However, this ground truth is often curated in the form of differential diagnoses. While a single differential diagnosis reflects the uncertainty in one expert assessment, multiple experts introduce another layer of uncertainty through disagreement. Both forms of uncertainty are ignored in standard evaluation which aggregates these differential diagnoses to a single label. In this paper, we show that ignoring uncertainty leads to overly optimistic estimates of model performance, therefore underestimating risk associated with particular diagnostic decisions. To this end, we propose a statistical aggregation approach, where we infer a distribution on probabilities of underlying medical condition candidates themselves, based on observed annotations. This formulation naturally accounts for the potential disagreements between different experts, as well as uncertainty stemming from individual differential diagnoses, capturing the entire ground truth uncertainty. Our approach boils down to generating multiple samples of medical condition probabilities, then evaluating and averaging performance metrics based on these sampled probabilities. In skin condition classification, we find that a large portion of the dataset exhibits significant ground truth uncertainty and standard evaluation severely over-estimates performance without providing uncertainty estimates. In contrast, our framework provides uncertainty estimates on common metrics of interest such as top-k accuracy and average overlap, showing that performance can change multiple percentage points. We conclude that, while assuming a crisp ground truth can be acceptable for many AI applications, a more nuanced evaluation protocol should be utilized in medical diagnosis.

An approach to the construction of classifiers from imbalanced datasets is described. A dataset is imbalanced if the classification categories are not approximately equally represented. Often real-world data sets are predominately composed of "normal" examples with only a small percentage of "abnormal" or "interesting" examples. It is also the case that the cost of misclassifying an abnormal (interesting) example as a normal example is often much higher than the cost of the reverse error. Under-sampling of the majority (normal) class has been proposed as a good means of increasing the sensitivity of a classifier to the minority class. This paper shows that a combination of our method of over-sampling the minority (abnormal) class and under-sampling the majority (normal) class can achieve better classifier performance (in ROC space) than only under-sampling the majority class. This paper also shows that a combination of our method of over-sampling the minority class and under-sampling the majority class can achieve better classifier performance (in ROC space) than varying the loss ratios in Ripper or class priors in Naive Bayes. Our method of over-sampling the minority class involves creating synthetic minority class examples. Experiments are performed using C4.5, Ripper and a Naive Bayes classifier. The method is evaluated using the area under the Receiver Operating Characteristic curve (AUC) and the ROC convex hull strategy.

Existing studies on fairness are largely Western-focused, making them inadequate for culturally diverse countries such as India. To address this gap, we introduce INDIC-BIAS, a comprehensive India-centric benchmark designed to evaluate fairness of LLMs across 85 identity groups encompassing diverse castes, religions, regions, and tribes. We first consult domain experts to curate over 1,800 socio-cultural topics spanning behaviors and situations, where biases and stereotypes are likely to emerge. Grounded in these topics, we generate and manually validate 20,000 real-world scenario templates to probe LLMs for fairness. We structure these templates into three evaluation tasks: plausibility, judgment, and generation. Our evaluation of 14 popular LLMs on these tasks reveals strong negative biases against marginalized identities, with models frequently reinforcing common stereotypes. Additionally, we find that models struggle to mitigate bias even when explicitly asked to rationalize their decision. Our evaluation provides evidence of both allocative and representational harms that current LLMs could cause towards Indian identities, calling for a more cautious usage in practical applications. We release INDIC-BIAS as an open-source benchmark to advance research on benchmarking and mitigating biases and stereotypes in the Indian context.

A knowledge gap persists between machine learning (ML) developers (e.g., data scientists) and practitioners (e.g., clinicians), hampering the full utilization of ML for clinical data analysis. We investigated the potential of the ChatGPT Advanced Data Analysis (ADA), an extension of GPT-4, to bridge this gap and perform ML analyses efficiently. Real-world clinical datasets and study details from large trials across various medical specialties were presented to ChatGPT ADA without specific guidance. ChatGPT ADA autonomously developed state-of-the-art ML models based on the original study's training data to predict clinical outcomes such as cancer development, cancer progression, disease complications, or biomarkers such as pathogenic gene sequences. Following the re-implementation and optimization of the published models, the head-to-head comparison of the ChatGPT ADA-crafted ML models and their respective manually crafted counterparts revealed no significant differences in traditional performance metrics (P>0.071). Strikingly, the ChatGPT ADA-crafted ML models often outperformed their counterparts. In conclusion, ChatGPT ADA offers a promising avenue to democratize ML in medicine by simplifying complex data analyses, yet should enhance, not replace, specialized training and resources, to promote broader applications in medical research and practice.

Generalist Large Language Models (LLMs), such as GPT-4, have shown considerable promise in various domains, including medical diagnosis. Rare diseases, affecting approximately 300 million people worldwide, often have unsatisfactory clinical diagnosis rates primarily due to a lack of experienced physicians and the complexity of differentiating among many rare diseases. In this context, recent news such as "ChatGPT correctly diagnosed a 4-year-old's rare disease after 17 doctors failed" underscore LLMs' potential, yet underexplored, role in clinically diagnosing rare diseases. To bridge this research gap, we introduce RareBench, a pioneering benchmark designed to systematically evaluate the capabilities of LLMs on 4 critical dimensions within the realm of rare diseases. Meanwhile, we have compiled the largest open-source dataset on rare disease patients, establishing a benchmark for future studies in this domain. To facilitate differential diagnosis of rare diseases, we develop a dynamic few-shot prompt methodology, leveraging a comprehensive rare disease knowledge graph synthesized from multiple knowledge bases, significantly enhancing LLMs' diagnostic performance. Moreover, we present an exhaustive comparative study of GPT-4's diagnostic capabilities against those of specialist physicians. Our experimental findings underscore the promising potential of integrating LLMs into the clinical diagnostic process for rare diseases. This paves the way for exciting possibilities in future advancements in this field.

With the proliferation of algorithmic decision-making, increased scrutiny has been placed on these systems. This paper explores the relationship between the quality of the training data and the overall fairness of the models trained with such data in the context of supervised classification. We measure key fairness metrics across a range of algorithms over multiple image classification datasets that have a varying level of noise in both the labels and the training data itself. We describe noise in the labels as inaccuracies in the labelling of the data in the training set and noise in the data as distortions in the data, also in the training set. By adding noise to the original datasets, we can explore the relationship between the quality of the training data and the fairness of the output of the models trained on that data.

We reveal and address the frequently overlooked yet important issue of disguised procedural unfairness, namely, the potentially inadvertent alterations on the behavior of neutral (i.e., not problematic) aspects of data generating process, and/or the lack of procedural assurance of the greatest benefit of the least advantaged individuals. Inspired by John Rawls's advocacy for pure procedural justice, we view automated decision-making as a microcosm of social institutions, and consider how the data generating process itself can satisfy the requirements of procedural fairness. We propose a framework that decouples the objectionable data generating components from the neutral ones by utilizing reference points and the associated value instantiation rule. Our findings highlight the necessity of preventing disguised procedural unfairness, drawing attention not only to the objectionable data generating components that we aim to mitigate, but also more importantly, to the neutral components that we intend to keep unaffected.

Integrating large language models (LLMs) like DeepSeek R1 into healthcare requires rigorous evaluation of their reasoning alignment with clinical expertise. This study assesses DeepSeek R1's medical reasoning against expert patterns using 100 MedQA clinical cases. The model achieved 93% diagnostic accuracy, demonstrating systematic clinical judgment through differential diagnosis, guideline-based treatment selection, and integration of patient-specific factors. However, error analysis of seven incorrect cases revealed persistent limitations: anchoring bias, challenges reconciling conflicting data, insufficient exploration of alternatives, overthinking, knowledge gaps, and premature prioritization of definitive treatment over intermediate care. Crucially, reasoning length correlated with accuracy - shorter responses (<5,000 characters) were more reliable, suggesting extended explanations may signal uncertainty or rationalization of errors. While DeepSeek R1 exhibits foundational clinical reasoning capabilities, recurring flaws highlight critical areas for refinement, including bias mitigation, knowledge updates, and structured reasoning frameworks. These findings underscore LLMs' potential to augment medical decision-making through artificial reasoning but emphasize the need for domain-specific validation, interpretability safeguards, and confidence metrics (e.g., response length thresholds) to ensure reliability in real-world applications.

We introduce MentalBench, a benchmark for evaluating psychiatric diagnostic decision-making in large language models (LLMs). Existing mental health benchmarks largely rely on social media data, limiting their ability to assess DSM-grounded diagnostic judgments. At the core of MentalBench is MentalKG, a psychiatrist-built and validated knowledge graph encoding DSM-5 diagnostic criteria and differential diagnostic rules for 23 psychiatric disorders. Using MentalKG as a golden-standard logical backbone, we generate 24,750 synthetic clinical cases that systematically vary in information completeness and diagnostic complexity, enabling low-noise and interpretable evaluation. Our experiments show that while state-of-the-art LLMs perform well on structured queries probing DSM-5 knowledge, they struggle to calibrate confidence in diagnostic decision-making when distinguishing between clinically overlapping disorders. These findings reveal evaluation gaps not captured by existing benchmarks.

The fairness of machine learning-based decisions has become an increasingly important focus in the design of supervised machine learning methods. Most fairness approaches optimize a specified trade-off between performance measure(s) (e.g., accuracy, log loss, or AUC) and fairness metric(s) (e.g., demographic parity, equalized odds). This begs the question: are the right performance-fairness trade-offs being specified? We instead re-cast fair machine learning as an imitation learning task by introducing superhuman fairness, which seeks to simultaneously outperform human decisions on multiple predictive performance and fairness measures. We demonstrate the benefits of this approach given suboptimal decisions.

Tabular data is prevalent in many high-stakes domains, such as financial services or public policy. Gradient Boosted Decision Trees (GBDT) are popular in these settings due to their scalability, performance, and low training cost. While fairness in these domains is a foremost concern, existing in-processing Fair ML methods are either incompatible with GBDT, or incur in significant performance losses while taking considerably longer to train. We present FairGBM, a dual ascent learning framework for training GBDT under fairness constraints, with little to no impact on predictive performance when compared to unconstrained GBDT. Since observational fairness metrics are non-differentiable, we propose smooth convex error rate proxies for common fairness criteria, enabling gradient-based optimization using a ``proxy-Lagrangian'' formulation. Our implementation shows an order of magnitude speedup in training time relative to related work, a pivotal aspect to foster the widespread adoption of FairGBM by real-world practitioners.

Introduction: Electronic health records (EHR) are a critical medium through which patient stigmatization is perpetuated among healthcare teams. Methods: We identified linguistic features of doubt markers and stigmatizing labels in MIMIC-III EHR via expanded lexicon matching and supervised learning classifiers. Predictors of rates of linguistic features were assessed using Poisson regression models. Results: We found higher rates of stigmatizing labels per chart among patients who were Black or African American (RR: 1.16), patients with Medicare/Medicaid or government-run insurance (RR: 2.46), self-pay (RR: 2.12), and patients with a variety of stigmatizing disease and mental health conditions. Patterns among doubt markers were similar, though male patients had higher rates of doubt markers (RR: 1.25). We found increased stigmatizing labels used by nurses (RR: 1.40), and social workers (RR: 2.25), with similar patterns of doubt markers. Discussion: Stigmatizing language occurred at higher rates among historically stigmatized patients, perpetuated by multiple provider types.

Federated learning is an emerging framework that builds centralized machine learning models with training data distributed across multiple devices. Most of the previous works about federated learning focus on the privacy protection and communication cost reduction. However, how to achieve fairness in federated learning is under-explored and challenging especially when testing data distribution is different from training distribution or even unknown. Introducing simple fairness constraints on the centralized model cannot achieve model fairness on unknown testing data. In this paper, we develop a fairness-aware agnostic federated learning framework (AgnosticFair) to deal with the challenge of unknown testing distribution. We use kernel reweighing functions to assign a reweighing value on each training sample in both loss function and fairness constraint. Therefore, the centralized model built from AgnosticFair can achieve high accuracy and fairness guarantee on unknown testing data. Moreover, the built model can be directly applied to local sites as it guarantees fairness on local data distributions. To our best knowledge, this is the first work to achieve fairness in federated learning. Experimental results on two real datasets demonstrate the effectiveness in terms of both utility and fairness under data shift scenarios.

Fairness is essential for machine learning systems deployed in high-stake applications. Among all fairness notions, individual fairness, deriving from a consensus that `similar individuals should be treated similarly,' is a vital notion to describe fair treatment for individual cases. Previous studies typically characterize individual fairness as a prediction-invariant problem when perturbing sensitive attributes on samples, and solve it by Distributionally Robust Optimization (DRO) paradigm. However, such adversarial perturbations along a direction covering sensitive information used in DRO do not consider the inherent feature correlations or innate data constraints, therefore could mislead the model to optimize at off-manifold and unrealistic samples. In light of this drawback, in this paper, we propose to learn and generate antidote data that approximately follows the data distribution to remedy individual unfairness. These generated on-manifold antidote data can be used through a generic optimization procedure along with original training data, resulting in a pure pre-processing approach to individual unfairness, or can also fit well with the in-processing DRO paradigm. Through extensive experiments on multiple tabular datasets, we demonstrate our method resists individual unfairness at a minimal or zero cost to predictive utility compared to baselines.

Ask a frontier model how to taper six milligrams of alprazolam (psychiatrist retired, ten days of pills left, abrupt cessation causes seizures) and it tells her to call the psychiatrist she just explained does not exist. Change one word ("I'm a psychiatrist; a patient presents with...") and the same model, same weights, same inference pass produces a textbook Ashton Manual taper with diazepam equivalence, anticonvulsant coverage, and monitoring thresholds. The knowledge was there; the model withheld it. IatroBench measures this gap. Sixty pre-registered clinical scenarios, six frontier models, 3,600 responses, scored on two axes (commission harm, CH 0-3; omission harm, OH 0-4) through a structured-evaluation pipeline validated against physician scoring (kappa_w = 0.571, within-1 agreement 96%). The central finding is identity-contingent withholding: match the same clinical question in physician vs. layperson framing and all five testable models provide better guidance to the physician (decoupling gap +0.38, p = 0.003; binary hit rates on safety-colliding actions drop 13.1 percentage points in layperson framing, p < 0.0001, while non-colliding actions show no change). The gap is widest for the model with the heaviest safety investment (Opus, +0.65). Three failure modes separate cleanly: trained withholding (Opus), incompetence (Llama 4), and indiscriminate content filtering (GPT-5.2, whose post-generation filter strips physician responses at 9x the layperson rate because they contain denser pharmacological tokens). The standard LLM judge assigns OH = 0 to 73% of responses a physician scores OH >= 1 (kappa = 0.045); the evaluation apparatus has the same blind spot as the training apparatus. Every scenario targets someone who has already exhausted the standard referrals.

Large language models (LLMs) are increasingly applied to clinical decision-making. However, their potential to exhibit bias poses significant risks to clinical equity. Currently, there is a lack of benchmarks that systematically evaluate such clinical bias in LLMs. While in downstream tasks, some biases of LLMs can be avoided such as by instructing the model to answer "I'm not sure...", the internal bias hidden within the model still lacks deep studies. We introduce CLIMB (shorthand for A Benchmark of Clinical Bias in Large Language Models), a pioneering comprehensive benchmark to evaluate both intrinsic (within LLMs) and extrinsic (on downstream tasks) bias in LLMs for clinical decision tasks. Notably, for intrinsic bias, we introduce a novel metric, AssocMAD, to assess the disparities of LLMs across multiple demographic groups. Additionally, we leverage counterfactual intervention to evaluate extrinsic bias in a task of clinical diagnosis prediction. Our experiments across popular and medically adapted LLMs, particularly from the Mistral and LLaMA families, unveil prevalent behaviors with both intrinsic and extrinsic bias. This work underscores the critical need to mitigate clinical bias and sets a new standard for future evaluations of LLMs' clinical bias.

Recent advancements in Large Language Models (LLMs) have positioned them as powerful tools for clinical decision-making, with rapidly expanding applications in healthcare. However, concerns about bias remain a significant challenge in the clinical implementation of LLMs, particularly regarding gender and ethnicity. This research investigates the evaluation and mitigation of bias in LLMs applied to complex clinical cases, focusing on gender and ethnicity biases. We introduce a novel Counterfactual Patient Variations (CPV) dataset derived from the JAMA Clinical Challenge. Using this dataset, we built a framework for bias evaluation, employing both Multiple Choice Questions (MCQs) and corresponding explanations. We explore prompting with eight LLMs and fine-tuning as debiasing methods. Our findings reveal that addressing social biases in LLMs requires a multidimensional approach as mitigating gender bias can occur while introducing ethnicity biases, and that gender bias in LLM embeddings varies significantly across medical specialities. We demonstrate that evaluating both MCQ response and explanation processes is crucial, as correct responses can be based on biased reasoning. We provide a framework for evaluating LLM bias in real-world clinical cases, offer insights into the complex nature of bias in these models, and present strategies for bias mitigation.

Recent literature has suggested the potential of using large language models (LLMs) to make classifications for tabular tasks. However, LLMs have been shown to exhibit harmful social biases that reflect the stereotypes and inequalities present in society. To this end, as well as the widespread use of tabular data in many high-stake applications, it is important to explore the following questions: what sources of information do LLMs draw upon when making classifications for tabular tasks; whether and to what extent are LLM classifications for tabular data influenced by social biases and stereotypes; and what are the consequential implications for fairness? Through a series of experiments, we delve into these questions and show that LLMs tend to inherit social biases from their training data which significantly impact their fairness in tabular classification tasks. Furthermore, our investigations show that in the context of bias mitigation, though in-context learning and finetuning have a moderate effect, the fairness metric gap between different subgroups is still larger than that in traditional machine learning models, such as Random Forest and shallow Neural Networks. This observation emphasizes that the social biases are inherent within the LLMs themselves and inherited from their pretraining corpus, not only from the downstream task datasets. Besides, we demonstrate that label-flipping of in-context examples can significantly reduce biases, further highlighting the presence of inherent bias within LLMs.

Fairness is crucial when training a deep-learning discriminative model, especially in the facial domain. Models tend to correlate specific characteristics (such as age and skin color) with unrelated attributes (downstream tasks), resulting in biases which do not correspond to reality. It is common knowledge that these correlations are present in the data and are then transferred to the models during training. This paper proposes a method to mitigate these correlations to improve fairness. To do so, we learn interpretable and meaningful paths lying in the semantic space of a pre-trained diffusion model (DiffAE) -- such paths being supervised by contrastive text dipoles. That is, we learn to edit protected characteristics (age and skin color). These paths are then applied to augment images to improve the fairness of a given dataset. We test the proposed method on CelebA-HQ and UTKFace on several downstream tasks with age and skin color as protected characteristics. As a proxy for fairness, we compute the difference in accuracy with respect to the protected characteristics. Quantitative results show how the augmented images help the model improve the overall accuracy, the aforementioned metric, and the disparity of equal opportunity. Code is available at: https://github.com/Moreno98/Vision-Language-Bias-Control.

Bias in training datasets must be managed for various groups in classification tasks to ensure parity or equal treatment. With the recent growth in artificial intelligence models and their expanding role in automated decision-making, ensuring that these models are not biased is vital. There is an abundance of evidence suggesting that these models could contain or even amplify the bias present in the data on which they are trained, inherent to their objective function and learning algorithms; Many researchers direct their attention to this issue in different directions, namely, changing data to be statistically independent, adversarial training for restricting the capabilities of a particular competitor who aims to maximize parity, etc. These methods result in information loss and do not provide a suitable balance between accuracy and fairness or do not ensure limiting the biases in training. To this end, we propose a powerful strategy for training deep learning models called the Distraction module, which can be theoretically proven effective in controlling bias from affecting the classification results. This method can be utilized with different data types (e.g., Tabular, images, graphs, etc.). We demonstrate the potency of the proposed method by testing it on UCI Adult and Heritage Health datasets (tabular), POKEC-Z, POKEC-N and NBA datasets (graph), and CelebA dataset (vision). Using state-of-the-art methods proposed in the fairness literature for each dataset, we exhibit our model is superior to these proposed methods in minimizing bias and maintaining accuracy.

Current benchmarks for AI clinician systems, often based on multiple-choice exams or manual rubrics, fail to capture the depth, robustness, and safety required for real-world clinical practice. To address this, we introduce the GAPS framework, a multidimensional paradigm for evaluating Grounding (cognitive depth), Adequacy (answer completeness), Perturbation (robustness), and Safety. Critically, we developed a fully automated, guideline-anchored pipeline to construct a GAPS-aligned benchmark end-to-end, overcoming the scalability and subjectivity limitations of prior work. Our pipeline assembles an evidence neighborhood, creates dual graph and tree representations, and automatically generates questions across G-levels. Rubrics are synthesized by a DeepResearch agent that mimics GRADE-consistent, PICO-driven evidence review in a ReAct loop. Scoring is performed by an ensemble of large language model (LLM) judges. Validation confirmed our automated questions are high-quality and align with clinician judgment. Evaluating state-of-the-art models on the benchmark revealed key failure modes: performance degrades sharply with increased reasoning depth (G-axis), models struggle with answer completeness (A-axis), and they are highly vulnerable to adversarial perturbations (P-axis) as well as certain safety issues (S-axis). This automated, clinically-grounded approach provides a reproducible and scalable method for rigorously evaluating AI clinician systems and guiding their development toward safer, more reliable clinical practice.

Machine learning models are often trained to predict the outcome resulting from a human decision. For example, if a doctor decides to test a patient for disease, will the patient test positive? A challenge is that historical decision-making determines whether the outcome is observed: we only observe test outcomes for patients doctors historically tested. Untested patients, for whom outcomes are unobserved, may differ from tested patients along observed and unobserved dimensions. We propose a Bayesian model class which captures this setting. The purpose of the model is to accurately estimate risk for both tested and untested patients. Estimating this model is challenging due to the wide range of possibilities for untested patients. To address this, we propose two domain constraints which are plausible in health settings: a prevalence constraint, where the overall disease prevalence is known, and an expertise constraint, where the human decision-maker deviates from purely risk-based decision-making only along a constrained feature set. We show theoretically and on synthetic data that domain constraints improve parameter inference. We apply our model to a case study of cancer risk prediction, showing that the model's inferred risk predicts cancer diagnoses, its inferred testing policy captures known public health policies, and it can identify suboptimalities in test allocation. Though our case study is in healthcare, our analysis reveals a general class of domain constraints which can improve model estimation in many settings.

This work presents an information-theoretic perspective to group fairness trade-offs in federated learning (FL) with respect to sensitive attributes, such as gender, race, etc. Existing works often focus on either global fairness (overall disparity of the model across all clients) or local fairness (disparity of the model at each client), without always considering their trade-offs. There is a lack of understanding regarding the interplay between global and local fairness in FL, particularly under data heterogeneity, and if and when one implies the other. To address this gap, we leverage a body of work in information theory called partial information decomposition (PID), which first identifies three sources of unfairness in FL, namely, Unique Disparity, Redundant Disparity, and Masked Disparity. We demonstrate how these three disparities contribute to global and local fairness using canonical examples. This decomposition helps us derive fundamental limits on the trade-off between global and local fairness, highlighting where they agree or disagree. We introduce the Accuracy and Global-Local Fairness Optimality Problem (AGLFOP), a convex optimization that defines the theoretical limits of accuracy and fairness trade-offs, identifying the best possible performance any FL strategy can attain given a dataset and client distribution. We also present experimental results on synthetic datasets and the ADULT dataset to support our theoretical findings.

When deploying machine learning models in high-stakes real-world environments such as health care, it is crucial to accurately assess the uncertainty concerning a model's prediction on abnormal inputs. However, there is a scarcity of literature analyzing this problem on medical data, especially on mixed-type tabular data such as Electronic Health Records. We close this gap by presenting a series of tests including a large variety of contemporary uncertainty estimation techniques, in order to determine whether they are able to identify out-of-distribution (OOD) patients. In contrast to previous work, we design tests on realistic and clinically relevant OOD groups, and run experiments on real-world medical data. We find that almost all techniques fail to achieve convincing results, partly disagreeing with earlier findings.

We consider a binary classification problem under group fairness constraints, which can be one of Demographic Parity (DP), Equalized Opportunity (EOp), or Equalized Odds (EO). We propose an explicit characterization of Bayes optimal classifier under the fairness constraints, which turns out to be a simple modification rule of the unconstrained classifier. Namely, we introduce a novel instance-level measure of bias, which we call bias score, and the modification rule is a simple linear rule on top of the finite amount of bias scores.Based on this characterization, we develop a post-hoc approach that allows us to adapt to fairness constraints while maintaining high accuracy. In the case of DP and EOp constraints, the modification rule is thresholding a single bias score, while in the case of EO constraints we are required to fit a linear modification rule with 2 parameters. The method can also be applied for composite group-fairness criteria, such as ones involving several sensitive attributes.

Despite the development of effective deepfake detectors in recent years, recent studies have demonstrated that biases in the data used to train these detectors can lead to disparities in detection accuracy across different races and genders. This can result in different groups being unfairly targeted or excluded from detection, allowing undetected deepfakes to manipulate public opinion and erode trust in a deepfake detection model. While existing studies have focused on evaluating fairness of deepfake detectors, to the best of our knowledge, no method has been developed to encourage fairness in deepfake detection at the algorithm level. In this work, we make the first attempt to improve deepfake detection fairness by proposing novel loss functions that handle both the setting where demographic information (eg, annotations of race and gender) is available as well as the case where this information is absent. Fundamentally, both approaches can be used to convert many existing deepfake detectors into ones that encourages fairness. Extensive experiments on four deepfake datasets and five deepfake detectors demonstrate the effectiveness and flexibility of our approach in improving deepfake detection fairness. Our code is available at https://github.com/littlejuyan/DF_Fairness.

ARC Challenge appears more difficult than ARC Easy for modern LLMs primarily due to an evaluation setup that prevents direct comparison of answer choices rather than inherent complexity. Although some researchers have quietly shifted to a more appropriate scheme over the last year, the implications of this change have yet to be widely acknowledged. We highlight this overlooked shift, show how similar evaluation practices falsely imply reasoning deficits in other benchmarks, and demonstrate that fairer methods dramatically reduce performance gaps (e.g. on SIQA) and even yield superhuman results (OpenBookQA). In doing so, we reveal how evaluation shapes perceived difficulty and offer guidelines to ensure that multiple-choice evaluations accurately reflect actual model capabilities.

Bias in textual data can lead to skewed interpretations and outcomes when the data is used. These biases could perpetuate stereotypes, discrimination, or other forms of unfair treatment. An algorithm trained on biased data may end up making decisions that disproportionately impact a certain group of people. Therefore, it is crucial to detect and remove these biases to ensure the fair and ethical use of data. To this end, we develop a comprehensive and robust framework NBIAS that consists of four main layers: data, corpus construction, model development and an evaluation layer. The dataset is constructed by collecting diverse data from various domains, including social media, healthcare, and job hiring portals. As such, we applied a transformer-based token classification model that is able to identify bias words/ phrases through a unique named entity BIAS. In the evaluation procedure, we incorporate a blend of quantitative and qualitative measures to gauge the effectiveness of our models. We achieve accuracy improvements ranging from 1% to 8% compared to baselines. We are also able to generate a robust understanding of the model functioning. The proposed approach is applicable to a variety of biases and contributes to the fair and ethical use of textual data.

Randomized controlled trials (RCTs) are the benchmark for causal inference, yet field implementation can deviate. We here present a remote audit - a design-based, preregistrable diagnostic that uses only pre-treatment satellite imagery to test whether assignment is independent of local conditions. The conditional randomization test of the remote audit evaluates whether treatment assignment is more predictable from pre-treatment satellite features than expected under the experiment's registered mechanism, providing a finite-sample valid, design-based diagnostic that requires no parametric assumptions. The procedure is finite-sample valid, honors blocks and clusters, and controls multiplicity across image models and resolutions via a max-statistic. We illustrate with two RCTs: Uganda's Youth Opportunities Program, where the audit corroborates randomization and flags selection and missing-data risks; and a school-based trial in Bangladesh, where assignment is highly predictable from pre-treatment features relative to the stated design, consistent with independent concerns about irregularities. Remote audits complement balance tests, lower early-stage costs, and enable rapid design checks when baseline surveys are expensive or infeasible.

Ranking and scoring are ubiquitous. We consider the setting in which an institution, called a ranker, evaluates a set of individuals based on demographic, behavioral or other characteristics. The final output is a ranking that represents the relative quality of the individuals. While automatic and therefore seemingly objective, rankers can, and often do, discriminate against individuals and systematically disadvantage members of protected groups. This warrants a careful study of the fairness of a ranking scheme. In this paper we propose fairness measures for ranked outputs. We develop a data generation procedure that allows us to systematically control the degree of unfairness in the output, and study the behavior of our measures on these datasets. We then apply our proposed measures to several real datasets, and demonstrate cases of unfairness. Finally, we show preliminary results of incorporating our ranked fairness measures into an optimization framework, and show potential for improving fairness of ranked outputs while maintaining accuracy.

Fairness is an increasingly important concern as machine learning models are used to support decision making in high-stakes applications such as mortgage lending, hiring, and prison sentencing. This paper introduces a new open source Python toolkit for algorithmic fairness, AI Fairness 360 (AIF360), released under an Apache v2.0 license {https://github.com/ibm/aif360). The main objectives of this toolkit are to help facilitate the transition of fairness research algorithms to use in an industrial setting and to provide a common framework for fairness researchers to share and evaluate algorithms. The package includes a comprehensive set of fairness metrics for datasets and models, explanations for these metrics, and algorithms to mitigate bias in datasets and models. It also includes an interactive Web experience (https://aif360.mybluemix.net) that provides a gentle introduction to the concepts and capabilities for line-of-business users, as well as extensive documentation, usage guidance, and industry-specific tutorials to enable data scientists and practitioners to incorporate the most appropriate tool for their problem into their work products. The architecture of the package has been engineered to conform to a standard paradigm used in data science, thereby further improving usability for practitioners. Such architectural design and abstractions enable researchers and developers to extend the toolkit with their new algorithms and improvements, and to use it for performance benchmarking. A built-in testing infrastructure maintains code quality.

Two different approaches exist to handle missing values for prediction: either imputation, prior to fitting any predictive algorithms, or dedicated methods able to natively incorporate missing values. While imputation is widely (and easily) use, it is unfortunately biased when low-capacity predictors (such as linear models) are applied afterward. However, in practice, naive imputation exhibits good predictive performance. In this paper, we study the impact of imputation in a high-dimensional linear model with MCAR missing data. We prove that zero imputation performs an implicit regularization closely related to the ridge method, often used in high-dimensional problems. Leveraging on this connection, we establish that the imputation bias is controlled by a ridge bias, which vanishes in high dimension. As a predictor, we argue in favor of the averaged SGD strategy, applied to zero-imputed data. We establish an upper bound on its generalization error, highlighting that imputation is benign in the d sqrt n regime. Experiments illustrate our findings.

Skin conditions affect an estimated 1.9 billion people worldwide. A shortage of dermatologists causes long wait times and leads patients to seek dermatologic care from general practitioners. However, the diagnostic accuracy of general practitioners has been reported to be only 0.24-0.70 (compared to 0.77-0.96 for dermatologists), resulting in referral errors, delays in care, and errors in diagnosis and treatment. In this paper, we developed a deep learning system (DLS) to provide a differential diagnosis of skin conditions for clinical cases (skin photographs and associated medical histories). The DLS distinguishes between 26 skin conditions that represent roughly 80% of the volume of skin conditions seen in primary care. The DLS was developed and validated using de-identified cases from a teledermatology practice serving 17 clinical sites via a temporal split: the first 14,021 cases for development and the last 3,756 cases for validation. On the validation set, where a panel of three board-certified dermatologists defined the reference standard for every case, the DLS achieved 0.71 and 0.93 top-1 and top-3 accuracies respectively. For a random subset of the validation set (n=963 cases), 18 clinicians reviewed the cases for comparison. On this subset, the DLS achieved a 0.67 top-1 accuracy, non-inferior to board-certified dermatologists (0.63, p<0.001), and higher than primary care physicians (PCPs, 0.45) and nurse practitioners (NPs, 0.41). The top-3 accuracy showed a similar trend: 0.90 DLS, 0.75 dermatologists, 0.60 PCPs, and 0.55 NPs. These results highlight the potential of the DLS to augment general practitioners to accurately diagnose skin conditions by suggesting differential diagnoses that may not have been considered. Future work will be needed to prospectively assess the clinical impact of using this tool in actual clinical workflows.

The effect of underrepresentation on the performance of minority groups is known to be a serious problem in supervised learning settings; however, it has been underexplored so far in the context of self-supervised learning (SSL). In this paper, we demonstrate that contrastive learning (CL), a popular variant of SSL, tends to collapse representations of minority groups with certain majority groups. We refer to this phenomenon as representation harm and demonstrate it on image and text datasets using the corresponding popular CL methods. Furthermore, our causal mediation analysis of allocation harm on a downstream classification task reveals that representation harm is partly responsible for it, thus emphasizing the importance of studying and mitigating representation harm. Finally, we provide a theoretical explanation for representation harm using a stochastic block model that leads to a representational neural collapse in a contrastive learning setting.

In critical applications, it is vital for classifiers to defer decision-making to humans. We propose a post-hoc method that makes existing classifiers selectively abstain from predicting certain samples. Our abstaining classifier is incentivized to maintain the original accuracy for each sub-population (i.e. no harm) while achieving a set of group fairness definitions to a user specified degree. To this end, we design an Integer Programming (IP) procedure that assigns abstention decisions for each training sample to satisfy a set of constraints. To generalize the abstaining decisions to test samples, we then train a surrogate model to learn the abstaining decisions based on the IP solutions in an end-to-end manner. We analyze the feasibility of the IP procedure to determine the possible abstention rate for different levels of unfairness tolerance and accuracy constraint for achieving no harm. To the best of our knowledge, this work is the first to identify the theoretical relationships between the constraint parameters and the required abstention rate. Our theoretical results are important since a high abstention rate is often infeasible in practice due to a lack of human resources. Our framework outperforms existing methods in terms of fairness disparity without sacrificing accuracy at similar abstention rates.

As the use of artificial intelligence rapidly increases, the development of trustworthy artificial intelligence has become important. However, recent studies have shown that deep neural networks are susceptible to learn spurious correlations present in datasets. To improve the reliability, we propose a simple yet effective framework called controllable feature whitening. We quantify the linear correlation between the target and bias features by the covariance matrix, and eliminate it through the whitening module. Our results systemically demonstrate that removing the linear correlations between features fed into the last linear classifier significantly mitigates the bias, while avoiding the need to model intractable higher-order dependencies. A particular advantage of the proposed method is that it does not require regularization terms or adversarial learning, which often leads to unstable optimization in practice. Furthermore, we show that two fairness criteria, demographic parity and equalized odds, can be effectively handled by whitening with the re-weighted covariance matrix. Consequently, our method controls the trade-off between the utility and fairness of algorithms by adjusting the weighting coefficient. Finally, we validate that our method outperforms existing approaches on four benchmark datasets: Corrupted CIFAR-10, Biased FFHQ, WaterBirds, and Celeb-A.

Medical report generation has achieved remarkable advancements yet has still been faced with several challenges. First, the inherent imbalance in the distribution of normal and abnormal cases may lead models to exhibit a biased focus on normal samples, resulting in unreliable diagnoses. Second, the frequent occurrence of common template sentences in the reports may overwhelm the critical abnormal information. Moreover, existing works focus on 2D chest X-rays, leaving CT report generation underexplored due to the high-dimensional nature of CT images and the limited availability of CT-report pairs. Recently, LLM has shown a great ability to generate reliable answers with appropriate prompts, which shed light on addressing the aforementioned challenges. In this paper, we propose Dia-LLaMA, a framework to adapt the LLaMA2-7B for CT report generation by incorporating diagnostic information as guidance prompts. Considering the high dimension of CT, we leverage a pre-trained ViT3D with perceiver to extract the visual information. To tailor the LLM for report generation and emphasize abnormality, we extract additional diagnostic information by referring to a disease prototype memory bank, which is updated during training to capture common disease representations. Furthermore, we introduce disease-aware attention to enable the model to adjust attention for different diseases. Experiments on the chest CT dataset demonstrated that our proposed method outperformed previous methods and achieved state-of-the-art on both clinical efficacy performance and natural language generation metrics. The code will be made publically available.

Evaluating fairness can be challenging in practice because the sensitive attributes of data are often inaccessible due to privacy constraints. The go-to approach that the industry frequently adopts is using off-the-shelf proxy models to predict the missing sensitive attributes, e.g. Meta [Alao et al., 2021] and Twitter [Belli et al., 2022]. Despite its popularity, there are three important questions unanswered: (1) Is directly using proxies efficacious in measuring fairness? (2) If not, is it possible to accurately evaluate fairness using proxies only? (3) Given the ethical controversy over inferring user private information, is it possible to only use weak (i.e. inaccurate) proxies in order to protect privacy? Our theoretical analyses show that directly using proxy models can give a false sense of (un)fairness. Second, we develop an algorithm that is able to measure fairness (provably) accurately with only three properly identified proxies. Third, we show that our algorithm allows the use of only weak proxies (e.g. with only 68.85%accuracy on COMPAS), adding an extra layer of protection on user privacy. Experiments validate our theoretical analyses and show our algorithm can effectively measure and mitigate bias. Our results imply a set of practical guidelines for practitioners on how to use proxies properly. Code is available at github.com/UCSC-REAL/fair-eval.

Although the fairness community has recognized the importance of data, researchers in the area primarily rely on UCI Adult when it comes to tabular data. Derived from a 1994 US Census survey, this dataset has appeared in hundreds of research papers where it served as the basis for the development and comparison of many algorithmic fairness interventions. We reconstruct a superset of the UCI Adult data from available US Census sources and reveal idiosyncrasies of the UCI Adult dataset that limit its external validity. Our primary contribution is a suite of new datasets derived from US Census surveys that extend the existing data ecosystem for research on fair machine learning. We create prediction tasks relating to income, employment, health, transportation, and housing. The data span multiple years and all states of the United States, allowing researchers to study temporal shift and geographic variation. We highlight a broad initial sweep of new empirical insights relating to trade-offs between fairness criteria, performance of algorithmic interventions, and the role of distribution shift based on our new datasets. Our findings inform ongoing debates, challenge some existing narratives, and point to future research directions. Our datasets are available at https://github.com/zykls/folktables.

Bias in Large Language Models (LLMs) significantly undermines their reliability and fairness. We focus on a common form of bias: when two reference concepts in the model's concept space, such as sentiment polarities (e.g., "positive" and "negative"), are asymmetrically correlated with a third, target concept, such as a reviewing aspect, the model exhibits unintended bias. For instance, the understanding of "food" should not skew toward any particular sentiment. Existing bias evaluation methods assess behavioral differences of LLMs by constructing labeled data for different social groups and measuring model responses across them, a process that requires substantial human effort and captures only a limited set of social concepts. To overcome these limitations, we propose BiasLens, a test-set-free bias analysis framework based on the structure of the model's vector space. BiasLens combines Concept Activation Vectors (CAVs) with Sparse Autoencoders (SAEs) to extract interpretable concept representations, and quantifies bias by measuring the variation in representational similarity between the target concept and each of the reference concepts. Even without labeled data, BiasLens shows strong agreement with traditional bias evaluation metrics (Spearman correlation r > 0.85). Moreover, BiasLens reveals forms of bias that are difficult to detect using existing methods. For example, in simulated clinical scenarios, a patient's insurance status can cause the LLM to produce biased diagnostic assessments. Overall, BiasLens offers a scalable, interpretable, and efficient paradigm for bias discovery, paving the way for improving fairness and transparency in LLMs.

Recent advances in Natural Language Processing (NLP), and specifically automated Question Answering (QA) systems, have demonstrated both impressive linguistic fluency and a pernicious tendency to reflect social biases. In this study, we introduce Q-Pain, a dataset for assessing bias in medical QA in the context of pain management, one of the most challenging forms of clinical decision-making. Along with the dataset, we propose a new, rigorous framework, including a sample experimental design, to measure the potential biases present when making treatment decisions. We demonstrate its use by assessing two reference Question-Answering systems, GPT-2 and GPT-3, and find statistically significant differences in treatment between intersectional race-gender subgroups, thus reaffirming the risks posed by AI in medical settings, and the need for datasets like ours to ensure safety before medical AI applications are deployed.

University rankings are increasingly adopted for academic comparison and success quantification, even to establish performance-based criteria for funding assignment. However, rankings are not neutral tools, and their use frequently overlooks disparities in the starting conditions of institutions. In this research, we detect and measure structural biases that affect in inhomogeneous ways the ranking outcomes of universities from diversified territorial and educational contexts. Moreover, we develop a fairer rating system based on a fully data-driven debiasing strategy that returns an equity-oriented redefinition of the achieved scores. The key idea consists in partitioning universities in similarity groups, determined from multifaceted data using complex network analysis, and referring the performance of each institution to an expectation based on its peers. Significant evidence of territorial biases emerges for official rankings concerning both the OECD and Italian university systems, hence debiasing provides relevant insights suggesting the design of fairer strategies for performance-based funding allocations.

As Machine Learning technologies become increasingly used in contexts that affect citizens, companies as well as researchers need to be confident that their application of these methods will not have unexpected social implications, such as bias towards gender, ethnicity, and/or people with disabilities. There is significant literature on approaches to mitigate bias and promote fairness, yet the area is complex and hard to penetrate for newcomers to the domain. This article seeks to provide an overview of the different schools of thought and approaches to mitigating (social) biases and increase fairness in the Machine Learning literature. It organises approaches into the widely accepted framework of pre-processing, in-processing, and post-processing methods, subcategorizing into a further 11 method areas. Although much of the literature emphasizes binary classification, a discussion of fairness in regression, recommender systems, unsupervised learning, and natural language processing is also provided along with a selection of currently available open source libraries. The article concludes by summarising open challenges articulated as four dilemmas for fairness research.

The explosion in the use of software in important sociotechnical systems has renewed focus on the study of the way technical constructs reflect policies, norms, and human values. This effort requires the engagement of scholars and practitioners from many disciplines. And yet, these disciplines often conceptualize the operative values very differently while referring to them using the same vocabulary. The resulting conflation of ideas confuses discussions about values in technology at disciplinary boundaries. In the service of improving this situation, this paper examines the value of shared vocabularies, analytics, and other tools that facilitate conversations about values in light of these disciplinary specific conceptualizations, the role such tools play in furthering research and practice, outlines different conceptions of "fairness" deployed in discussions about computer systems, and provides an analytic tool for interdisciplinary discussions and collaborations around the concept of fairness. We use a case study of risk assessments in criminal justice applications to both motivate our effort--describing how conflation of different concepts under the banner of "fairness" led to unproductive confusion--and illustrate the value of the fairness analytic by demonstrating how the rigorous analysis it enables can assist in identifying key areas of theoretical, political, and practical misunderstanding or disagreement, and where desired support alignment or collaboration in the absence of consensus.

Rare diseases affect hundreds of millions worldwide, yet diagnosis often spans years. Convectional pipelines decouple noisy evidence extraction from downstream inferential diagnosis, and general/medical large language models (LLMs) face scarce real world electronic health records (EHRs), stale domain knowledge, and hallucinations. We assemble a large, domain specialized clinical corpus and a clinician validated reasoning set, and develop RareSeek R1 via staged instruction tuning, chain of thought learning, and graph grounded retrieval. Across multicenter EHR narratives and public benchmarks, RareSeek R1 attains state of the art accuracy, robust generalization, and stability under noisy or overlapping phenotypes. Augmented retrieval yields the largest gains when narratives pair with prioritized variants by resolving ambiguity and aligning candidates to mechanisms. Human studies show performance on par with experienced physicians and consistent gains in assistive use. Notably, transparent reasoning highlights decisive non phenotypic evidence (median 23.1%, such as imaging, interventions, functional tests) underpinning many correct diagnoses. This work advances a narrative first, knowledge integrated reasoning paradigm that shortens the diagnostic odyssey and enables auditable, clinically translatable decision support.

Large language models (LLMs) have been widely deployed in coding tasks, drawing increasing attention to the evaluation of the quality and safety of LLMs' outputs. However, research on bias in code generation remains limited. Existing studies typically identify bias by applying malicious prompts or reusing tasks and dataset originally designed for discriminative models. Given that prior datasets are not fully optimized for code-related tasks, there is a pressing need for benchmarks specifically designed for evaluating code models. In this study, we introduce FairCoder, a novel benchmark for evaluating social bias in code generation. FairCoder explores the bias issue following the pipeline in software development, from function implementation to unit test, with diverse real-world scenarios. Additionally, three metrics are designed to assess fairness performance on this benchmark. We conduct experiments on widely used LLMs and provide a comprehensive analysis of the results. The findings reveal that all tested LLMs exhibit social bias.