FairEHR-CLP: Towards Fairness-Aware Clinical Predictions with Contrastive Learning in Multimodal Electronic Health Records

Fuente: arXiv
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Main Authors: Wang, Yuqing, Pillai, Malvika, Zhao, Yun, Curtin, Catherine, Hernandez-Boussard, Tina
Format: Preprint
Published: 2024
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author Wang, Yuqing
Pillai, Malvika
Zhao, Yun
Curtin, Catherine
Hernandez-Boussard, Tina
author_facet Wang, Yuqing
Pillai, Malvika
Zhao, Yun
Curtin, Catherine
Hernandez-Boussard, Tina
contents In the high-stakes realm of healthcare, ensuring fairness in predictive models is crucial. Electronic Health Records (EHRs) have become integral to medical decision-making, yet existing methods for enhancing model fairness restrict themselves to unimodal data and fail to address the multifaceted social biases intertwined with demographic factors in EHRs. To mitigate these biases, we present FairEHR-CLP: a general framework for Fairness-aware Clinical Predictions with Contrastive Learning in EHRs. FairEHR-CLP operates through a two-stage process, utilizing patient demographics, longitudinal data, and clinical notes. First, synthetic counterparts are generated for each patient, allowing for diverse demographic identities while preserving essential health information. Second, fairness-aware predictions employ contrastive learning to align patient representations across sensitive attributes, jointly optimized with an MLP classifier with a softmax layer for clinical classification tasks. Acknowledging the unique challenges in EHRs, such as varying group sizes and class imbalance, we introduce a novel fairness metric to effectively measure error rate disparities across subgroups. Extensive experiments on three diverse EHR datasets on three tasks demonstrate the effectiveness of FairEHR-CLP in terms of fairness and utility compared with competitive baselines. FairEHR-CLP represents an advancement towards ensuring both accuracy and equity in predictive healthcare models.
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id arxiv_https___arxiv_org_abs_2402_00955
institution arXiv
publishDate 2024
record_format arxiv
spellingShingle FairEHR-CLP: Towards Fairness-Aware Clinical Predictions with Contrastive Learning in Multimodal Electronic Health Records
Wang, Yuqing
Pillai, Malvika
Zhao, Yun
Curtin, Catherine
Hernandez-Boussard, Tina
Machine Learning
Computers and Society
In the high-stakes realm of healthcare, ensuring fairness in predictive models is crucial. Electronic Health Records (EHRs) have become integral to medical decision-making, yet existing methods for enhancing model fairness restrict themselves to unimodal data and fail to address the multifaceted social biases intertwined with demographic factors in EHRs. To mitigate these biases, we present FairEHR-CLP: a general framework for Fairness-aware Clinical Predictions with Contrastive Learning in EHRs. FairEHR-CLP operates through a two-stage process, utilizing patient demographics, longitudinal data, and clinical notes. First, synthetic counterparts are generated for each patient, allowing for diverse demographic identities while preserving essential health information. Second, fairness-aware predictions employ contrastive learning to align patient representations across sensitive attributes, jointly optimized with an MLP classifier with a softmax layer for clinical classification tasks. Acknowledging the unique challenges in EHRs, such as varying group sizes and class imbalance, we introduce a novel fairness metric to effectively measure error rate disparities across subgroups. Extensive experiments on three diverse EHR datasets on three tasks demonstrate the effectiveness of FairEHR-CLP in terms of fairness and utility compared with competitive baselines. FairEHR-CLP represents an advancement towards ensuring both accuracy and equity in predictive healthcare models.
title FairEHR-CLP: Towards Fairness-Aware Clinical Predictions with Contrastive Learning in Multimodal Electronic Health Records
topic Machine Learning
Computers and Society
url https://arxiv.org/abs/2402.00955