Balancing Fairness and Performance in Healthcare AI: A Gradient Reconciliation Approach

Fuente: arXiv
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Hauptverfasser: Wang, Xiaoyang, Yang, Christopher C.
Format: Preprint
Veröffentlicht: 2025
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author Wang, Xiaoyang
Yang, Christopher C.
author_facet Wang, Xiaoyang
Yang, Christopher C.
contents The rapid growth of healthcare data and advances in computational power have accelerated the adoption of artificial intelligence (AI) in medicine. However, AI systems deployed without explicit fairness considerations risk exacerbating existing healthcare disparities, potentially leading to inequitable resource allocation and diagnostic disparities across demographic subgroups. To address this challenge, we propose FairGrad, a novel gradient reconciliation framework that automatically balances predictive performance and multi-attribute fairness optimization in healthcare AI models. Our method resolves conflicting optimization objectives by projecting each gradient vector onto the orthogonal plane of the others, thereby regularizing the optimization trajectory to ensure equitable consideration of all objectives. Evaluated on diverse real-world healthcare datasets and predictive tasks - including Substance Use Disorder (SUD) treatment and sepsis mortality - FairGrad achieved statistically significant improvements in multi-attribute fairness metrics (e.g., equalized odds) while maintaining competitive predictive accuracy. These results demonstrate the viability of harmonizing fairness and utility in mission-critical medical AI applications.
format Preprint
id arxiv_https___arxiv_org_abs_2504_14388
institution arXiv
publishDate 2025
record_format arxiv
spellingShingle Balancing Fairness and Performance in Healthcare AI: A Gradient Reconciliation Approach
Wang, Xiaoyang
Yang, Christopher C.
Machine Learning
Computers and Society
The rapid growth of healthcare data and advances in computational power have accelerated the adoption of artificial intelligence (AI) in medicine. However, AI systems deployed without explicit fairness considerations risk exacerbating existing healthcare disparities, potentially leading to inequitable resource allocation and diagnostic disparities across demographic subgroups. To address this challenge, we propose FairGrad, a novel gradient reconciliation framework that automatically balances predictive performance and multi-attribute fairness optimization in healthcare AI models. Our method resolves conflicting optimization objectives by projecting each gradient vector onto the orthogonal plane of the others, thereby regularizing the optimization trajectory to ensure equitable consideration of all objectives. Evaluated on diverse real-world healthcare datasets and predictive tasks - including Substance Use Disorder (SUD) treatment and sepsis mortality - FairGrad achieved statistically significant improvements in multi-attribute fairness metrics (e.g., equalized odds) while maintaining competitive predictive accuracy. These results demonstrate the viability of harmonizing fairness and utility in mission-critical medical AI applications.
title Balancing Fairness and Performance in Healthcare AI: A Gradient Reconciliation Approach
topic Machine Learning
Computers and Society
url https://arxiv.org/abs/2504.14388