AI Alignment in Medical Imaging: Unveiling Hidden Biases Through Counterfactual Analysis

Fuente: arXiv
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Main Authors: Ma, Haroui, Quinzan, Francesco, Willem, Theresa, Bauer, Stefan
Format: Preprint
Published: 2025
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author Ma, Haroui
Quinzan, Francesco
Willem, Theresa
Bauer, Stefan
author_facet Ma, Haroui
Quinzan, Francesco
Willem, Theresa
Bauer, Stefan
contents Machine learning (ML) systems for medical imaging have demonstrated remarkable diagnostic capabilities, but their susceptibility to biases poses significant risks, since biases may negatively impact generalization performance. In this paper, we introduce a novel statistical framework to evaluate the dependency of medical imaging ML models on sensitive attributes, such as demographics. Our method leverages the concept of counterfactual invariance, measuring the extent to which a model's predictions remain unchanged under hypothetical changes to sensitive attributes. We present a practical algorithm that combines conditional latent diffusion models with statistical hypothesis testing to identify and quantify such biases without requiring direct access to counterfactual data. Through experiments on synthetic datasets and large-scale real-world medical imaging datasets, including \textsc{cheXpert} and MIMIC-CXR, we demonstrate that our approach aligns closely with counterfactual fairness principles and outperforms standard baselines. This work provides a robust tool to ensure that ML diagnostic systems generalize well, e.g., across demographic groups, offering a critical step towards AI safety in healthcare. Code: https://github.com/Neferpitou3871/AI-Alignment-Medical-Imaging.
format Preprint
id arxiv_https___arxiv_org_abs_2504_19621
institution arXiv
publishDate 2025
record_format arxiv
spellingShingle AI Alignment in Medical Imaging: Unveiling Hidden Biases Through Counterfactual Analysis
Ma, Haroui
Quinzan, Francesco
Willem, Theresa
Bauer, Stefan
Machine Learning
Image and Video Processing
Machine learning (ML) systems for medical imaging have demonstrated remarkable diagnostic capabilities, but their susceptibility to biases poses significant risks, since biases may negatively impact generalization performance. In this paper, we introduce a novel statistical framework to evaluate the dependency of medical imaging ML models on sensitive attributes, such as demographics. Our method leverages the concept of counterfactual invariance, measuring the extent to which a model's predictions remain unchanged under hypothetical changes to sensitive attributes. We present a practical algorithm that combines conditional latent diffusion models with statistical hypothesis testing to identify and quantify such biases without requiring direct access to counterfactual data. Through experiments on synthetic datasets and large-scale real-world medical imaging datasets, including \textsc{cheXpert} and MIMIC-CXR, we demonstrate that our approach aligns closely with counterfactual fairness principles and outperforms standard baselines. This work provides a robust tool to ensure that ML diagnostic systems generalize well, e.g., across demographic groups, offering a critical step towards AI safety in healthcare. Code: https://github.com/Neferpitou3871/AI-Alignment-Medical-Imaging.
title AI Alignment in Medical Imaging: Unveiling Hidden Biases Through Counterfactual Analysis
topic Machine Learning
Image and Video Processing
url https://arxiv.org/abs/2504.19621