Evidence map›Paper›PMID 38043883›Full record

ArticleJournal of biomedical informatics2024

Efficient adversarial debiasing with concept activation vector - Medical image case-studies.

Ramon Correa, Khushbu Pahwa, Bhavik Patel, Celine M Vachon, Judy W Gichoya, Imon Banerjee

Open access · greenAbstract read
In one paragraph

Article in Journal of biomedical informatics, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
3.1field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 18 citations in OpenAlex.

  1. Article
  2. MOSCARD - Multimodal Opportunistic Screening for Cardiovascular Adverse events with Causal Reasoning and De-confounding.Medical image computing and computer-assisted intervention : MICCAI ... International Conference on Medical Image Computing and Computer-Assisted Intervention · 2026
    Article
  3. Article
  4. Mitigating Bias in Opportunistic Screening for MACE with Causal Reasoning.IEEE transactions on artificial intelligence · 2025
    Article
  5. Review
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 5 institutions in 1 country.

Ramon CorreaArizona State University, SCAI, Tempe, AZ, 85281, USA. Electronic address: rlcorrea@asu.edu.
Khushbu PahwaUniversity of California Los Angeles, LA, USA.
Bhavik PatelArizona State University, SCAI, Tempe, AZ, 85281, USA; Mayo Clinic, Department of Radiology, Phoenix, AZ, 85054, USA. Electronic address: https://twitter.com/@bhavik_md.
Celine M VachonMayo Clinic, Department of Quantitative Health Sciences, Rochester, 55905, USA.
Judy W GichoyaEmory University, Department of Radiology, Atlanta, GA, 44106, USA. Electronic address: https://twitter.com/@judywawira.
Imon BanerjeeArizona State University, SCAI, Tempe, AZ, 85281, USA; Mayo Clinic, Department of Radiology, Phoenix, AZ, 85054, USA. Electronic address: ibanerj7@asu.edu.
WinnMed · USArizona State University · USEmory University · USMayo Clinic in Florida · USUniversity of California, Los Angeles · US

Funding

Population-level Pulmonary Embolism Outcome Prediction with Imaging and Clinical Data: A Multi-Center StudyR01HL155410 · NHLBI · STANFORD UNIVERSITY · PI LANGLOTZ, CURTIS P, SHAH, NIGAM H · 2021 to 2024
$2.1M
NHLBI NIH HHS R01 HL155410
6 · The paper itself

Abstract

backgroundA major hurdle for the real time deployment of the AI models is ensuring trustworthiness of these models for the unseen population. More often than not, these complex models are black boxes in which promising results are generated. However, when scrutinized, these models begin to reveal implicit biases during the decision making, particularly for the minority subgroups.

methodWe develop an efficient adversarial de-biasing approach with partial learning by incorporating the existing concept activation vectors (CAV) methodology, to reduce racial disparities while preserving the performance of the targeted task. CAV is originally a model interpretability technique which we adopted to identify convolution layers responsible for learning race and only fine-tune up to that layer instead of fine-tuning the complete network, limiting the drop in performance

results: The methodology has been evaluated on two independent medical image case-studies - chest X-ray and mammograms, and we also performed external validation on a different racial population. On the external datasets for the chest X-ray use-case, debiased models (averaged AUC 0.87 ) outperformed the baseline convolution models (averaged AUC 0.57 ) as well as the models trained with the popular fine-tuning strategy (averaged AUC 0.81). Moreover, the mammogram models is debiased using a single dataset (white, black and Asian) and improved the performance on an external datasets (averaged AUC 0.8 to 0.86 ) with completely different population (primarily Hispanic patients).

conclusionIn this study, we demonstrated that the adversarial models trained only with internal data performed equally or often outperformed the standard fine-tuning strategy with data from an external setting. The adversarial training approach described can be applied regardless of predictor's model architecture, as long as the convolution model is trained using a gradient-based method. We release the training code with academic open-source license - https://github.com/ramon349/JBI2023_TCAV_debiasing.

Indexed as

Artificial IntelligenceClinical Decision-MakingDiagnostic ImagingRacial GroupsBiasHealthcare DisparitiesHumansMammographyMinority GroupsAdversarial fairnessConcept activation vectorDebiasingMammogram imagesX-ray images

Identifiers

PMID38043883
PMCPMC11192465
OpenAlexW4389219880

What Socratic holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.