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Abstract Deep learning has become a popular tool for computer-aided diagnosis using medical images, sometimes matching or exceeding the performance of clinicians. However, these models can also reflect and amplify human bias, potentially resulting inaccurate missed diagnoses. Despite this concern, the problem of improving model fairness in medical image classification by deep learning has yet to be fully studied. To address this issue, we propose an algorithm that leverages the marginal pairwise equal opportunity to reduce bias in medical image classification. Our evaluations across four tasks using four independent large-scale cohorts demonstrate that our proposed algorithm not only improves fairness in individual and intersectional subgroups but also maintains overall performance. Specifically, the relative change in pairwise fairness difference between our proposed model and the baseline model was reduced by over 35%, while the relative change in AUC value was typically within 1%. By reducing the bias generated by deep learning models, our proposed approach can potentially alleviate concerns about the fairness and reliability of image-based computer-aided diagnosis. 

Deep neural networks have witnessed huge successes in many challenging prediction tasks and yet they often suffer from out-of-distribution (OoD) samples, misclassifying them with high confidence. Recent advances show promising OoD detection performance for centralized training, and however, OoD detection in federated learning (FL) is largely overlooked, even though many security sensitive applications such as autonomous driving and voice recognition authorization are commonly trained using FL for data privacy concerns. The main challenge that prevents previous state-of-the-art OoD detection methods from being incorporated to FL is that they require large amount of real OoD samples. However, in real-world scenarios, such large-scale OoD training data can be costly or even infeasible to obtain, especially for resource-limited local devices. On the other hand, a notorious challenge in FL is data heterogeneity where each client collects non-identically and independently distributed (non-iid) data. We propose to take advantage of such heterogeneity and turn the curse into a blessing that facilitates OoD detection in FL. The key is that for each client, non-iid data from other clients (unseen external classes) can serve as an alternative to real OoD samples. Specifically, we propose a novel Federated Out-of-Distribution Synthesizer (FOSTER), which learns a class-conditional generator to synthesize virtual external-class OoD samples, and maintains data confidentiality and communication efficiency required by FL. Experimental results show that our method outperforms the state-of-the-art by 2.49%, 2.88%, 1.42% AUROC, and 0.01%, 0.89%, 1.74% ID accuracy, on CIFAR-10, CIFAR-100, and STL10, respectively. 

Increasing concerns have been raised on deep learning fairness in recent years. Existing fairness-aware machine learning methods mainly focus on the fairness of in-distribution data. However, in real-world applications, it is common to have a distribution shift between the training and test data. In this paper, we first show that the fairness achieved by existing methods can be easily broken by slight distribution shifts. To solve this problem, we propose a novel fairness learning method termed CUrvature MAtching (CUMA), which can achieve robust fairness generalizable to unseen domains with unknown distributional shifts. Specifically, CUMA enforces the model to have similar generalization ability on the majority and minority groups, by matching the loss curvature distributions of the two groups. We evaluate our method on three popular fairness datasets. Compared with existing methods, CUMA achieves superior fairness under unseen distribution shifts, without sacrificing either the overall accuracy or the in-distribution fairness.