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The use of machine learning systems to support decision making in healthcare raises questions as to what extent these systems may introduce or exacerbate disparities in care for historically underrepresented and mistreated groups, due to biases implicitly embedded in observational data in electronic health records. To address this problem in the context of clinical risk prediction models, we develop an augmented counterfactual fairness criteria to extend the group fairness criteria of equalized odds to an individual level. We do so by requiring that the same prediction be made for a patient, and a counterfactual patient resulting from changing a sensitive attribute, if the factual and counterfactual outcomes do not differ. We investigate the extent to which the augmented counterfactual fairness criteria may be applied to develop fair models for prolonged inpatient length of stay and mortality with observational electronic health records data. As the fairness criteria is ill-defined without knowledge of the data generating process, we use a variational autoencoder to perform counterfactual inference in the context of an assumed causal graph. While our technique provides a means to trade off maintenance of fairness with reduction in predictive performance in the context of a learned generative model, further work is needed to assess the generality of this approach.
The use of machine learning to guide clinical decision making has the potential to worsen existing health disparities. Several recent works frame the problem as that of algorithmic fairness, a framework that has attracted considerable attention and c
Bias mitigation approaches reduce models dependence on sensitive features of data, such as social group tokens (SGTs), resulting in equal predictions across the sensitive features. In hate speech detection, however, equalizing model predictions may i
Algorithmic risk assessments are increasingly used to help humans make decisions in high-stakes settings, such as medicine, criminal justice and education. In each of these cases, the purpose of the risk assessment tool is to inform actions, such as
Although recent multi-task learning methods have shown to be effective in improving the generalization of deep neural networks, they should be used with caution for safety-critical applications, such as clinical risk prediction. This is because even
Fairness concerns about algorithmic decision-making systems have been mainly focused on the outputs (e.g., the accuracy of a classifier across individuals or groups). However, one may additionally be concerned with fairness in the inputs. In this pap