Daily Papers

Vision language models (VLMs) show promise in medical diagnosis, but their performance across demographic subgroups when using in-context learning (ICL) remains poorly understood. We examine how the demographic composition of demonstration examples affects VLM performance in two medical imaging tasks: skin lesion malignancy prediction and pneumothorax detection from chest radiographs. Our analysis reveals that ICL influences model predictions through multiple mechanisms: (1) ICL allows VLMs to learn subgroup-specific disease base rates from prompts and (2) ICL leads VLMs to make predictions that perform differently across demographic groups, even after controlling for subgroup-specific disease base rates. Our empirical results inform best-practices for prompting current VLMs (specifically examining demographic subgroup performance, and matching base rates of labels to target distribution at a bulk level and within subgroups), while also suggesting next steps for improving our theoretical understanding of these models.

Hospitals struggle to predict critical outcomes. Traditional early warning systems, like NEWS and MEWS, rely on static variables and fixed thresholds, limiting their adaptability, accuracy, and personalization. We previously developed the Enhanced Transformer for Health Outcome Simulation (ETHOS), an AI model that tokenizes patient health timelines (PHTs) from EHRs and uses transformer-based architectures to predict future PHTs. ETHOS is a versatile framework for developing a wide range of applications. In this work, we develop the Adaptive Risk Estimation System (ARES) that leverages ETHOS to compute dynamic, personalized risk probabilities for clinician-defined critical events. ARES also features a personalized explainability module that highlights key clinical factors influencing risk estimates. We evaluated ARES using the MIMIC-IV v2.2 dataset together with its Emergency Department (ED) extension and benchmarked performance against both classical early warning systems and contemporary machine learning models. The entire dataset was tokenized resulting in 285,622 PHTs, comprising over 360 million tokens. ETHOS outperformed benchmark models in predicting hospital admissions, ICU admissions, and prolonged stays, achieving superior AUC scores. Its risk estimates were robust across demographic subgroups, with calibration curves confirming model reliability. The explainability module provided valuable insights into patient-specific risk factors. ARES, powered by ETHOS, advances predictive healthcare AI by delivering dynamic, real-time, personalized risk estimation with patient-specific explainability. Although our results are promising, the clinical impact remains uncertain. Demonstrating ARES's true utility in real-world settings will be the focus of our future work. We release the source code to facilitate future research.

Fair machine learning seeks to mitigate model prediction bias against certain demographic subgroups such as elder and female. Recently, fair representation learning (FRL) trained by deep neural networks has demonstrated superior performance, whereby representations containing no demographic information are inferred from the data and then used as the input to classification or other downstream tasks. Despite the development of FRL methods, their vulnerability under data poisoning attack, a popular protocol to benchmark model robustness under adversarial scenarios, is under-explored. Data poisoning attacks have been developed for classical fair machine learning methods which incorporate fairness constraints into shallow-model classifiers. Nonetheless, these attacks fall short in FRL due to notably different fairness goals and model architectures. This work proposes the first data poisoning framework attacking FRL. We induce the model to output unfair representations that contain as much demographic information as possible by injecting carefully crafted poisoning samples into the training data. This attack entails a prohibitive bilevel optimization, wherefore an effective approximated solution is proposed. A theoretical analysis on the needed number of poisoning samples is derived and sheds light on defending against the attack. Experiments on benchmark fairness datasets and state-of-the-art fair representation learning models demonstrate the superiority of our attack.

Intersectionality is a critical framework that, through inquiry and praxis, allows us to examine how social inequalities persist through domains of structure and discipline. Given AI fairness' raison d'etre of "fairness", we argue that adopting intersectionality as an analytical framework is pivotal to effectively operationalizing fairness. Through a critical review of how intersectionality is discussed in 30 papers from the AI fairness literature, we deductively and inductively: 1) map how intersectionality tenets operate within the AI fairness paradigm and 2) uncover gaps between the conceptualization and operationalization of intersectionality. We find that researchers overwhelmingly reduce intersectionality to optimizing for fairness metrics over demographic subgroups. They also fail to discuss their social context and when mentioning power, they mostly situate it only within the AI pipeline. We: 3) outline and assess the implications of these gaps for critical inquiry and praxis, and 4) provide actionable recommendations for AI fairness researchers to engage with intersectionality in their work by grounding it in AI epistemology.

Large language models (LLMs) are increasingly essential in processing natural languages, yet their application is frequently compromised by biases and inaccuracies originating in their training data. In this study, we introduce Cross-Care, the first benchmark framework dedicated to assessing biases and real world knowledge in LLMs, specifically focusing on the representation of disease prevalence across diverse demographic groups. We systematically evaluate how demographic biases embedded in pre-training corpora like ThePile influence the outputs of LLMs. We expose and quantify discrepancies by juxtaposing these biases against actual disease prevalences in various U.S. demographic groups. Our results highlight substantial misalignment between LLM representation of disease prevalence and real disease prevalence rates across demographic subgroups, indicating a pronounced risk of bias propagation and a lack of real-world grounding for medical applications of LLMs. Furthermore, we observe that various alignment methods minimally resolve inconsistencies in the models' representation of disease prevalence across different languages. For further exploration and analysis, we make all data and a data visualization tool available at: www.crosscare.net.

Achieving robust performance and fairness across diverse patient populations remains a challenge in developing clinically deployable deep learning models for diagnostic imaging. Synthetic data generation has emerged as a promising strategy to address limitations in dataset scale and diversity. We introduce RoentGen-v2, a text-to-image diffusion model for chest radiographs that enables fine-grained control over both radiographic findings and patient demographic attributes, including sex, age, and race/ethnicity. RoentGen-v2 is the first model to generate clinically plausible images with demographic conditioning, facilitating the creation of a large, demographically balanced synthetic dataset comprising over 565,000 images. We use this large synthetic dataset to evaluate optimal training pipelines for downstream disease classification models. In contrast to prior work that combines real and synthetic data naively, we propose an improved training strategy that leverages synthetic data for supervised pretraining, followed by fine-tuning on real data. Through extensive evaluation on over 137,000 chest radiographs from five institutions, we demonstrate that synthetic pretraining consistently improves model performance, generalization to out-of-distribution settings, and fairness across demographic subgroups. Across datasets, synthetic pretraining led to a 6.5% accuracy increase in the performance of downstream classification models, compared to a modest 2.7% increase when naively combining real and synthetic data. We observe this performance improvement simultaneously with the reduction of the underdiagnosis fairness gap by 19.3%. These results highlight the potential of synthetic imaging to advance equitable and generalizable medical deep learning under real-world data constraints. We open source our code, trained models, and synthetic dataset at https://github.com/StanfordMIMI/RoentGen-v2 .

This work presents a comprehensive evaluation of how quantization affects model bias, with particular attention to its impact on individual demographic subgroups. We focus on weight and activation quantization strategies and examine their effects across a broad range of bias types, including stereotypes, toxicity, sentiment, and fairness. We employ both probabilistic and generated text-based metrics across nine benchmarks and evaluate models varying in architecture family and reasoning ability. Our findings show that quantization has a nuanced impact on bias: while it can reduce model toxicity and does not significantly impact sentiment, it tends to slightly increase stereotypes and unfairness in generative tasks, especially under aggressive compression. These trends are generally consistent across demographic categories and model types, although their magnitude depends on the specific setting. Overall, our results highlight the importance of carefully balancing efficiency and ethical considerations when applying quantization in practice.

The growing capability and accessibility of machine learning has led to its application to many real-world domains and data about people. Despite the benefits algorithmic systems may bring, models can reflect, inject, or exacerbate implicit and explicit societal biases into their outputs, disadvantaging certain demographic subgroups. Discovering which biases a machine learning model has introduced is a great challenge, due to the numerous definitions of fairness and the large number of potentially impacted subgroups. We present FairVis, a mixed-initiative visual analytics system that integrates a novel subgroup discovery technique for users to audit the fairness of machine learning models. Through FairVis, users can apply domain knowledge to generate and investigate known subgroups, and explore suggested and similar subgroups. FairVis' coordinated views enable users to explore a high-level overview of subgroup performance and subsequently drill down into detailed investigation of specific subgroups. We show how FairVis helps to discover biases in two real datasets used in predicting income and recidivism. As a visual analytics system devoted to discovering bias in machine learning, FairVis demonstrates how interactive visualization may help data scientists and the general public understand and create more equitable algorithmic systems.

Despite excellent average-case performance of many image classifiers, their performance can substantially deteriorate on semantically coherent subgroups of the data that were under-represented in the training data. These systematic errors can impact both fairness for demographic minority groups as well as robustness and safety under domain shift. A major challenge is to identify such subgroups with subpar performance when the subgroups are not annotated and their occurrence is very rare. We leverage recent advances in text-to-image models and search in the space of textual descriptions of subgroups ("prompts") for subgroups where the target model has low performance on the prompt-conditioned synthesized data. To tackle the exponentially growing number of subgroups, we employ combinatorial testing. We denote this procedure as PromptAttack as it can be interpreted as an adversarial attack in a prompt space. We study subgroup coverage and identifiability with PromptAttack in a controlled setting and find that it identifies systematic errors with high accuracy. Thereupon, we apply PromptAttack to ImageNet classifiers and identify novel systematic errors on rare subgroups.

Stereotype benchmark datasets are crucial to detect and mitigate social stereotypes about groups of people in NLP models. However, existing datasets are limited in size and coverage, and are largely restricted to stereotypes prevalent in the Western society. This is especially problematic as language technologies gain hold across the globe. To address this gap, we present SeeGULL, a broad-coverage stereotype dataset, built by utilizing generative capabilities of large language models such as PaLM, and GPT-3, and leveraging a globally diverse rater pool to validate the prevalence of those stereotypes in society. SeeGULL is in English, and contains stereotypes about identity groups spanning 178 countries across 8 different geo-political regions across 6 continents, as well as state-level identities within the US and India. We also include fine-grained offensiveness scores for different stereotypes and demonstrate their global disparities. Furthermore, we include comparative annotations about the same groups by annotators living in the region vs. those that are based in North America, and demonstrate that within-region stereotypes about groups differ from those prevalent in North America. CONTENT WARNING: This paper contains stereotype examples that may be offensive.

Machine learning models often perform poorly on subgroups that are underrepresented in the training data. Yet, little is understood on the variation in mechanisms that cause subpopulation shifts, and how algorithms generalize across such diverse shifts at scale. In this work, we provide a fine-grained analysis of subpopulation shift. We first propose a unified framework that dissects and explains common shifts in subgroups. We then establish a comprehensive benchmark of 20 state-of-the-art algorithms evaluated on 12 real-world datasets in vision, language, and healthcare domains. With results obtained from training over 10,000 models, we reveal intriguing observations for future progress in this space. First, existing algorithms only improve subgroup robustness over certain types of shifts but not others. Moreover, while current algorithms rely on group-annotated validation data for model selection, we find that a simple selection criterion based on worst-class accuracy is surprisingly effective even without any group information. Finally, unlike existing works that solely aim to improve worst-group accuracy (WGA), we demonstrate the fundamental tradeoff between WGA and other important metrics, highlighting the need to carefully choose testing metrics. Code and data are available at: https://github.com/YyzHarry/SubpopBench.

Understanding how people of various demographics think, feel, and express themselves (collectively called group expression) is essential for social science and underlies the assessment of bias in Large Language Models (LLMs). While LLMs can effectively summarize group expression when provided with empirical examples, coming up with generalizable theories of how a group's expression manifests in real-world text is challenging. In this paper, we define a new task called Group Theorization, in which a system must write theories that differentiate expression across demographic groups. We make available a large dataset on this task, Splits!, constructed by splitting Reddit posts by neutral topics (e.g. sports, cooking, and movies) and by demographics (e.g. occupation, religion, and race). Finally, we suggest a simple evaluation framework for assessing how effectively a method can generate 'better' theories about group expression, backed by human validation. We publicly release the raw corpora and evaluation scripts for Splits! to help researchers assess how methods infer--and potentially misrepresent--group differences in expression. We make Splits! and our evaluation module available at https://github.com/eyloncaplan/splits.

This paper studies the fair range clustering problem in which the data points are from different demographic groups and the goal is to pick k centers with the minimum clustering cost such that each group is at least minimally represented in the centers set and no group dominates the centers set. More precisely, given a set of n points in a metric space (P,d) where each point belongs to one of the ell different demographics (i.e., P = P_1 uplus P_2 uplus cdots uplus P_ell) and a set of ell intervals [alpha_1, beta_1], cdots, [alpha_ell, beta_ell] on desired number of centers from each group, the goal is to pick a set of k centers C with minimum ell_p-clustering cost (i.e., (sum_{vin P} d(v,C)^p)^{1/p}) such that for each group iin ell, |Ccap P_i| in [alpha_i, beta_i]. In particular, the fair range ell_p-clustering captures fair range k-center, k-median and k-means as its special cases. In this work, we provide efficient constant factor approximation algorithms for fair range ell_p-clustering for all values of pin [1,infty).

Background: AI-based classification models are essential for improving lung cancer diagnosis. However, the relative performance of lesion-level versus chest-region models in internal and external datasets remains unclear. Purpose: This study evaluates the performance of lesion-level and chest-region models for lung cancer classification, comparing their effectiveness across internal Duke Lung Nodule Dataset 2024 (DLND24) and external (LUNA16, NLST) datasets, with a focus on subgroup analyses by demographics, histology, and imaging characteristics. Materials and Methods: Two AI models were trained: one using lesion-centric patches (64,64,64) and the other using chest-region patches (512,512,8). Internal validation was conducted on DLND24, while external validation utilized LUNA16 and NLST datasets. The models performances were assessed using AUC-ROC, with subgroup analyses for demographic, clinical, and imaging factors. Statistical comparisons were performed using DeLongs test. Gradient-based visualizations and probability distribution were further used for analysis. Results: The lesion-level model consistently outperformed the chest-region model across datasets. In internal validation, the lesion-level model achieved an AUC of 0.71(CI: 0.61-0.81), compared to 0.68(0.57-0.77) for the chest-region model. External validation showed similar trends, with AUCs of 0.90(0.87-0.92) and 0.81(0.79-0.82) on LUNA16 and NLST, respectively. Subgroup analyses revealed significant advantages for lesion-level models in certain histological subtypes (adenocarcinoma) and imaging conditions (CT manufacturers). Conclusion: Lesion-level models demonstrate superior classification performance, especially for external datasets and challenging subgroups, suggesting their clinical utility for precision lung cancer diagnostics.

Personality and demographics are important variables in social sciences, while in NLP they can aid in interpretability and removal of societal biases. However, datasets with both personality and demographic labels are scarce. To address this, we present PANDORA, the first large-scale dataset of Reddit comments labeled with three personality models (including the well-established Big 5 model) and demographics (age, gender, and location) for more than 10k users. We showcase the usefulness of this dataset on three experiments, where we leverage the more readily available data from other personality models to predict the Big 5 traits, analyze gender classification biases arising from psycho-demographic variables, and carry out a confirmatory and exploratory analysis based on psychological theories. Finally, we present benchmark prediction models for all personality and demographic variables.

We provide the largest compiled publicly available dictionaries of first, middle, and last names for the purpose of imputing race and ethnicity using, for example, Bayesian Improved Surname Geocoding (BISG). The dictionaries are based on the voter files of six Southern states that collect self-reported racial data upon voter registration. Our data cover a much larger scope of names than any comparable dataset, containing roughly one million first names, 1.1 million middle names, and 1.4 million surnames. Individuals are categorized into five mutually exclusive racial and ethnic groups -- White, Black, Hispanic, Asian, and Other -- and racial/ethnic counts by name are provided for every name in each dictionary. Counts can then be normalized row-wise or column-wise to obtain conditional probabilities of race given name or name given race. These conditional probabilities can then be deployed for imputation in a data analytic task for which ground truth racial and ethnic data is not available.

Hypertension remains a global health concern with a rising prevalence, necessitating effective monitoring and understanding of blood pressure (BP) dynamics. This study delves into the wealth of information derived from BP measurement, a crucial approach in informing our understanding of hypertensive trends. Numerous studies have reported on the relationship between BP variation and various factors. In this research, we leveraged an extensive dataset comprising 75 million records spanning two decades, offering a unique opportunity to explore and analyze BP variations across demographic features such as age, race, and gender. Our findings revealed that gender-based BP variation was not statistically significant, challenging conventional assumptions. Interestingly, systolic blood pressure (SBP) consistently increased with age, while diastolic blood pressure (DBP) displayed a distinctive peak in the forties age group. Moreover, our analysis uncovered intriguing similarities in the distribution of BP among some of the racial groups. This comprehensive investigation contributes to the ongoing discourse on hypertension and underscores the importance of considering diverse demographic factors in understanding BP variations. Our results provide valuable insights that may inform personalized healthcare approaches tailored to specific demographic profiles.

A lack of demographic context in existing toxic speech datasets limits our understanding of how different age groups communicate online. In collaboration with funk, a German public service content network, this research introduces the first large-scale German dataset annotated for toxicity and enriched with platform-provided age estimates. The dataset includes 3,024 human-annotated and 30,024 LLM-annotated anonymized comments from Instagram, TikTok, and YouTube. To ensure relevance, comments were consolidated using predefined toxic keywords, resulting in 16.7\% labeled as problematic. The annotation pipeline combined human expertise with state-of-the-art language models, identifying key categories such as insults, disinformation, and criticism of broadcasting fees. The dataset reveals age-based differences in toxic speech patterns, with younger users favoring expressive language and older users more often engaging in disinformation and devaluation. This resource provides new opportunities for studying linguistic variation across demographics and supports the development of more equitable and age-aware content moderation systems.

Existing public face datasets are strongly biased toward Caucasian faces, and other races (e.g., Latino) are significantly underrepresented. This can lead to inconsistent model accuracy, limit the applicability of face analytic systems to non-White race groups, and adversely affect research findings based on such skewed data. To mitigate the race bias in these datasets, we construct a novel face image dataset, containing 108,501 images, with an emphasis of balanced race composition in the dataset. We define 7 race groups: White, Black, Indian, East Asian, Southeast Asian, Middle East, and Latino. Images were collected from the YFCC-100M Flickr dataset and labeled with race, gender, and age groups. Evaluations were performed on existing face attribute datasets as well as novel image datasets to measure generalization performance. We find that the model trained from our dataset is substantially more accurate on novel datasets and the accuracy is consistent between race and gender groups.