Fair AI-powered orthopedic image segmentation: addressing bias and promoting equitable healthcare.

Journal: Scientific reports
Published Date:

Abstract

AI-powered segmentation of hip and knee bony anatomy has revolutionized orthopedics, transforming pre-operative planning and post-operative assessment. Despite the remarkable advancements in AI algorithms for medical imaging, the potential for biases inherent within these models remains largely unexplored. This study tackles these concerns by thoroughly re-examining AI-driven segmentation for hip and knee bony anatomy. While advanced imaging modalities like CT and MRI offer comprehensive views, plain radiographs (X-rays) predominate the standard initial clinical assessment due to their widespread availability, low cost, and rapid acquisition. Hence, we focused on plain radiographs to ensure the utilization of our contribution in diverse healthcare settings, including those with limited access to advanced imaging technologies. This work provides insights into the underlying causes of biases in AI-based knee and hip image segmentation through an extensive evaluation, presenting targeted mitigation strategies to alleviate biases related to sex, race, and age, using an automatic segmentation that is fair, impartial, and safe in the context of AI. Our contribution can enhance inclusivity, ethical practices, equity, and an unbiased healthcare environment with advanced clinical outcomes, aiding decision-making and osteoarthritis research. Furthermore, we have made all the codes and datasets publicly and freely accessible to promote open scientific research.

Authors

  • Ismaeel A Siddiqui
    Department of Health Information Management, University of Pittsburgh, Pittsburgh, 15620, USA.
  • Nickolas Littlefield
    Intelligent Systems Program, University of Pittsburgh, Pittsburgh, PA, 15213, USA.
  • Luke A Carlson
    Department of Artificial Intelligence and Informatics, Mayo Clinic, Rochester, MN, United States.
  • Matthew Gong
    Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, 15213, USA.
  • Avani Chhabra
    Department of Health Information Management, University of Pittsburgh, Pittsburgh, 15620, USA.
  • Zoe Menezes
    Department of Health Information Management, University of Pittsburgh, Pittsburgh, 15620, USA.
  • George M Mastorakos
    Cortechs.ai, San Diego, 92122, USA.
  • Sakshi Mehul Thakar
    Department of Health Information Management, University of Pittsburgh, Pittsburgh, 15620, USA.
  • Mehrnaz Abedian
    Department of Health Information Management, University of Pittsburgh, Pittsburgh, 15620, USA.
  • Ines Lohse
    Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, 15213, USA.
  • Kurt R Weiss
    Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, 15213, USA.
  • Johannes F Plate
    Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, 15213, USA. platefj2@upmc.edu.
  • Hamidreza Moradi
    Department of Data Science, University of Mississippi Medical Center, Jackson, Mississippi, United States of America.
  • Soheyla Amirian
    School of Computing, University of Georgia, Athens, GA, 30602 USA.
  • Ahmad P Tafti
    School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA 15260, USA.