Mitigating machine learning bias between high income and low-middle income countries for enhanced model fairness and generalizability.

Journal: Scientific reports
PMID:

Abstract

Collaborative efforts in artificial intelligence (AI) are increasingly common between high-income countries (HICs) and low- to middle-income countries (LMICs). Given the resource limitations often encountered by LMICs, collaboration becomes crucial for pooling resources, expertise, and knowledge. Despite the apparent advantages, ensuring the fairness and equity of these collaborative models is essential, especially considering the distinct differences between LMIC and HIC hospitals. In this study, we show that collaborative AI approaches can lead to divergent performance outcomes across HIC and LMIC settings, particularly in the presence of data imbalances. Through a real-world COVID-19 screening case study, we demonstrate that implementing algorithmic-level bias mitigation methods significantly improves outcome fairness between HIC and LMIC sites while maintaining high diagnostic sensitivity. We compare our results against previous benchmarks, utilizing datasets from four independent United Kingdom Hospitals and one Vietnamese hospital, representing HIC and LMIC settings, respectively.

Authors

  • Jenny Yang
    Department of Engineering Science, Institute of Biomedical Engineering, University of Oxford, Oxford, England. jenny.yang@eng.ox.ac.uk.
  • Lei Clifton
    Nuffield Department of Population Health, University of Oxford, Oxford, England.
  • Nguyen Thanh Dung
    Hospital for Tropical Diseases, Ho Chi Minh, Vietnam.
  • Nguyen Thanh Phong
    Hospital for Tropical Diseases, Ho Chi Minh, Vietnam.
  • Lam Minh Yen
    Oxford University Clinical Research Unit, Ho Chi Minh, Vietnam.
  • Doan Bui Xuan Thy
    Oxford University Clinical Research Unit, Ho Chi Minh, Vietnam.
  • Andrew A S Soltan
    Oxford University Hospitals NHS Foundation Trust, Oxford OX3 9DU, United Kingdom.
  • Louise Thwaites
    Oxford University Clinical Research Unit, Ho Chi Minh City and Hanoi, Vietnam.
  • David A Clifton