From Challenges and Pitfalls to Recommendations and Opportunities: Implementing Federated Learning in Healthcare

Federated learning holds great potential for enabling large-scale healthcare research and collaboration across multiple centres while ensuring data privacy and security are not compromised. Although numerous recent studies suggest or utilize federated learning based methods in healthcare, it remains unclear which ones have potential clinical utility. This review paper considers and analyzes the most recent studies up to May 2024 that describe federated learning based methods in healthcare. After a thorough review, we find that the vast majority are not appropriate for clinical use due to their methodological flaws and/or underlying biases which include but are not limited to privacy concerns, generalization issues, and communication costs. As a result, the effectiveness of federated learning in healthcare is significantly compromised. To overcome these challenges, we provide recommendations and promising opportunities that might be implemented to resolve these problems and improve the quality of model development in federated learning with healthcare.

Detecting and Identifying Selection Structure in Sequential Data

We argue that the selective inclusion of data points based on latent objectives is common in practical situations, such as music sequences. Since this selection process often distorts statistical analysis, previous work primarily views it as a bias to be corrected and proposes various methods to mitigate its effect. However, while controlling this bias is crucial, selection also offers an opportunity to provide a deeper insight into the hidden generation process, as it is a fundamental mechanism underlying what we observe. In particular, overlooking selection in sequential data can lead to an incomplete or overcomplicated inductive bias in modeling, such as assuming a universal autoregressive structure for all dependencies. Therefore, rather than merely viewing it as a bias, we explore the causal structure of selection in sequential data to delve deeper into the complete causal process. Specifically, we show that selection structure is identifiable without any parametric assumptions or interventional experiments. Moreover, even in cases where selection variables coexist with latent confounders, we still establish the nonparametric identifiability under appropriate structural conditions. Meanwhile, we also propose a provably correct algorithm to detect and identify selection structures as well as other types of dependencies. The framework has been validated empirically on both synthetic data and real-world music.

Long-Term Fairness Inquiries and Pursuits in Machine Learning: A Survey of Notions, Methods, and Challenges

The widespread integration of Machine Learning systems in daily life, particularly in high-stakes domains, has raised concerns about the fairness implications. While prior works have investigated static fairness measures, recent studies reveal that automated decision-making has long-term implications and that off-the-shelf fairness approaches may not serve the purpose of achieving long-term fairness. Additionally, the existence of feedback loops and the interaction between models and the environment introduces additional complexities that may deviate from the initial fairness goals. In this survey, we review existing literature on long-term fairness from different perspectives and present a taxonomy for long-term fairness studies. We highlight key challenges and consider future research directions, analyzing both current issues and potential further explorations.

Steering LLMs Towards Unbiased Responses: A Causality-Guided Debiasing Framework

Large language models (LLMs) can easily generate biased and discriminative responses. As LLMs tap into consequential decision-making (e.g., hiring and healthcare), it is of crucial importance to develop strategies to mitigate these biases. This paper focuses on social bias, tackling the association between demographic information and LLM outputs. We propose a causality-guided debiasing framework that utilizes causal understandings of (1) the data-generating process of the training corpus fed to LLMs, and (2) the internal reasoning process of LLM inference, to guide the design of prompts for debiasing LLM outputs through selection mechanisms. Our framework unifies existing de-biasing prompting approaches such as inhibitive instructions and in-context contrastive examples, and sheds light on new ways of debiasing by encouraging bias-free reasoning. Our strong empirical performance on real-world datasets demonstrates that our framework provides principled guidelines on debiasing LLM outputs even with only the black-box access.

Hunting imaging biomarkers in pulmonary fibrosis: Benchmarks of the AIIB23 challenge

Airway-related quantitative imaging biomarkers are crucial for examination, diagnosis, and prognosis in pulmonary diseases. However, the manual delineation of airway trees remains prohibitively time-consuming. While significant efforts have been made towards enhancing airway modelling, current public-available datasets concentrate on lung diseases with moderate morphological variations. The intricate honeycombing patterns present in the lung tissues of fibrotic lung disease patients exacerbate the challenges, often leading to various prediction errors. To address this issue, the 'Airway-Informed Quantitative CT Imaging Biomarker for Fibrotic Lung Disease 2023' (AIIB23) competition was organized in conjunction with the official 2023 International Conference on Medical Image Computing and Computer Assisted Intervention (MICCAI). The airway structures were meticulously annotated by three experienced radiologists. Competitors were encouraged to develop automatic airway segmentation models with high robustness and generalization abilities, followed by exploring the most correlated QIB of mortality prediction. A training set of 120 high-resolution computerised tomography (HRCT) scans were publicly released with expert annotations and mortality status. The online validation set incorporated 52 HRCT scans from patients with fibrotic lung disease and the offline test set included 140 cases from fibrosis and COVID-19 patients. The results have shown that the capacity of extracting airway trees from patients with fibrotic lung disease could be enhanced by introducing voxel-wise weighted general union loss and continuity loss. In addition to the competitive image biomarkers for prognosis, a strong airway-derived biomarker (Hazard ratio>1.5, p<0.0001) was revealed for survival prognostication compared with existing clinical measurements, clinician assessment and AI-based biomarkers.

Tier Balancing: Towards Dynamic Fairness over Underlying Causal Factors

The pursuit of long-term fairness involves the interplay between decision-making and the underlying data generating process. In this paper, through causal modeling with a directed acyclic graph (DAG) on the decision-distribution interplay, we investigate the possibility of achieving long-term fairness from a dynamic perspective. We propose Tier Balancing, a technically more challenging but more natural notion to achieve in the context of long-term, dynamic fairness analysis. Different from previous fairness notions that are defined purely on observed variables, our notion goes one step further, capturing behind-the-scenes situation changes on the unobserved latent causal factors that directly carry out the influence from the current decision to the future data distribution. Under the specified dynamics, we prove that in general one cannot achieve the long-term fairness goal only through one-step interventions. Furthermore, in the effort of approaching long-term fairness, we consider the mission of "getting closer to" the long-term fairness goal and present possibility and impossibility results accordingly.

Fuzzy Attention Neural Network to Tackle Discontinuity in Airway Segmentation

Airway segmentation is crucial for the examination, diagnosis, and prognosis of lung diseases, while its manual delineation is unduly burdensome. To alleviate this time-consuming and potentially subjective manual procedure, researchers have proposed methods to automatically segment airways from computerized tomography (CT) images. However, some small-sized airway branches (e.g., bronchus and terminal bronchioles) significantly aggravate the difficulty of automatic segmentation by machine learning models. In particular, the variance of voxel values and the severe data imbalance in airway branches make the computational module prone to discontinuous and false-negative predictions. especially for cohorts with different lung diseases. Attention mechanism has shown the capacity to segment complex structures, while fuzzy logic can reduce the uncertainty in feature representations. Therefore, the integration of deep attention networks and fuzzy theory, given by the fuzzy attention layer, should be an escalated solution for better generalization and robustness. This paper presents an efficient method for airway segmentation, comprising a novel fuzzy attention neural network and a comprehensive loss function to enhance the spatial continuity of airway segmentation. The deep fuzzy set is formulated by a set of voxels in the feature map and a learnable Gaussian membership function. Different from the existing attention mechanism, the proposed channel-specific fuzzy attention addresses the issue of heterogeneous features in different channels. Furthermore, a novel evaluation metric is proposed to assess both the continuity and completeness of airway structures. The efficiency, generalization and robustness of the proposed method have been proved by training on normal lung disease while testing on datasets of lung cancer, COVID-19 and pulmonary fibrosis.

Human Treelike Tubular Structure Segmentation: A Comprehensive Review and Future Perspectives

Various structures in human physiology follow a treelike morphology, which often expresses complexity at very fine scales. Examples of such structures are intrathoracic airways, retinal blood vessels, and hepatic blood vessels. Large collections of 2D and 3D images have been made available by medical imaging modalities such as magnetic resonance imaging (MRI), computed tomography (CT), Optical coherence tomography (OCT) and ultrasound in which the spatial arrangement can be observed. Segmentation of these structures in medical imaging is of great importance since the analysis of the structure provides insights into disease diagnosis, treatment planning, and prognosis. Manually labelling extensive data by radiologists is often time-consuming and error-prone. As a result, automated or semi-automated computational models have become a popular research field of medical imaging in the past two decades, and many have been developed to date. In this survey, we aim to provide a comprehensive review of currently publicly available datasets, segmentation algorithms, and evaluation metrics. In addition, current challenges and future research directions are discussed.

What-Is and How-To for Fairness in Machine Learning: A Survey, Reflection, and Perspective

Algorithmic fairness has attracted increasing attention in the machine learning community. Various definitions are proposed in the literature, but the differences and connections among them are not clearly addressed. In this paper, we review and reflect on various fairness notions previously proposed in machine learning literature, and make an attempt to draw connections to arguments in moral and political philosophy, especially theories of justice. We also consider fairness inquiries from a dynamic perspective, and further consider the long-term impact that is induced by current prediction and decision. In light of the differences in the characterized fairness, we present a flowchart that encompasses implicit assumptions and expected outcomes of different types of fairness inquiries on the data generating process, on the predicted outcome, and on the induced impact, respectively. This paper demonstrates the importance of matching the mission (which kind of fairness one would like to enforce) and the means (which spectrum of fairness analysis is of interest, what is the appropriate analyzing scheme) to fulfill the intended purpose.

Attainability and Optimality: The Equalized Odds Fairness Revisited

Fairness of machine learning algorithms has been of increasing interest. In order to suppress or eliminate discrimination in prediction, various notions as well as approaches have been proposed to impose fairness. Given a notion of fairness, an essential problem is then whether or not it can always be attained, even if with an unlimited amount of data. This issue is, however, not well addressed yet. In this paper, focusing on the Equalized Odds notion of fairness, we consider the attainability of this criterion and, furthermore, if it is attainable, the optimality of the prediction performance under various settings. In particular, for prediction performed by a deterministic function of input features, we give conditions under which Equalized Odds can hold true; if the stochastic prediction is acceptable, we show that under mild assumptions, fair predictors can always be derived. For classification, we further prove that compared to enforcing fairness by post-processing, one can always benefit from exploiting all available features during training and get potentially better prediction performance while remaining fair. Moreover, while stochastic prediction can attain Equalized Odds with theoretical guarantees, we also discuss its limitation and potential negative social impacts.