[HN Gopher] AI recognition of patient race in medical imaging: a...
       ___________________________________________________________________
        
       AI recognition of patient race in medical imaging: a modelling
       study
        
       Author : aunterste
       Score  : 71 points
       Date   : 2022-05-17 12:33 UTC (10 hours ago)
        
 (HTM) web link (www.thelancet.com)
 (TXT) w3m dump (www.thelancet.com)
        
       | HWR_14 wrote:
       | A lot of people are proposing simple reasons why this could be
       | the case. They did so last year when the study that inspired this
       | got published.
       | 
       | Maybe this needs to be updated from physicists:
       | https://xkcd.com/793/
        
       | ppqqrr wrote:
       | So there's material differences that supports certain prejudices;
       | big surprise, turns out human societies have been (and still is)
       | working very hard for thousands of years to craft those
       | differences - isolating, separating, enslaving, oppressing,
       | exiling their scapegoat "others". The question is not whether the
       | differences are real, but whether we can prevent AI from being
       | used to perpetuate those differences. TBH, we don't stand a
       | chance; we live in a society where most people cannot even wrap
       | their heads around why it _shouldn't_ perpetuate those
       | differences.
        
       | tejohnso wrote:
       | "This issue creates an enormous risk for all model deployments in
       | medical imaging: if an AI model relies on its ability to detect
       | racial identity to make medical decisions, but in doing so
       | produced race-specific errors, clinical radiologists would not be
       | able to tell, thereby possibly leading to errors in health-care
       | decision processes."
       | 
       | Why would a model rely on its ability to detect racial identity
       | to make decisions?
       | 
       | What kind of errors are race-specific?
        
         | matthewdgreen wrote:
         | https://www.hopkinsmedicine.org/news/media/releases/er_docto...
        
         | amarshall wrote:
         | Just because the model relies on race in some way doesn't mean
         | that _we_ know it relies on it. I.e., the model is, unbeknownst
         | to us, biased on race in inaccurate ways.
        
           | codefreeordie wrote:
           | Presumably the model would actually be biased on race in
           | _accurate_ ways, if it found the correlation itself
        
             | amarshall wrote:
             | Maybe, maybe not. Hard to say--which is the problem they
             | call out in the paper
             | 
             | > efforts to control [model race-prediction] when it is
             | undesirable will be challenging and demand further study
        
               | codefreeordie wrote:
               | The correlation being "undesirable" to the individuals
               | doing the research does not mean that the correlation is
               | inaccurate.
               | 
               | I mean, sure, there are _tons_ of ways for garbage data
               | to sneak into ML models -- though these guys tried pretty
               | hard to control for that -- but if the model actually
               | determined that  "race" is a meaningful feature, then
               | that might be because it is, and science should be
               | concerned with what is, not with what we wish were.
        
               | amarshall wrote:
               | If one believes and proclaims that they have controlled
               | for variable X, but they haven't actually done so, then
               | their results and analysis may well be invalid or
               | misleading because of that. Whether they actually should
               | have controlled for X or not is orthogonal.
        
               | codefreeordie wrote:
               | Oh, yes, sorry. If by the correlation being possibly-
               | undesirable you meant that it was possibly-spurious due
               | to incompletely controlling for some bias in the source
               | data, then yes, conclusions based on a model which found
               | such a spurious correlation caused by incomplete input
               | control might be undesirably biased in a not-accurate
               | fashion.
               | 
               | This study appears to have done a good job controlling
               | for known biases that could have been proxies for race,
               | but it is presumably possible that they missed something
               | and tainted the data
        
               | amarshall wrote:
               | Right, and that's pretty much the conclusion: our
               | explicit goal was to control for race, and yet, we appear
               | to have failed and don't know why (so don't know how to
               | adjust the control yet). So likely others using similar-
               | enough methodologies and techniques are unknowingly
               | failing to control.
        
             | Ancapistani wrote:
             | I could be entirely wrong here, so if you've got more
             | context in this area by all means correct me.
             | 
             | Consider an "AI" that rates the probability of recidivism
             | for prisoners nearing their parole date. That score would
             | then be presented to the parole board, and taken into
             | consideration in determining whether or not to grant
             | parole. If this AI were accidentally/incidentally
             | accurately determining the race of the prisoner, then the
             | output score would take that into account as well. Black
             | men have a recidivism rate significantly higher than other
             | groups[1]. The reasons for the above aside - it's a complex
             | topic, and outside the scope of this analogy - this is
             | extremely undesirable behavior for a process that is
             | intended to remove human biases.
             | 
             | You might then ask, how does this relate to medical
             | imaging? Medical decisions are regularly made based on the
             | expected lifespan of the individual. It makes little sense
             | to aggressively treat leukemia in a patient who is
             | currently undergoing unrelated failure of multiple organs.
             | Similarly it would likely make sense for a healthy 30-year-
             | old to undergo a joint replacement and associated physical
             | therapy, because that person can reasonably be expected to
             | live for an additional 40 years while the same treatment
             | wouldn't make sense for a 70-year-old with long-term
             | chronic issues. This concept is commonly represented as
             | "QALY" - "quality-adjusted life years".
             | 
             | Life expectancy can vary significantly based on race[2].
             | 
             | An AI that evaluates medical imagery that considers QALY in
             | providing a care recommendation may result in a positive
             | indicator for a white hispanic woman and a negative
             | indicator for a black non-hispanic man, with all else being
             | equal and with race as the only differentiator.
             | 
             | In short - it's not necessarily a bad thing for a model to
             | be able to predict the race of the input imagery. The
             | problem is that we don't know why it can do so. Unless we
             | know that, we can't trust that the output is actually
             | measuring what we intend it to be measuring.
             | 
             | 1: https://prisoninsight.com/recidivism-the-ultimate-guide/
             | 2: https://www.cdc.gov/nchs/products/databriefs/db244.htm
        
               | codefreeordie wrote:
               | At the risk of discussing sensitive topics on a platform
               | ill-suited:
               | 
               | If, in your hypothetical recidivism case, an AI
               | "accurately" determined that a pattern of higher
               | recidivism-related features was correlated to race, and
               | was able to determine "accurately" that the specific
               | subset of recidivism-related features predicted race, why
               | would it be wrong to make parole decisions using those
               | recidivism-related features?
        
               | gadflyinyoureye wrote:
               | If you decided on race, in this instance, you would be
               | making people much more deterministic as a result of the
               | power of race. Race is too broad a concept to reliably
               | say that all white people are at X chance of recidivism.
               | Instead we want to know if Marlowe is at risk of high
               | recidivism based on her character.
        
               | codefreeordie wrote:
               | Both responses address the problem with a human making a
               | biased decision based on race, which I think mostly we
               | all agree would be bad.
               | 
               | The question I was posing is different, though, because
               | this was discussing an AI system that looked at the
               | underlying [in this case, recidivism] data _which had
               | race and race-adjacent information removed_ , and the AI
               | has effectively rediscovered the concept of "race" by
               | connecting it to some set of attributes of the actual [in
               | this case, recidivism-predicting] features. If the AI
               | were to determine such a link, that doesn't make its
               | results biased, it just makes them uncomfortable. It's
               | not clear to me that in such a case that would mean that
               | we should remove those [recidivism-predicting] features
               | from the dataset just because they ended up being
               | correlated to race.
        
               | pessimizer wrote:
               | Because both the original conviction and any recidivism
               | is determined through the decision-making of people who
               | are aware of race and racial stereotypes. The AI would
               | just be laundering the decisions you were already making,
               | not improving them.
               | 
               | edit: imagine I was a teacher who systematically scored
               | people with certain physical characteristics 10% lower
               | than people who didn't have them. Let's say, for example,
               | that I was a stand-up comedy teacher that wasn't amused
               | by women.
               | 
               | If I used an AI trained on that data to choose future
               | admissions (assuming plentiful applicants), I would end
               | up with an all-male class. If this happened throughout
               | the industry (especially noting that the all-male
               | enrollment that I have would supply the teachers of the
               | future), stand-up comedy would simply become a thing that
               | women were seen as not having the aptitude to do,
               | although nobody explicitly ever meant to sabotage women,
               | just to direct them into something that they would have a
               | better chance to succeed in.
        
         | eklitzke wrote:
         | Let's say you're trying to train an model to predict if a
         | patient has a cancerous tumor based on some imaging data. You
         | have a data set for this that includes images from people with
         | tumors and people without, from all races. However, unbeknownst
         | to you, most of the images from people of race X had tumors and
         | most of the images from people of race Y did not have tumors.
         | 
         | If the AI is also implicitly learning to detect race from the
         | images, it's going to learn an association that people of race
         | X usually have tumors and people of race Y usually do not.
         | 
         | The problem here is that the people training the model and the
         | clinical radiologists interpreting data from the model may not
         | realize that race was a confounding factor in training, so
         | they'll be unaware that the model may make racial inferences in
         | the real world data.
         | 
         | If people of race X really do have a higher incidence rate for
         | a specific type of cancer than race Y, maybe this is OK. But if
         | the issue is that there was bias in the training/validation
         | data set that was unknown to the people building the model, and
         | in the real world people of race X and race Y have exactly the
         | same incidence rate for this type of cancer, then this is going
         | to be a problem because it's likely to introduce race-specific
         | errors.
        
           | [deleted]
        
         | SpicyLemonZest wrote:
         | Using race as an independent factor to make medical decisions
         | isn't unheard of today. The medical community is largely trying
         | to stop doing that as a matter of social policy, so it's a
         | problem for that goal if an AI model might be doing it under
         | the hood.
         | 
         | See e.g. https://www.ucsf.edu/news/2021/09/421466/new-kidney-
         | function...
        
       | ars wrote:
       | If this is true I suspect a human could be trained the same way.
       | 
       | I read once that a radiologist can't always explain what they see
       | in an image that leads them to one diagnosis or another, they say
       | that after seeing many of them they just know.
       | 
       | So I suspect the same could be done for race. This would be a
       | super interesting thing to try with some college students - pay
       | them to train for a few days on images and see how they do.
        
       | uberwindung wrote:
       | .."In this modelling study, we defined race as a social,
       | political, and legal construct that relates to the interaction
       | between external perceptions (ie, "how do others see me?") and
       | self-identification, and specifically make use of self-reported
       | race of patients in all of our experiments."
       | 
       | Garbage research.
        
         | [deleted]
        
         | groby_b wrote:
         | And you are qualified to make that assessment because...?
        
         | axg11 wrote:
         | Perfect example of citations-driven research. The authors
         | aren't motivated by a genuinely interesting scientific question
         | ("are anatomical differences between genetically distinct
         | groups of people visible in X-rays?"). Instead, the authors
         | know that training a classifier to predict race will generate
         | controversial headlines and tweets. All publicity, positive or
         | negative, leads to more citations.
        
           | colinmhayes wrote:
           | > genetically distinct groups of people
           | 
           | Is race a genetically distinct marker though? I guess if you
           | limit the sample enough it is, but I've always thought of
           | race as more of a continuous quality than a distinct one.
        
             | axg11 wrote:
             | Race _is_ a spectrum but genetic differences themselves are
             | distinct (SNPs). It's trivial to train a classifier to
             | distinguish race from genetic data, hence, I'd argue they
             | are distinct groups.
        
       | Imnimo wrote:
       | The fact that the model seems to be able to make highly accurate
       | predictions even on the images in Figure 2 (including HPF 50 and
       | LPF 10) makes me skeptical. It feels much more probable that this
       | is a sign of data leakage than that the underlying true signal is
       | so strong that it persists even under these transformations.
       | 
       | https://arxiv.org/pdf/2011.06496.pdf
       | 
       | Compare the performance under high pass and low pass filters in
       | this paper on CIFAR-10. Is it really the case that
       | differentiating cats from airplanes is so much more fragile than
       | predicting race from chest x-rays?
        
       | kerblang wrote:
       | > Importantly, if used, such models would lead to more patients
       | who are Black and female being *incorrectly* identified as
       | healthy
       | 
       | I think this is the point a lot of people are missing; they
       | think, "So what if 'black' correlates to unhealthy and the model
       | notices? It's just seeing the truth!"
       | 
       | However, I'm still wondering how this incorrectness works; can
       | anyone explain?
       | 
       | Edit: Clue: The AI is predicting _self-reported_ race, and the
       | authors indicated that self-reported race correlates poorly to
       | _actual_ genetic differences.
        
         | KaiserPro wrote:
         | My guess is that they are using an american dataset. This I
         | would suspect encodes socioeconomic data into the samples. ie
         | rich people, have access to better diagnostics, get seen
         | earlier and are treated sooner. Conversely poorer present later
         | and with more obvious symptoms. _also_ the type of system used
         | to take the images would also be strongly correlated.
        
       | jl6 wrote:
       | > Models trained on low-pass filtered images maintained high
       | performance even for highly degraded images. More strikingly,
       | models that were trained on high-pass filtered images maintained
       | performance well beyond the point that the degraded images
       | contained no recognisable structures; to the human coauthors and
       | radiologists it was not clear that the image was an x-ray at all.
       | 
       | What voodoo have they unearthed?
        
         | civilized wrote:
         | I think there's a significantly greater than zero chance that
         | they simply botched their ML pipeline horribly and would get
         | their 0.98 AUCs from completely blank images.
        
         | JumpCrisscross wrote:
         | > _What voodoo have they unearthed?_
         | 
         | Curious for the take not of a neuro-ophthalmologist. If they
         | too are stumped, this may be a path to a deeper understanding
         | our visual system.
         | 
         | Simple transformations obviously discernible to us blind
         | computer vision. (CAPTCHAs.) There may be analogs for human
         | vision which don't present in the natural world. Evidence of
         | such artefacts would partially validate our current path for
         | artificial intelligence, as it suggests the aforementioned
         | failures of our primitive AIs have analogs in our own.
        
         | 6gvONxR4sf7o wrote:
         | I think it's pretty straightforward. Imagine the fourier
         | transforms of some recognizeable audio signals. Maybe a
         | symphony and a traffic jam. They'll look totally different,
         | even to the naked eye. If you chop off the low frequency
         | components, you can still probably tell which fourier spectrum
         | is which. But now do the same thing in time domain (high-pass
         | filter the audio). It probably won't be clear that you're
         | listening to a symphony anymore.
        
         | proto-n wrote:
         | I tend to not believe unbelievable results in machine learning.
         | It's too easy to unintenionally cause some kind of information
         | leakage. I haven't read the paper in detail though, so their
         | experimentation setup could be foolproof, this is not a
         | critique of this paper specifically.
        
           | dragonwriter wrote:
           | > I tend to not believe unbelievable results
           | 
           | That seems tautologically true.
        
           | sidewndr46 wrote:
           | This reminds me of the ML research that could predict sex
           | from an iris. It turns out they were using entire photos of
           | eyes to do this. There are so many obvious cues to pick up on
           | in that case, like eyeliner, eyelashes being uniform (or
           | fake), trimmed eyebrows, general makeup on the skin, etc.
        
         | Der_Einzige wrote:
         | ... Adversarial examples.
         | 
         | It's a whole field of research, and it's pretty trivial to
         | generate them for most classes of ML models. It's actually
         | quite difficult to create robust models that DON'T have this
         | problem...
        
       | tech-historian wrote:
       | The interpretation part hit home: "The results from our study
       | emphasise that the ability of AI deep learning models to predict
       | self-reported race is itself not the issue of importance.
       | However, our finding that AI can accurately predict self-reported
       | race, even from corrupted, cropped, and noised medical images,
       | often when clinical experts cannot, creates an enormous risk for
       | all model deployments in medical imaging."
        
         | Animats wrote:
         | "Predict self-reported race". Not race from DNA. (That's
         | routinely available from 23andMe, and is considered an
         | objective measurement.[1]) They should have collected both. Now
         | they don't know what they've measured.
         | 
         | [1] https://www.nytimes.com/2021/02/16/opinion/23andme-
         | ancestry-...
        
         | nerdponx wrote:
         | I suspect this is a "tank vs sky" problem. The article says
         | that the bright areas of bone are not the most important for
         | predicting race. What if it's some features of different
         | hospitals and x-ray setups?
         | 
         | Also did they release their code and anonymized data? If not,
         | it's impossible to tell if this is a bug.
         | 
         | If I got this result in my work, I would check it 10k times
         | over because it defies belief. Even allowing subtle skeletal
         | differences in different ethnic groups, the differences in this
         | case are not in the bone and at least sometimes not visible to
         | the human eye. Unless there is an undiscovered difference in
         | radio-opacity across ethnicities, the result doesn't make
         | sense.
        
           | nerdponx wrote:
           | Replying to my own post because I can't edit it anymore.
           | 
           | Apparently this is a known and persistent affect across a
           | variety of other medical images, tests, and scans. Not just
           | for a "race" but for ethnic groups in general, as well as
           | biological sex. So this might actually just be an "AI hit
           | piece" that otherwise confirms an unpalatable but persistent
           | and strong effect in the literature. The causes seem to be
           | badly understudied, in part due of the obvious need for
           | delicacy and respect around such topics.
           | 
           | This result is tremendously implausible to me, but I am
           | finding quite a few articles documenting similar phenomena
           | across things like retina scans and brain MRIs.
        
             | prometheus76 wrote:
             | What you are experiencing is cognitive dissonance. Take
             | your time. It's never fun.
        
         | aulin wrote:
         | what's this enormous risk they're talking about? racial bias in
         | x-ray reading? race can be a risk factor in plenty of diseases,
         | why should we actively try to remove this information from
         | medical images?
        
           | [deleted]
        
           | KaiserPro wrote:
           | > racial bias in x-ray reading?
           | 
           | no, it implies there is a signal in the dataset that could be
           | something other than clinical. This means that until they can
           | pinpoint the cause, or the thing the AI is detecting, all the
           | other things it predicts are suspect.
           | 
           | ie if the AI thinks the subject is west african, then it
           | might be more inclined to diagnose something related to
           | sickle cell.
           | 
           | Or north western european woman in her mid 60s vs a japanese
           | woman might get widly different bone density readings for the
           | same level of "blob" (most medical imaging is divining the
           | meaning of blobs and smears )
        
           | sim7c00 wrote:
           | soon they will want to remove race indicators for photographs
           | and tik tok videos. who knows, maybe its racist to be of a
           | race >.>
        
           | matthewdgreen wrote:
           | "This issue creates an enormous risk for all model
           | deployments in medical imaging: if an AI model relies on its
           | ability to detect racial identity to make medical decisions,
           | but in doing so produced race-specific errors, clinical
           | radiologists (who do not typically have access to racial
           | demographic information) would not be able to tell, thereby
           | possibly leading to errors in health-care decision
           | processes."
        
             | ibejoeb wrote:
             | Typically? It's coded in the standard. There's a DICOM tag
             | for it.
             | 
             | https://dicom.innolitics.com/ciods/procedure-
             | log/patient/001...
        
               | matthewdgreen wrote:
               | Unlike the authors of this research paper I am not a
               | trained clinician, so I can't tell you. However I would
               | note that the first exemplary value in the link you gave
               | me is "REMOVED".
        
               | ibejoeb wrote:
               | It doesn't provide example data, but there's still a spot
               | in the standard for it. The values can differ by modality
               | or manufacturer. Sure, it's not required, but certainly
               | it's very important in some situations. Consider
               | dermoscopy.
               | 
               | If interested, searching for "dicom conformance" should
               | yield lots of docs that probably contain specific values
               | for those things.
        
               | ska wrote:
               | FWIW, the standard printed out is multiple linear feet of
               | shelf space. There is a spot for a lot of things.
               | 
               | One common issue is a lot of these kinds of tags rely on
               | optional human input and are inconsistently applied. As
               | opposed to say, modality specific parameters produced by
               | a machine, which are consistent.
               | 
               | DICOM is a great example of design by committee, with the
               | +'ve and -'ves that implies.
        
             | aulin wrote:
             | ok, maybe it's an US specific thing, why wouldn't a
             | clinical radiologist have all the information he can gather
             | about his patient including race to help the diagnosis?
        
               | codefreeordie wrote:
               | Because in the US we are required to pretend that there
               | is no such thing as race and no such thing as gender, and
               | all people are exactly and precisely the same and there
               | can be no differences.
        
               | sandworm101 wrote:
               | >> Because in the US we are required to pretend that
               | there is no such thing as race
               | 
               | Then you are not pretending very well. When I lived in
               | the US I was shocked at how often it was an issue. It
               | permeates nearly every aspect of US culture.
               | 
               | The icing on that cake: A government-run interactive map
               | so you can lookup which races live in which
               | neighborhoods. Some versions allow you to zoom in to see
               | little dots representing clusters of black or white
               | residents. https://www.census.gov/library/visualizations/
               | 2021/geo/demog...
        
               | nradov wrote:
               | Actually, the US federal government specifically
               | recommends that healthcare providers record patients'
               | race, ethnicity, assigned sex, and gender identity. Most
               | of those elements are self identified.
               | 
               | https://www.healthit.gov/isa/uscdi-data-class/patient-
               | demogr...
        
               | Loughla wrote:
               | Not to get into a flame war, but I want to present an
               | alternate option to yours.
               | 
               | Because in the US some people have a hard time
               | understanding that all races and genders deserve to be
               | treated equally as humans with the same access to goods
               | and services. Further, that there are disparities in care
               | based on race/ethnicity[1][2] and gender[3][4] because of
               | that racism/sexism present in the systems. This then
               | leads to requiring that race/ethnicity and gender data be
               | scrubbed sometimes to keep people from impacting outcomes
               | based on their own biases.
               | 
               | [1] https://www.americanbar.org/groups/crsj/publications/
               | human_r...
               | 
               | [2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1924616/
               | 
               | [3] https://www.americashealthrankings.org/learn/reports/
               | 2019-se...
               | 
               | [4] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2965695/
        
               | codefreeordie wrote:
               | It sometimes makes sense to scrub race/ethnicity/gender
               | information from certain types of data, typically when a
               | human is going to be making individual decisions.
               | 
               | For example, not having race data on resumes is generally
               | productive, because that categorization can't provide a
               | meaningful input to the decision associated with an
               | individual person. Even if it were to be the case that
               | there was some correlation between race and skill at
               | whatever job you're interviewing for[1], the size of the
               | effect is almost certainly small, and in the meanwhile
               | you've also controlled for any bias in the person doing
               | the reviewing.
               | 
               | If you're having a machine look at a dataset, and the
               | machine determines that race or ethnicity is a material
               | factor in determining some attribute in that dataset,
               | you're not doing anybody any good by denying that fact
               | and destroying the result.
               | 
               | [1]Let's ignore for the purposes of this discussion,
               | fields (like certain sports) where extreme competition
               | combines with a position heavily dependent upon racially-
               | linked physical characteristics. Though even in this
               | case, there is still a (different, weaker) argument for
               | suppressing race data in "resumes" (yes, I know,
               | ballplayers don't submit resumes to their local NBA
               | franchise)
        
               | bumby wrote:
               | > _If you 're having a machine look at a dataset, and the
               | machine determines that race or ethnicity is a material
               | factor in determining some attribute in that dataset..._
               | 
               | I think the trickiness is in providing the machine
               | unbiased data to begin with so that it doesn't incorrect
               | associations between features like race. The most
               | egregious examples I'm aware of are the machine learning
               | systems used to suggest criminal sentencing, but, apropos
               | to this topic I believe there are cases where it may
               | produce erroneous associations in something like skin
               | cancer risk.
        
               | nerdponx wrote:
               | Then you should be looking at ethnicity and not "race" as
               | such. For example, Ashkenazi Jews as an ethnic group are
               | genetically very distinct from other Europeans, but are
               | generally considered "white" on self-reported race
               | surveys.
        
               | pessimizer wrote:
               | Race is a rough, subjective, culturally-bound summary of
               | characteristics. If you're already evaluating
               | characteristics, adding either your guess of race or a
               | self-reported race is like injecting gossip into good
               | data.
               | 
               | If the outcome that you're trying to predict is also
               | affected by perceptions of race, you've built a gossip
               | feedback loop.
        
             | nradov wrote:
             | I don't understand that part. All modern EHRs have a field
             | for self-reported race, and clinical radiologists do
             | typically have access to that information. (Whether they
             | actually look at it, or whether it's useful when reading
             | images, are separate issues.)
        
             | towaway15463 wrote:
             | Without knowing the actual outcome, isn't there also a
             | possibility of error due to not knowing the race of the
             | individual? They used mammogram images in the study and it
             | is well known that incidence of breast cancer varies by
             | race. Removing that information from the model could result
             | in worse performance.
        
               | cameldrv wrote:
               | Well one thing you wouldn't want to do is take the output
               | of this model and then apply a correction factor for race
               | on top of it, because the model is already taking that
               | into account.
        
               | towaway15463 wrote:
               | Is that true or would it help as a tie breaker in cases
               | where the confidence was just at or below the threshold?
        
           | Retric wrote:
           | AI is driven by the training sets, but the goal is to find
           | the underling issues.
           | 
           | Suppose AI #1 got a higher score on the training data and AI
           | #2 had a more accurate diagnosis. Obviously you want #2 but
           | if there is bias in the training data based on race and the
           | AI has access to race then eventually you overfit into #1.
        
           | dekhn wrote:
           | yep, the case for "enormous risk" hasn't been well
           | articulated. It's been repeated a lot, but of all the
           | problems in medical care, this isn't one of the larger ones.
        
           | pdpi wrote:
           | ML models are great tools, but they're way too much of a
           | black box. What you have here is a model that's predicting
           | something you think it shouldn't have been possible to
           | predict, and you can't simply ask it where that prediction
           | comes from. Absent an explanation for how the model is doing
           | this, you have to consider the possibility that whatever is
           | poisoning that prediction will also poison others.
        
             | axg11 wrote:
             | > ML models are great tools, but they're way too much of a
             | black box.
             | 
             | A human doctor is also a black box, in meat form.
        
           | fumblebee wrote:
           | My first thought here is to relate this to the problem of
           | early colour film, which was largely tested and validated
           | with only light skin tones in mind. Once it was put out into
           | the wild, folks with darker skin tones found the product to
           | be total crap. Why? Because there was a glaring OOD (Out of
           | Distribution) problem during testing.
           | 
           | Similarly, if the train/test sets used here - for X-ray based
           | diagnostics - using Machine Learning relies only on specific
           | races, then the performance _might_ be worse for other races,
           | given that there 's a new discriminatory variable in play.
           | 
           | The obvious solution here is to reduce bias by ensuring race
           | is part of the dataset used for training and testing. Which,
           | due to PII laws in play, may actually be quite challenging!
           | Fascinating tradeoff imo.
        
           | [deleted]
        
           | unsupp0rted wrote:
           | What if it turns out that humans have identifiable biological
           | differences among genetic sub-groups, ethnicities, etc? It
           | would be anarchy in the social sciences.
        
           | ibejoeb wrote:
           | I don't get it either. It's accurate. It would be a problem
           | if it got it wrong, which could, for example, underweight
           | quantitative genetic data and adversely influence
           | differential diagnosis.
        
       | [deleted]
        
       | oaktrout wrote:
       | I recall seeing a paper in the early 2010s with an algorithm that
       | could discriminate between white and Asian based on head MRI
       | images. I'm having trouble finding it now, but this finding to me
       | is not too surprising.
        
       | bitcurious wrote:
       | I would guess a causal chain through environmental factors, given
       | how much archeologists are able to tell about prehisotric humans'
       | lives based on bone samples.
       | 
       | Bone density, micro fractures and deviations in shape. The
       | mongols had famously had bowed legs from spending a majority of
       | their waking lives on horseback.
        
       | wittycardio wrote:
       | I don't trust medical journals or experimental AI research to be
       | particularly scientific so I'll just throw this into the
       | meaningless bin for now.
        
       | mensetmanusman wrote:
       | What does this mean in terms of race being a social
       | construct/concept?
        
         | badrabbit wrote:
         | Still is? The AI is correlating biological features with self
         | reported race. There are biological differences between people
         | who have different ancestors. Finns are different from brits.
         | The spanish are different from russians. Nigerians look
         | different than somalians. The Japanese look differnet than
         | filipinos.
         | 
         | Race picks specific and arbitrary differences , for example
         | hispanic is a different race in US society but black and white
         | based on skin color are as well, indians and east asians are
         | also one "race".
         | 
         | Ethnicities are not social constructs but race is. The AI finds
         | ethnic differences and correlates them with self-percievied
         | social/racial classification.
         | 
         | "Race" as the evil social construct it is, takes ethnic
         | differences and intrprets them to mean some ethnicities are
         | different races of humans than others as in not just different
         | ancestors but differently created or evolved despite all
         | evidence and major religion saying all humans are one species
         | (homosapiens) that have a common homosapien ancestor.
         | 
         | I thought all this was obvious but the social climate recently
         | is very weird.
        
           | fullstackchris wrote:
           | Race as an entire concept to me has always been stupid at
           | best. Sure, there are vast swaths of biological similarities
           | (typically, though not necessarily) according to general
           | geographic regions of the globe, but the real mistake was
           | trying to give this vague concept a label. Can anybody give a
           | definition of what "white" or "black" REALLY means? It's an
           | impossible task. If we're talking just visually about skin
           | color, congratulations, that represents citizens of some 100+
           | odd countries on the planet and just as many (if not many
           | more!) cultures and languages. But leave it to humans to try
           | and over optimize and try to denote evermore meaningless
           | abstractions...
           | 
           | Let the social "culture war" rage on. The only war I see
           | going on in the west (U.S. mostly) is a _lack_ of culture.
        
           | dijit wrote:
           | I believe you're inverting race and ethnicity.
           | 
           | From national geographic: "Race" is usually associated with
           | biology and linked with physical characteristics such as skin
           | color or hair texture. "Ethnicity" is linked with cultural
           | expression and identification.
        
             | badrabbit wrote:
             | I am not. Historically ethnicities and ancestoral lines
             | aligned so ethnic differences and biological differences
             | due to generational mating choices largely influenced by
             | the culture that is a component of the ethnicity are
             | aligned as well. Race is not a biological classification
             | because it is appearance based but arbitrary. Appearance is
             | not the same as biology. A husky appears similar to a small
             | wolf but it might be correct to consider them (dogs) a race
             | of wolves.
             | 
             | The deceptively evil part of the concept of race is, it
             | does not simply differentiate biological features but it
             | goes on to impose a fork at the root of the ancestoral tree
             | where people of that race share the same origin and same
             | differences. In reality biological differences are a result
             | if what a culture considers attractive multiplied by
             | mutations that help people adopt to different environments
             | (e.g.: skin color being a result of adaptation to sun light
             | and vitamin d levels instead of a being a feature that
             | shows ancestoral forks in creation or evolution).
             | 
             | It is simply inaccurate to label people by race but it is
             | useful to impose social evils. But biological differences
             | due to mating and cultural choices are very real and can be
             | examined at a granular level that takes the actual factors
             | for the differences into account instead of the lazy+evil
             | correlation that is the concept of race.
             | 
             | Ethnicity is not what culture you identify with. You don't
             | become ethnically african american because you like african
             | american culture and grew in a specific neighborhood. It is
             | the marriage of culture and ancestry.
        
           | nradov wrote:
           | Medical software used in the US classifies Hispanic as an
           | ethnic group, not a race. Those are separate fields in a
           | patient's chart. Here is the official federal government
           | guideline.
           | 
           | https://www.healthit.gov/isa/taxonomy/term/741/uscdi-v2
           | 
           | https://www.healthit.gov/isa/taxonomy/term/746/uscdi-v2
           | 
           | (I'm not claiming that this is an optimal approach, just
           | pointing out how it works in most software today.)
        
             | badrabbit wrote:
             | Yes, but socially when you ask people their race they will
             | say black or hispanic or white. And with little consitency.
             | It is more of a way to justify and impose social classes.
        
           | towaway15463 wrote:
           | So isn't the "evil social construct" part actually the
           | invalid extension of the theory that biological or phenotypic
           | differences mean that someone is more or less human? You can
           | remove that part and still acknowledge that there are
           | biological differences between people based on their genetic
           | lineage without invalidating their basic humanity.
        
             | badrabbit wrote:
             | The evil part is not differences but considering people as
             | part of a different race of humans because of those
             | differences.
        
         | [deleted]
        
         | ibejoeb wrote:
         | I'm just going to abandon the term race because nothing
         | constructive is going to come from it. It is not contentious
         | that there are various physiological developments among groups
         | of humans.
        
           | pessimizer wrote:
           | > various physiological developments among groups
           | 
           | This is a very contrived way to say that people share
           | characteristics with other people. The real question is why
           | people don't say that I belong to the six-foot tall bad-knees
           | race.
        
             | ibejoeb wrote:
             | Really? It's very contrived?
             | 
             | I'm not here to tell you what to do. Use race then. I
             | offered up why I think this article is only generating
             | interest is because race is a loaded word, and if it
             | weren't used, it'd be passed over.
             | 
             | > The real question is why people don't say that I belong
             | to the six-foot tall bad-knees race
             | 
             | This is an article about ML accurately predicting self-
             | identified race. This is not even on the spectrum of real
             | questions.
        
           | HKH2 wrote:
           | What term are you going to use instead? Subspecies? Breed?
        
             | ibejoeb wrote:
             | I don't know. My hunch is that these suggestions, though,
             | will be received poorly.
        
         | dijit wrote:
         | Race, in terms of physiology has never been regarded by science
         | to be a social construct.
         | 
         | In fact it can be medically harmful to think this way.
        
           | wutbrodo wrote:
           | Unfortunately, that's not quite true. Here's the AMA[1] with
           | a press release entitled "New AMA policies recognize race as
           | a social, not biological, construct".
           | 
           | They discourage using race as a source of any physiological
           | signal. They do allow using genetics, but the relevant
           | situations are the many many ones where genetic testing isn't
           | possible or doesn't yet provide useful signal.
           | 
           | Unaccountable institutions get captured very easily, and the
           | race cult that's swept through our educated class has been a
           | very powerful one.
           | 
           | [1] https://www.ama-assn.org/press-center/press-releases/new-
           | ama...
        
           | PartiallyTyped wrote:
           | One of the reasons certain communities were hit harder with
           | Covid was vit D deficiency as a consequence of skin color.
        
             | dijit wrote:
             | That is one hypothesised cause for the disparity, social
             | factors in those cases need to be controlled for.
             | 
             | A better discussion is around sickle cell anaemia[0] which
             | is exclusively carried by people of African or Afro-
             | Caribbean descent.
             | 
             | [0]: https://en.wikipedia.org/wiki/Sickle_cell_disease
        
               | PartiallyTyped wrote:
               | That's a better example, thank you. Reminded me that I
               | know quite a few people with Thalassemia/Mediterranean
               | anemia.
        
               | pessimizer wrote:
               | Sickle cell disease is exclusively caused by genetics,
               | not race. The vast majority of people of African or Afro-
               | Caribbean descent aren't carriers, so have the same
               | likelihood as everyone else who is not a carrier to
               | develop it.
        
             | pessimizer wrote:
             | Skin color isn't race.
        
         | tom_ wrote:
         | Same as it always did, as humans have long claimed to be able
         | to distinguish race simply by looking.
        
         | bb123 wrote:
         | Perhaps there is some quality of the x rays themselves that is
         | different? Maybe white people tend to visit hospitals with
         | newer, better equipment or better trained radiographers and the
         | model is picking up on differences in the exposures from that.
        
           | [deleted]
        
           | shortgiraffe wrote:
           | They mostly accounted for this: >Race prediction performance
           | was also robust across models trained on single equipment and
           | single hospital location on the chest x-ray and mammogram
           | datasets
           | 
           | Sure, it's possible that bias due to the radiographer is the
           | culprit, but this seems unlikely.
        
           | oaktrout wrote:
           | From the paper "Race prediction performance was also robust
           | across models trained on single equipment and single hospital
           | location on the chest x-ray and mammogram datasets"
        
           | gbasin wrote:
           | Interesting hypothesis but I can't tell if you're being
           | serious
        
         | polski-g wrote:
         | It means that is a lie.
        
         | [deleted]
        
         | PheonixPharts wrote:
         | I've noticed people in all parts of the political spectrum have
         | a hard time understanding the term "social construct". It
         | doesn't mean the same as "completely made up".
         | 
         | Nations are uncontroversially recognized as a social
         | constructs. However I'm certain that AI could also detect
         | images taken outdoors in Mexico vs those in Finland.
         | Additionally I, a US citizen, cannot simply declare that I am
         | now a citizen of France and expect to get a French passport.
         | 
         | However it also means that what a nation is, is not set in
         | stone for eternity. It means that different people can debate
         | about the precise definitions of about what defines a
         | particular nation. It means that Czechoslovakia _can_ become
         | the Czech republic and Slovakia. It means that not everyone
         | agrees if Transnistria _is_ an independent nation. It means
         | that the EU _can_ decide that a German citizen can have the
         | same passport as a French citizen.
         | 
         | As a more controversial example, this is also the case when
         | people talk about gender being a "social construct". It doesn't
         | mean that we can simply pretend like the ideas "men" and
         | "women" doesn't exist (as people both declare and fear). But it
         | does mean there is some flexibility in these terms and we as a
         | society can choose how we want these ideas to evolve.
         | 
         | Society is a complex and powerful part of our reality, arguably
         | more impactful on us from day to day than most of physics
         | (after all we did survive for hundreds of thousands of years
         | without even understanding the basics of physics). Therefore
         | something being classified as a "social construct" doesn't mean
         | it "isn't real". Even more important is that individuals cannot
         | choose who social construct evolve. I cannot, for example,
         | declare that since taxes are a social construct, I'm not paying
         | them anymore. We can however, as a society, change what and how
         | these constructs are interpreted.
        
         | mlindner wrote:
         | Science does not claim that race is a social
         | construct/concept...
        
           | SpicyLemonZest wrote:
           | While I agree with you that "social construct" isn't the
           | right way to think about it, the authors in this very paper
           | say that it is.
        
         | emddudley wrote:
         | There is no scientific, consistent way to define race. The
         | groups we put people into is fairly arbitrary. They don't
         | correlate to appearance, genetics, country of origin, etc.
         | 
         | An interesting question in the U.S. is "who is considered
         | white?" There was a Supreme Court case in which someone who was
         | literally from the Caucasus was ruled not white. This is why
         | it's sociological, not scientific.
         | 
         | https://www.sceneonradio.org/episode-40-citizen-thind-seeing...
        
           | orangepurple wrote:
           | Alloco 2007 looked at random locations of single nucleotide
           | polymorphisms(SNPs) and found that, using random SNPs, you
           | still get very good correspondence between self-
           | identification and best fit genetic cluster. Using as few as
           | 100 randomly selected SNPs, they found a roughly 97%
           | correspondence between self-reported ancestry and best-fit
           | genetic cluster.
           | 
           | https://pubmed.ncbi.nlm.nih.gov/17349058/
        
             | pessimizer wrote:
             | Were the formulations of genetic clusters created through
             | marking samples with self-reported race? If so, why
             | couldn't you create an entirely different rubric of race by
             | choosing a few arbitrary features to define each of them
             | and find exactly the same thing?
        
           | daenz wrote:
           | If there's no scientific, consistent way to define race, how
           | is it that a machine learning model is able to pick the race
           | that somebody self-identifies as consistently? The model is
           | simply using rules based on math to deduce an accurate guess.
        
         | greenthrow wrote:
         | It still is. Just because it includes physical signifiers that
         | can be measured doesn't mean it isn't still a social construct.
         | 
         | To give a contrived example; if I say people with ring fingers
         | over 3 inches long are Longfings and people wkth ring fingers 3
         | inches or less are Shortfings, and then out society treats
         | people differently based on being Longfing or Shortfing, this
         | is a social construct that is causing problems for people based
         | on a contrived criteria that has no real meaning. The same is
         | true of race.
        
           | inkblotuniverse wrote:
           | What if shortfings tend to be drastically taller, and the
           | longfings are complaining that they're overrepresented in
           | jumpball?
        
             | pessimizer wrote:
             | > What if shortfings tend to be drastically taller
             | 
             | What does it mean for shortfings to be dramatically taller?
             | Are you saying that shortfings must transmit height along
             | with finger length; some sort of race invariance? Or are
             | you saying that most shortfings you meet are also tall?
             | 
             | If a black person is a pale as a white person, they're
             | still considered black (and may share many other
             | characteristics that many black people have.) If some of
             | your shortfings have long fingers, does the distinction
             | still make sense as a scientific category?
             | 
             | > the longfings are complaining that they're
             | overrepresented in jumpball?
             | 
             | Is admission to jumpball determined by finger measuring, or
             | through social factors?
        
         | inglor_cz wrote:
         | Ever more complicated attempts to bridge the gap by muddying
         | the waters.
         | 
         | Frankly, even a freshly arrived alien from Mars or Titan could
         | easily tell Icelanders, Mongols and Xhosa apart, without
         | knowing anything about our culture. The fact that there has
         | been a lot of interbreeding/admixture since the Age of Sail
         | began, does not mean that there aren't meaningful biological
         | differences between the original groups, which still obviously
         | exist.
         | 
         | An analogy: much like the existence of twilight does not render
         | the concept of night and day a 'social construct' either. We
         | attach certain social meanings to those natural phenomena, and
         | a 'working day' can easily stretch into 'astronomical night'
         | (all too often!), but that does not mean that 'night' and 'day'
         | do not exist outside of our cultural reference framework.
         | 
         | There is a social concept of 'race' which corresponds to the
         | 'working day' concept in this analogy, e.g. 'BIPOC', claiming
         | Asians as 'white adjacent' or classifying North Africans or
         | Jews as 'white', even though they may not necessarily look
         | white. But this is almost certainly not what the AI identified.
         | This social concept of race _would_ confuse a Martian alien
         | unless he started to study the social and racial history of the
         | U.S., and possibly even afterwards. It definitely confuses me,
         | a random observer from Central Europe.
        
       | daniel-cussen wrote:
       | It could actually be the skin, it's designed to block rays, it
       | might also have a different x-ray opacity, and that can be judged
       | from the whole picture in particular where there's several layers
       | of melanin, or there's transitions from melanin to very little
       | like on hands and feet. Eyelids too, if they're retracted. And at
       | the perimeter, the profile, different angle for the ray.
       | 
       | And the intention is for melanin to block x-rays too, block all
       | rays, not just UV but deeper. Well it has a spectrum, that cannot
       | be denied. And if you're taking all the pixels in an image, there
       | might be aggregate effects as I described. You get a few million
       | pixels, let AI use every part of the buffalo of the information
       | of the picture, and you can get skin color through x-rays.
       | 
       | The question is what this says about Africans with light-skin
       | strictly because of albinism, ie lack of pigmentation, but
       | otherwise totally African.
        
       | mathieubordere wrote:
       | I mean, if color of skin, form of eyes and other visible,
       | "mechanical" characteristics can be different it's not that big
       | of a leap to observe that certain non-visible characteristics can
       | differ too between humans.
        
       | hellohowareu wrote:
       | Simply go to google image and search: "skeletal racial
       | differences".
       | 
       | subspecies are found across species-- they happen based on
       | geographic dispersion and geographic isolation, which humans
       | underwent for tens and hundreds of thousands of years.
       | 
       | Welcome to the sciences of anatomy, anthropology, and forensics.
       | 
       | other differences:
       | 
       | - slow twitch vs fast twitch muscle
       | 
       | - teeth shape
       | 
       | - shapes and colors of various parts
       | 
       | - genetic susceptibility to & advantages against specific
       | diseases
       | 
       | Just like Darwin's finches of the Gallapogos, humans faced
       | geographic dispersion resulting in genetic, diet (e.g. hunter-
       | gatherer vs farmer & malnutrition), and geographical (e.g.
       | altitude) differences which over the course of millennia affect
       | anatomical differences. We can see this effect across all biota:
       | bacteria, plants, animals, and yes, humans.
       | 
       | help keep politics out of science.
        
         | airza wrote:
         | The article is pretty fascinating and I recommend that you
         | actually read it. For example:
         | 
         | >"We found that deep learning models effectively predicted
         | patient race even when the bone density information was removed
         | for both MXR (AUC value for Black patients: 0*960 [CI
         | 0*958-0*963]) and CXP (AUC value for Black patients: 0*945 [CI
         | 0*94-0*949]) datasets. The average pixel thresholds for
         | different tissues did not produce any usable signal to detect
         | race (AUC 0*5). These findings suggest that race information
         | was not localised within the brightest pixels within the image
         | (eg, in the bone)."
        
           | jcranberry wrote:
           | So just from the silhouette of a skeleton, if I understand
           | that correctly?
        
             | airza wrote:
             | Even after being munged into a nearly-uniform gray by high
             | pass the effect seems pretty robust.
        
           | shakna wrote:
           | One of the primary ways of identifying possible race from
           | bones in anthropology involved calculating ratio from
           | lengths. Good for an estimate or fallback, but not completely
           | accurate. Removing the density would do absolutely nothing to
           | obscure that method. Any image will allow you to measure
           | ratio of bones sizes.
        
         | ZeroGravitas wrote:
         | The problem with 'race' as a concept isn't that you can
         | genetically tell people apart.
         | 
         | Our tools are so precise you can tell which parent a set of
         | cousins had with DNA tests, this doesn't make them a different
         | species/sub-species or race from each other, even if one group
         | has red hair and the other has black.
         | 
         | It's the pointless lumping together of people who are
         | genetically distinct and drawing arbitrary, unscientific lines
         | that's the issue.
         | 
         | Presumably the same experiments that can detect Asian Vs Black
         | Vs White could also detect the entirely made up 'races' of
         | Asian orBlack, AsianorWhite and WhiteorBlack since those are
         | logically equivalent.
         | 
         | So are the races I made up a moment ago real things? No. But a
         | computer can predict which category I'd assign, doesn't that
         | make them real and important racial classifications? No it
         | means my made up classifications map to other real genetic
         | concepts at a lower level, like red hair.
        
         | nerdponx wrote:
         | Then problem is that human experts sometimes can't tell the
         | difference while the model can.
        
           | inglor_cz wrote:
           | AI is also able to determine your sex from your retinal scan
           | with very good levels of certainty (provided that your retina
           | is healthy; its ability to tell sexes apart drops in diseased
           | retinas). [0]
           | 
           | Which came as a surprise to the ophthalmologists, because
           | they aren't aware of any significant differences between male
           | and female retinas.
           | 
           | [0] https://www.researchgate.net/publication/351558516_Predic
           | tin...
        
             | chopin wrote:
             | I am surprised that this is a surprise. At least color
             | vision is encoded in the X-Chromosome so there should be
             | variation as males have only one which can be expressed.
        
               | inglor_cz wrote:
               | It is a surprise, because the retina as an organ is very
               | well visible and observable in living people, so we have
               | a ton of observational data and practical clinical
               | experience. But despite that, humans haven't noticed
               | anything.
        
               | hugh-avherald wrote:
               | I've never seen a retina which had been separated from a
               | human.
        
         | KaiserPro wrote:
         | > skeletal racial differences
         | 
         | PS10 says that its not that. Anatomy is extraordinarily hard,
         | and AI isn't that good, yet. Sure different races have
         | different layouts, but often that's only really obvious post
         | mortem. (ie when you can yank out the bones and look at them,
         | there are of course corner cases where high res CAT/MRI scans
         | can pull out decent skeletal imagery in 3D) There are other
         | cases, but that should be easy to account for.
         | 
         | If I had to bet, and I knew where the data was coming from, I'd
         | say its probably picking up on the style of imaging, rather
         | than anything anatomical. Not all x-rays have bones in, and not
         | all bones differ reliably to detect race.
         | 
         | > keep politics out of science.
         | 
         | Yes, precisely, which is why the experiment needs to be
         | reproduced, and theories tested through experimentation. The
         | reason why this is important is because unless we workout where
         | this trait is coming from, we cannot be sure the diagnosis is
         | correct. For example those with sickle cells have a higher risk
         | of bone damage[1] which could indicate they are x-rayed more.
         | This could warp the dataset, causing false positives for sickle
         | cell style bone damage.
         | 
         | [1]https://www.hopkinsmedicine.org/health/conditions-and-
         | diseas...
        
           | knicholes wrote:
           | I wonder if some communities use certain x-ray machines
           | verses which machines are commonly used by other communities
           | and this has nothing to do with race but the machine being
           | used. I read over the paper but didn't really understand it.
           | Maybe all this is doing is identifying which machine was
           | used.
        
           | MontyCarloHall wrote:
           | >I'd say its probably picking up on the style of imaging,
           | rather than anything anatomical
           | 
           | Certainly possible! They do control for hospital and machine
           | ...
           | 
           | >Race prediction performance was also robust across models
           | trained on single equipment and single hospital location on
           | the chest x-ray and mammogram datasets
           | 
           | ... but it's also possible that different chest x-rays were
           | being used for different diagnostic purposes and thus have a
           | different imaging style, which a) may correlate with
           | ethnicity and b) does not appear to be explicitly controlled
           | for.
        
             | ASalazarMX wrote:
             | The weak factor in these AI studies seems to be data set
             | normalization.
        
           | tedivm wrote:
           | >If I had to bet, and I knew where the data was coming from,
           | I'd say its probably picking up on the style of imaging,
           | rather than anything anatomical. Not all x-rays have bones
           | in, and not all bones differ reliably to detect race.
           | 
           | This was my guess as well. I've spent a lot of time around
           | radiology and AI (I used to work at a company specializing in
           | it) and we read a lot of the failure cases as well. There was
           | one example where the model picked up on the hospital, and
           | one hospital was for higher risk patients- so it learned to
           | assign all patients from that hospital to the disease
           | category simply because they were at that hospital.
           | 
           | There are a ton of cases like this out there, especially when
           | using public datasets (which in the medical field tend to be
           | very unbalanced datasets due to the difficulties of building
           | a HIPAA compliant public dataset).
        
             | krona wrote:
             | > _one hospital was for higher risk patients- so it learned
             | to assign all patients from that hospital to the disease
             | category simply because they were at that hospital._
             | 
             | That just sounds like poor feature selection/engineering.
             | Garbage in, garbage out.
        
               | tedivm wrote:
               | Yeah there are definitely ways they would have avoided
               | that, but it's just one example of many. The whole point
               | of ML is that it picks up on learned patterns. The
               | problem is that it can be difficult to identify what it
               | is learning from- this paper itself says they do not know
               | what is causing it to make these predictions. As a result
               | it is difficult to validate that the model is doing what
               | people think it is.
        
         | scandox wrote:
        
           | andrewmcwatters wrote:
           | The reality is more humbling: humanity is vast and knowledge
           | is not uniformly dispersed.
        
           | rmbyrro wrote:
           | Why's that?
           | 
           | Does Google have a filter that leaves all good science out of
           | its indexes?
        
             | codefreeordie wrote:
             | Yeah, they remove anything they consider "misinformation"
        
             | scandox wrote:
             | I object more concretely to the word "simply". Everyone who
             | has some sort of agenda and doesn't actually read stuff
             | starts with the word "simply". I'm tired of "simply" -
             | meaning "listen to me and stop reading the actual content".
        
       | samatman wrote:
       | Physiologies are created by genetics, and differences in ancestry
       | are the basis for self-identified race.
       | 
       | Ordinary computer vision can also identify race fairly
       | accurately, the high pass filter thing is merely pointing out
       | that ML classifiers don't work like human retinas.
       | 
       | It's astonishing how many epicycles HN comments are trying to
       | introduce into a finding that anyone would have predicted.
       | Research which confirms predictable things is valuable of course,
       | but no apple carts have been upset.
        
       | omgJustTest wrote:
       | Given the complexity of datasets, and what is known about the
       | quality of medical scanners, is it possible that underserved
       | communities (ie higher noise scanners) serve a specific community
       | that is heavily skewed in race distributions?
        
         | cdot2 wrote:
         | "our finding that AI can accurately predict self-reported race,
         | even from corrupted, cropped, and noised medical images"
         | 
         | It doesn't seem like noise in the images is a factor
        
           | orangepurple wrote:
           | Imaging artifacts may persist despite corruption
        
       | bb123 wrote:
       | One idea is that there is some difference in the x-rays
       | themselves that could potentially be explained by racial
       | disparities in access to (and quality of) healthcare. Maybe white
       | people tend to visit hospitals with newer, better equipment or
       | better trained radiographers and the model is picking up on
       | differences in the exposures from that.
        
         | MontyCarloHall wrote:
         | They mostly accounted for this:
         | 
         | >Race prediction performance was also robust across models
         | trained on single equipment and single hospital location on the
         | chest x-ray and mammogram datasets
         | 
         | Sure, it's possible that bias due to the radiographer is the
         | culprit, but this seems unlikely.
        
         | Beltiras wrote:
         | That's an interesting confounding variable. I think it's
         | disproven by the fact that the AUC is too high given your
         | hypothesis.
        
         | redox99 wrote:
         | These results seem too accurate to be explained only by a
         | correlation to the medical equipment used.
        
         | krona wrote:
         | > _We also showed that the ability of deep models to predict
         | race was generalised across different clinical environments,
         | medical imaging modalities, and patient populations, suggesting
         | that these models do not rely on local idiosyncratic
         | differences in how imaging studies are conducted for patients
         | with different racial identities._
        
       | MontyCarloHall wrote:
       | Not too surprising that physical differences across ethnicities
       | are literally more than skin deep. It wouldn't be shocking that a
       | model could identify one's ethnicity based on, for example, a
       | microscope image of their hair; why should bone be any different?
       | 
       | I'm more surprised that the distinguishing features haven't been
       | obvious to trained radiographers for decades. It would be cool to
       | see a followup to this paper that identifies salient
       | distinguishing features. Perhaps a GAN-like model could work--
       | given the trained classifier network, train 1) a second network
       | to generate images that when fed to the classifier, maximize the
       | classification for a given ethnicity, and 2) a third network to
       | discriminate real from fake X-Ray images (to avoid generating
       | noise that happens to minimize the classifier's loss function). I
       | wonder if the generator would yield images with exaggerated
       | features specific to a given ethnicity, or whether it would yield
       | realistic but uninterpretable images.
        
         | hemreldop wrote:
        
         | eklitzke wrote:
         | I think it's more likely the case that (a) most radiographers
         | aren't trained in medical school to look for distinguishing
         | racial features (why would they be?) and (b) in most cases the
         | radiologist knows or can easily guess the race of the patient
         | anyway so there's no need to try to guess it from X-ray imaging
         | data. There are a lot of anatomical features related to race
         | that have been known since before radiology has been a field,
         | it's just not pertinent to the job of most radiologists.
        
       | tomp wrote:
       | If you're interested in "hard to describe features that can be
       | learned with enough expiration", look up _chick sexing_
       | 
       | https://en.wikipedia.org/wiki/Chick_sexing#Vent_sexing
        
         | Beltiras wrote:
         | Interesting field. You have to breed a couple of males to
         | maintain the species. If you were to pick those from the mis-
         | sexed group I suppose natural selection would reduce the
         | classifying feature over time. I wonder if poultry farms pick a
         | couple of the male-classified birds to maintain a stock of well
         | identifiable males and kill all the mis-classified males.
        
       | dang wrote:
       | The submitted title ("AI identifies race from xray, researchers
       | don't know how") broke the site guidelines by editorializing.
       | Submitters: please don't do that - it eventually causes your
       | account to lose submission privileges.
       | 
       | From the guidelines
       | (https://news.ycombinator.com/newsguidelines.html):
       | 
       | " _Please use the original title, unless it is misleading or
       | linkbait; don 't editorialize._"
        
         | gus_massa wrote:
         | It's the title of the Vice article about the same topic.
         | https://www.vice.com/en/article/wx5ypb/ai-can-guess-your-rac...
         | (It was posted last year.) (No idea why the OP used one title
         | and another URL.) (The title of Vice is a bad title anyway.)
        
           | dang wrote:
           | Good catch!
        
       | civilized wrote:
       | It would be nice to see more genuine, enthusiastic scientific
       | curiosity to understand how the ML algorithms are doing this,
       | rather than just abject terror and alarm.
        
         | SpicyLemonZest wrote:
         | It seems like the reason the researchers in this paper are
         | concerned is precisely that they tried and failed to understand
         | how the ML algorithms are doing this. If they'd discovered that
         | white people have a subtly distinctive vertebra shape the model
         | was detecting, it would have been much more of "oh, we
         | discovered a neat fact".
        
           | civilized wrote:
           | I don't think they tried very hard at all. I see no
           | meaningful use of modern explanation tools.
           | 
           | There are lots of known ways in which people of different
           | races are different physiologically. Probably even more
           | unknown ways.
           | 
           | There could also be differences in imaging technology used in
           | different communities, as others have suggested. I'd be a bit
           | surprised if something like that could create such a strong
           | signal but it's on the table.
        
             | SpicyLemonZest wrote:
             | For those of us less familiar with this space, what are
             | these modern explanation tools? (I certainly agree that
             | it's plausible the model is seeing a physiological
             | difference, and the researchers seem to have considered a
             | few concrete hypotheses on that dimension.)
        
               | civilized wrote:
               | Here's an introduction to one technique:
               | https://cloud.google.com/blog/products/ai-machine-
               | learning/e...
               | 
               | This is a cutting edge subfield of ML, so it's
               | understandable that one paper in a medical journal isn't
               | going to be on that cutting edge, but I think they should
               | at least acknowledge that their investigations barely
               | scratched the surface.
        
               | SpicyLemonZest wrote:
               | Thanks! This looks pretty neat, I'll have to dig more
               | into their explainable AI product later.
        
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