Abstract:Automated diagnosis from chest CT has improved considerably with deep learning, but models trained on skewed datasets tend to perform unevenly across patient demographics. However, the situation is worse than simple demographic bias. In clinical data, class imbalance and group underrepresentation often coincide, creating compound failure modes that neither standard rebalancing nor fairness corrections can fix alone. We introduce a two-level objective that targets both axes of this problem. Logit-adjusted cross-entropy loss operates at the sample level, shifting decision margins by class frequency with provable consistency guarantees. Conditional Value at Risk aggregation operates at the group level, directing optimization pressure toward whichever demographic group currently has the higher loss. We evaluate on the Fair Disease Diagnosis benchmark using a 3D ResNet-18 pretrained on Kinetics-400, classifying CT volumes into Adenocarcinoma, Squamous Cell Carcinoma, COVID-19, and Normal groups with patient sex annotations. The training set illustrates the compound problem concretely: squamous cell carcinoma has 84 samples total, 5 of them female. The combined loss reaches a gender-averaged macro F1 of 0.8403 with a fairness gap of 0.0239, a 13.3% improvement in score and 78% reduction in demographic disparity over the baseline. Ablations show that each component alone falls short. The code is publicly available at https://github.com/Purdue-M2/Fair-Disease-Diagnosis.
Abstract:Deep learning models for COVID-19 detection from chest CT scans generally perform well when the training and test data originate from the same institution, but they often struggle when scans are drawn from multiple centres with differing scanners, imaging protocols, and patient populations. One key reason is that existing methods treat COVID-19 classification as the sole training objective, without accounting for the data source of each scan. As a result, the learned representations tend to be biased toward centres that contribute more training data. To address this, we propose a multi-task learning approach in which the model is trained to predict both the COVID-19 diagnosis and the originating data centre. The two tasks share an EfficientNet-B7 backbone, which encourages the feature extractor to learn representations that hold across all four participating centres. Since the training data is not evenly distributed across sources, we apply a logit-adjusted cross-entropy loss [1] to the source classification head to prevent underrepresented centres from being overlooked. Our pre-processing follows the SSFL framework with KDS [2], selecting eight representative slices per scan. Our method achieves an F1 score of 0.9098 and an AUC-ROC of 0.9647 on a validation set of 308 scans. The code is publicly available at https://github.com/Purdue-M2/-multisource-covid-ct.