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Research Article
Loc Trinh
University of Southern California
Corresponding Author
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This work is licensed under a CC BY 4.0 License. Read Full License
The recent release of large-scale healthcare datasets has greatly propelled the research of data-driven deep learning models for healthcare applications. However, due to the nature of such deep black-boxed models, concerns about interpretability, fairness, and biases in healthcare scenarios where human lives are at stake call for a careful and thorough examination of both datasets and models. In this work, we focus on MIMIC-IV (Medical Information Mart for Intensive Care, version IV), the largest publicly available healthcare dataset, and conduct comprehensive analyses of dataset representation bias as well as interpretability and prediction fairness of deep learning models for in-hospital mortality prediction. In terms of interpretability, we observe that (1) the best-performing interpretability method successfully identifies critical features for mortality prediction on various prediction models; (2) demographic features are important for prediction. In terms of fairness, we observe that (1) there exists disparate treatment in prescribing mechanical ventilation among patient groups across ethnicity, gender and age; (2) all of the studied mortality predictors are generally fair while the IMV-LSTM (Interpretable Multi-Variable Long Short-Term Memory) model provides the most accurate and unbiased predictions across all protected groups. We further draw concrete connections between interpretability methods and fairness metrics by showing how feature importance from interpretability methods can be beneficial in quantifying potential disparities in mortality predictors.
Keywords
large-scale healthcare datasets, black-boxed model, MIMIC-IV, IMV-LSTM
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The full text of this article is available to read as a PDF.
No competing interests reported.
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CURRENT STATUS: Under Review
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Editorial decision: Major revision
On 11 Aug, 2021
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A new preprint design is coming!
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This preprint is under consideration at Scientific Reports. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research Article
Loc Trinh
University of Southern California
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 14 Apr, 2021
No community comments so far
Editorial decision: Major revision
On 11 Aug, 2021
Reviews received
Received 02 Aug, 2021
Reviewers agreed
On 07 Jul, 2021
Reviewers invited
Invitations sent on 20 Jun, 2021
Editor assigned
On 20 Jun, 2021
Editor invited
On 09 Apr, 2021
Submission checks complete
On 09 Apr, 2021
First submitted
On 07 Apr, 2021
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
The recent release of large-scale healthcare datasets has greatly propelled the research of data-driven deep learning models for healthcare applications. However, due to the nature of such deep black-boxed models, concerns about interpretability, fairness, and biases in healthcare scenarios where human lives are at stake call for a careful and thorough examination of both datasets and models. In this work, we focus on MIMIC-IV (Medical Information Mart for Intensive Care, version IV), the largest publicly available healthcare dataset, and conduct comprehensive analyses of dataset representation bias as well as interpretability and prediction fairness of deep learning models for in-hospital mortality prediction. In terms of interpretability, we observe that (1) the best-performing interpretability method successfully identifies critical features for mortality prediction on various prediction models; (2) demographic features are important for prediction. In terms of fairness, we observe that (1) there exists disparate treatment in prescribing mechanical ventilation among patient groups across ethnicity, gender and age; (2) all of the studied mortality predictors are generally fair while the IMV-LSTM (Interpretable Multi-Variable Long Short-Term Memory) model provides the most accurate and unbiased predictions across all protected groups. We further draw concrete connections between interpretability methods and fairness metrics by showing how feature importance from interpretability methods can be beneficial in quantifying potential disparities in mortality predictors.
Figure 1
Figure 2
The full text of this article is available to read as a PDF.
No competing interests reported.
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