Unreading Race: Purging Protected Features from Chest X-ray Embeddings

Purpose: To analyze and remove protected feature effects in chest radiograph embeddings of deep learning models. Materials and Methods: An orthogonalization is utilized to remove the influence of protected features (e.g., age, sex, race) in chest radiograph embeddings, ensuring feature-independent results. To validate the efficacy of the approach, we retrospectively study the MIMIC and CheXpert datasets using three pre-trained models, namely a supervised contrastive, a self-supervised contrastive, and a baseline classifier model. Our statistical analysis involves comparing the original versus the orthogonalized embeddings by estimating protected feature influences and evaluating the ability to predict race, age, or sex using the two types of embeddings. Results: Our experiments reveal a significant influence of protected features on predictions of pathologies. Applying orthogonalization removes these feature effects. Apart from removing any influence on pathology classification, while maintaining competitive predictive performance, orthogonalized embeddings further make it infeasible to directly predict protected attributes and mitigate subgroup disparities. Conclusion: The presented work demonstrates the successful application and evaluation of the orthogonalization technique in the domain of chest X-ray classification.