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Aasa Feragen

Aasa Feragen contributes to research discovery and scholarly infrastructure.

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Published work

4 published item(s)

preprint2026arXiv

A Framework for Exploring and Disentangling Intersectional Bias: A Case Study in Fetal Ultrasound

Bias in medical AI is often framed as a problem of representation. However, in image-based tasks such as fetal ultrasound, performance disparities can arise even when representation is adequate, because predictive accuracy depends strongly on image quality. Image quality is shaped by acquisition conditions and operator expertise, as well as patient-dependent factors such as maternal body mass index (BMI), all of which may correlate with sensitive demographic features. Consequently, observed disparities may reflect the combined influence of demographic, clinical, and acquisition-related factors rather than data imbalance alone, and may obscure underlying interaction or confounding effects. We propose a structured framework to explore and detect intersectional bias, combining unsupervised slice discovery, systematic factor-wise analysis, and targeted intersectional evaluation. In a case study of over 94{,}000 ultrasound images for fetal weight estimation, we analyze bias in a state-of-the-art deep learning (DL) model and the clinical standard Hadlock, a regression formula using biometric measurements. Pixel spacing (PS) -- a parameter considered suboptimal in current acquisition protocols -- emerged as a consistent driver of performance differences, with higher PS associated with improvements of up to 24\% in selected subgroups for both models. Because PS is often adapted in cases of high BMI or low gestational age (GA), this effect carries a substantial risk of confounding. Our intersectional analysis revealed that part of the PS-associated signal is explained by GA, while PS-related improvements persist across BMI strata, highlighting the importance of acquisition-aware and interaction-aware evaluation in medical AI fairness research.

preprint2026arXiv

Towards Fairness under Label Bias in Image Segmentation: Impact, Measurement and Mitigation

Labeled datasets reflect the biases of their annotation pipelines, which sometimes introduce label bias: group-conditional label errors that cause systematic performance disparities across demographic subgroups. Label bias in image segmentation remains underexplored, as even detecting it typically requires clean, unbiased annotations, which are not readily available. We present a data-centric adaptation of Confident Learning to segmentation, allowing detection of label bias directly in the training data without a clean, unbiased ground truth. By comparing the provided training labels to the model's confident predictions, we isolate directional errors that quantify the presence and nature of bias, where standard overlap metrics like Dice fail. We further show that label bias influences subgroup separability in the encoder's feature space, an artifact we leverage for bias mitigation rather than suppressing it. We evaluate three datasets, spanning from synthetic to real-life bias, showing how our framework reliably detects and mitigates bias without access to clean labels, achieving equitable performance across experimental conditions.

preprint2022arXiv

diffConv: Analyzing Irregular Point Clouds with an Irregular View

Standard spatial convolutions assume input data with a regular neighborhood structure. Existing methods typically generalize convolution to the irregular point cloud domain by fixing a regular "view" through e.g. a fixed neighborhood size, where the convolution kernel size remains the same for each point. However, since point clouds are not as structured as images, the fixed neighbor number gives an unfortunate inductive bias. We present a novel graph convolution named Difference Graph Convolution (diffConv), which does not rely on a regular view. diffConv operates on spatially-varying and density-dilated neighborhoods, which are further adapted by a learned masked attention mechanism. Experiments show that our model is very robust to the noise, obtaining state-of-the-art performance in 3D shape classification and scene understanding tasks, along with a faster inference speed.

preprint2022arXiv

Feature robustness and sex differences in medical imaging: a case study in MRI-based Alzheimer's disease detection

Convolutional neural networks have enabled significant improvements in medical image-based diagnosis. It is, however, increasingly clear that these models are susceptible to performance degradation when facing spurious correlations and dataset shift, leading, e.g., to underperformance on underrepresented patient groups. In this paper, we compare two classification schemes on the ADNI MRI dataset: a simple logistic regression model using manually selected volumetric features, and a convolutional neural network trained on 3D MRI data. We assess the robustness of the trained models in the face of varying dataset splits, training set sex composition, and stage of disease. In contrast to earlier work in other imaging modalities, we do not observe a clear pattern of improved model performance for the majority group in the training dataset. Instead, while logistic regression is fully robust to dataset composition, we find that CNN performance is generally improved for both male and female subjects when including more female subjects in the training dataset. We hypothesize that this might be due to inherent differences in the pathology of the two sexes. Moreover, in our analysis, the logistic regression model outperforms the 3D CNN, emphasizing the utility of manual feature specification based on prior knowledge, and the need for more robust automatic feature selection.