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Aasa Feragen

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Published work

10 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.

preprint2014arXiv

Geodesic Exponential Kernels: When Curvature and Linearity Conflict

We consider kernel methods on general geodesic metric spaces and provide both negative and positive results. First we show that the common Gaussian kernel can only be generalized to a positive definite kernel on a geodesic metric space if the space is flat. As a result, for data on a Riemannian manifold, the geodesic Gaussian kernel is only positive definite if the Riemannian manifold is Euclidean. This implies that any attempt to design geodesic Gaussian kernels on curved Riemannian manifolds is futile. However, we show that for spaces with conditionally negative definite distances the geodesic Laplacian kernel can be generalized while retaining positive definiteness. This implies that geodesic Laplacian kernels can be generalized to some curved spaces, including spheres and hyperbolic spaces. Our theoretical results are verified empirically.

preprint2014arXiv

Quantification and visualization of variation in anatomical trees

This paper presents two approaches to quantifying and visualizing variation in datasets of trees. The first approach localizes subtrees in which significant population differences are found through hypothesis testing and sparse classifiers on subtree features. The second approach visualizes the global metric structure of datasets through low-distortion embedding into hyperbolic planes in the style of multidimensional scaling. A case study is made on a dataset of airway trees in relation to Chronic Obstructive Pulmonary Disease.

preprint2013arXiv

Geometric tree kernels: Classification of COPD from airway tree geometry

Methodological contributions: This paper introduces a family of kernels for analyzing (anatomical) trees endowed with vector valued measurements made along the tree. While state-of-the-art graph and tree kernels use combinatorial tree/graph structure with discrete node and edge labels, the kernels presented in this paper can include geometric information such as branch shape, branch radius or other vector valued properties. In addition to being flexible in their ability to model different types of attributes, the presented kernels are computationally efficient and some of them can easily be computed for large datasets (N of the order 10.000) of trees with 30-600 branches. Combining the kernels with standard machine learning tools enables us to analyze the relation between disease and anatomical tree structure and geometry. Experimental results: The kernels are used to compare airway trees segmented from low-dose CT, endowed with branch shape descriptors and airway wall area percentage measurements made along the tree. Using kernelized hypothesis testing we show that the geometric airway trees are significantly differently distributed in patients with Chronic Obstructive Pulmonary Disease (COPD) than in healthy individuals. The geometric tree kernels also give a significant increase in the classification accuracy of COPD from geometric tree structure endowed with airway wall thickness measurements in comparison with state-of-the-art methods, giving further insight into the relationship between airway wall thickness and COPD. Software: Software for computing kernels and statistical tests is available at http://image.diku.dk/aasa/software.php.

preprint2012arXiv

Towards a theory of statistical tree-shape analysis

In order to develop statistical methods for shapes with a tree-structure, we construct a shape space framework for tree-like shapes and study metrics on the shape space. This shape space has singularities, corresponding to topological transitions in the represented trees. We study two closely related metrics on the shape space, TED and QED. QED is a quotient Euclidean distance arising naturally from the shape space formulation, while TED is the classical tree edit distance. Using Gromov's metric geometry we gain new insight into the geometries defined by TED and QED. We show that the new metric QED has nice geometric properties which facilitate statistical analysis, such as existence and local uniqueness of geodesics and averages. TED, on the other hand, does not share the geometric advantages of QED, but has nice algorithmic properties. We provide a theoretical framework and experimental results on synthetic data trees as well as airway trees from pulmonary CT scans. This way, we effectively illustrate that our framework has both the theoretical and qualitative properties necessary to build a theory of statistical tree-shape analysis.

preprint2011arXiv

The structure of groups of multigerm equivalences

We study the structure of classical groups of equivalences for smooth multigerms $f \colon (N,S) \to (P,y)$, and extend several known results for monogerm equivalences to the case of mulitgerms. In particular, we study the group $\A$ of source- and target diffeomorphism germs, and its stabilizer $\A_f$. For monogerms $f$ it is well-known that if $f$ is finitely $\A$-determined, then $\A_f$ has a maximal compact subgroup $MC(\A_f)$, unique up to conjugacy, and $\A_f/MC(\A_f)$ is contractible. We prove the same result for finitely $\A$-determined multigerms $f$. Moreover, we show that for a ministable multigerm $f$, the maximal compact subgroup $MC(\A_f)$ decomposes as a product of maximal compact subgroups $MC(\A_{g_i})$ for suitable representatives $g_i$ of the monogerm components of $f$. We study a product decomposition of $MC(\A_f)$ in terms of $MC(\mathscr{R}_f)$ and a group of target diffeomorphisms, and conjecture a decomposition theorem. Finally, we show that for a large class of maps, maximal compact subgroups are small and easy to compute.

preprint2010arXiv

A short and elementary proof of Hanner's theorem

Hanner's theorem is a classical theorem in the theory of retracts and extensors in topological spaces, which states that a local ANE is an ANE. While Hanner's original proof of the theorem is quite simple for separable spaces, it is rather involved for the general case. We provide a proof which is not only short, but also elementary, relying only on well-known classical point-set topology.