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Addressing fairness in lesion classification from dermatological images is crucial due to variations in how skin diseases manifest across skin tones. However, the absence of skin tone labels in public datasets hinders building a fair classifier. To date, such skin tone labels have been estimated prior to fairness analysis in independent studies using the Individual Typology Angle (ITA). Briefly, ITA calculates an angle based on pixels extracted from skin images taking into account the lightness and yellow-blue tints. These angles are then categorised into skin tones that are subsequently used to analyse fairness in skin cancer classification. In this work, we review and compare four ITA-based approaches of skin tone classification on the ISIC18 dataset, a common benchmark for assessing skin cancer classification fairness in the literature. Our analyses reveal a high disagreement among previously published studies demonstrating the risks of ITA-based skin tone estimation methods. Moreover, we investigate the causes of such large discrepancy among these approaches and find that the lack of diversity in the ISIC18 dataset limits its use as a testbed for fairness analysis. Finally, we recommend further research on robust ITA estimation and diverse dataset acquisition with skin tone annotation to facilitate conclusive fairness assessments of artificial intelligence tools in dermatology. Our code is available at https://github.com/tkalbl/RevisitingSkinToneFairness., Comment: Accepted at 2023 MICCAI FAIMI Workshop

Despite major advances in artificial intelligence (AI) for medicine and healthcare, the deployment and adoption of AI technologies remain limited in real-world clinical practice. In recent years, concerns have been raised about the technical, clinical, ethical and legal risks associated with medical AI. To increase real world adoption, it is essential that medical AI tools are trusted and accepted by patients, clinicians, health organisations and authorities. This work describes the FUTURE-AI guideline as the first international consensus framework for guiding the development and deployment of trustworthy AI tools in healthcare. The FUTURE-AI consortium was founded in 2021 and currently comprises 118 inter-disciplinary experts from 51 countries representing all continents, including AI scientists, clinicians, ethicists, and social scientists. Over a two-year period, the consortium defined guiding principles and best practices for trustworthy AI through an iterative process comprising an in-depth literature review, a modified Delphi survey, and online consensus meetings. The FUTURE-AI framework was established based on 6 guiding principles for trustworthy AI in healthcare, i.e. Fairness, Universality, Traceability, Usability, Robustness and Explainability. Through consensus, a set of 28 best practices were defined, addressing technical, clinical, legal and socio-ethical dimensions. The recommendations cover the entire lifecycle of medical AI, from design, development and validation to regulation, deployment, and monitoring. FUTURE-AI is a risk-informed, assumption-free guideline which provides a structured approach for constructing medical AI tools that will be trusted, deployed and adopted in real-world practice. Researchers are encouraged to take the recommendations into account in proof-of-concept stages to facilitate future translation towards clinical practice of medical AI.

Deep generative models, such as Variational Autoencoders (VAEs) and Generative Adversarial Networks (GANs), have been employed widely in computational creativity research. However, such models discourage out-of-distribution generation to avoid spurious sample generation, thereby limiting their creativity. Thus, incorporating research on human creativity into generative deep learning techniques presents an opportunity to make their outputs more compelling and human-like. As we see the emergence of generative models directed toward creativity research, a need for machine learning-based surrogate metrics to characterize creative output from these models is imperative. We propose group-based subset scanning to identify, quantify, and characterize creative processes by detecting a subset of anomalous node-activations in the hidden layers of the generative models. Our experiments on the standard image benchmarks, and their "creatively generated" variants, reveal that the proposed subset scores distribution is more useful for detecting creative processes in the activation space rather than the pixel space. Further, we found that creative samples generate larger subsets of anomalies than normal or non-creative samples across datasets. The node activations highlighted during the creative decoding process are different from those responsible for the normal sample generation. Lastly, we assess if the images from the subsets selected by our method were also found creative by human evaluators, presenting a link between creativity perception in humans and node activations within deep neural nets., Comment: Accepted to IJCAI 2022 - Creativity Track - Extended version from Synthetic Data Generation Workshop at ICLR'21 submission (arXiv:2104.00479). arXiv admin note: text overlap with arXiv:2105.12479

Generative Adversarial Networks (GANs) have recently achieved unprecedented success in photo-realistic image synthesis from low-dimensional random noise. The ability to synthesize high-quality content at a large scale brings potential risks as the generated samples may lead to misinformation that can create severe social, political, health, and business hazards. We propose SubsetGAN to identify generated content by detecting a subset of anomalous node-activations in the inner layers of pre-trained neural networks. These nodes, as a group, maximize a non-parametric measure of divergence away from the expected distribution of activations created from real data. This enable us to identify synthesised images without prior knowledge of their distribution. SubsetGAN efficiently scores subsets of nodes and returns the group of nodes within the pre-trained classifier that contributed to the maximum score. The classifier can be a general fake classifier trained over samples from multiple sources or the discriminator network from different GANs. Our approach shows consistently higher detection power than existing detection methods across several state-of-the-art GANs (PGGAN, StarGAN, and CycleGAN) and over different proportions of generated content., Comment: The paper is under consideration at Pattern Recognition Letters

Recent advances in deep learning have led to breakthroughs in the development of automated skin disease classification. As we observe an increasing interest in these models in the dermatology space, it is crucial to address aspects such as the robustness towards input data distribution shifts. Current skin disease models could make incorrect inferences for test samples from different hardware devices and clinical settings or unknown disease samples, which are out-of-distribution (OOD) from the training samples. To this end, we propose a simple yet effective approach that detect these OOD samples prior to making any decision. The detection is performed via scanning in the latent space representation (e.g., activations of the inner layers of any pre-trained skin disease classifier). The input samples could also perturbed to maximise divergence of OOD samples. We validate our ODD detection approach in two use cases: 1) identify samples collected from different protocols, and 2) detect samples from unknown disease classes. Additionally, we evaluate the performance of the proposed approach and compare it with other state-of-the-art methods. Furthermore, data-driven dermatology applications may deepen the disparity in clinical care across racial and ethnic groups since most datasets are reported to suffer from bias in skin tone distribution. Therefore, we also evaluate the fairness of these OOD detection methods across different skin tones. Our experiments resulted in competitive performance across multiple datasets in detecting OOD samples, which could be used (in the future) to design more effective transfer learning techniques prior to inferring on these samples., Comment: Under review for 6th Outlier Detection & Description Workshop

Recent advances in computer vision and deep learning have led to breakthroughs in the development of automated skin image analysis. In particular, skin cancer classification models have achieved performance higher than trained expert dermatologists. However, no attempt has been made to evaluate the consistency in performance of machine learning models across populations with varying skin tones. In this paper, we present an approach to estimate skin tone in benchmark skin disease datasets, and investigate whether model performance is dependent on this measure. Specifically, we use individual typology angle (ITA) to approximate skin tone in dermatology datasets. We look at the distribution of ITA values to better understand skin color representation in two benchmark datasets: 1) the ISIC 2018 Challenge dataset, a collection of dermoscopic images of skin lesions for the detection of skin cancer, and 2) the SD-198 dataset, a collection of clinical images capturing a wide variety of skin diseases. To estimate ITA, we first develop segmentation models to isolate non-diseased areas of skin. We find that the majority of the data in the the two datasets have ITA values between 34.5{\deg} and 48{\deg}, which are associated with lighter skin, and is consistent with under-representation of darker skinned populations in these datasets. We also find no measurable correlation between performance of machine learning model and ITA values, though more comprehensive data is needed for further validation., Comment: NeurIPS 2019 Workshop on Fair ML for Health

Gaining insight into how deep convolutional neural network models perform image classification and how to explain their outputs have been a concern to computer vision researchers and decision makers. These deep models are often referred to as black box due to low comprehension of their internal workings. As an effort to developing explainable deep learning models, several methods have been proposed such as finding gradients of class output with respect to input image (sensitivity maps), class activation map (CAM), and Gradient based Class Activation Maps (Grad-CAM). These methods under perform when localizing multiple occurrences of the same class and do not work for all CNNs. In addition, Grad-CAM does not capture the entire object in completeness when used on single object images, this affect performance on recognition tasks. With the intention to create an enhanced visual explanation in terms of visual sharpness, object localization and explaining multiple occurrences of objects in a single image, we present Smooth Grad-CAM++ \footnote{Simple demo: http://35.238.22.135:5000/}, a technique that combines methods from two other recent techniques---SMOOTHGRAD and Grad-CAM++. Our Smooth Grad-CAM++ technique provides the capability of either visualizing a layer, subset of feature maps, or subset of neurons within a feature map at each instance at the inference level (model prediction process). After experimenting with few images, Smooth Grad-CAM++ produced more visually sharp maps with better localization of objects in the given input images when compared with other methods., Comment: Accepted in the Intelligent Systems Conference 2019