# Interpretable bias mitigation for textual data: Reducing gender bias in patient notes while maintaining classification performance

arXiv: https://arxiv.org/abs/2103.05841 · HTML: https://mlsanity.com/paper/2103.05841/

## Key facts

- Cited by 3 papers in the map (data through 14 Oct 2026).
- Builds on 30 of its 64 references that are in the map.
- First posted on arXiv 10 Mar 2021.

## Builds on (most cited first, 30 of 30)

- [BERT: Pre-training of Deep Bidirectional Transformers for Language Understanding](https://mlsanity.com/paper/1810.04805/) (2018)
- [RoBERTa: A Robustly Optimized BERT Pretraining Approach](https://mlsanity.com/paper/1907.11692/) (2019)
- [Efficient Estimation of Word Representations in Vector Space](https://mlsanity.com/paper/1301.3781/) (2013)
- [Distributed Representations of Words and Phrases and their Compositionality](https://mlsanity.com/paper/1310.4546/) (2013)
- [Deep contextualized word representations](https://mlsanity.com/paper/1802.05365/) (2018)
- [HuggingFace's Transformers: State-of-the-art Natural Language Processing](https://mlsanity.com/paper/1910.03771/) (2019)
- [BioBERT: a pre-trained biomedical language representation model for biomedical text mining](https://mlsanity.com/paper/1901.08746/) (2019)
- [A Survey on Bias and Fairness in Machine Learning](https://mlsanity.com/paper/1908.09635/) (2019)
- [Man is to Computer Programmer as Woman is to Homemaker? Debiasing Word Embeddings](https://mlsanity.com/paper/1607.06520/) (2016)
- [Publicly Available Clinical BERT Embeddings](https://mlsanity.com/paper/1904.03323/) (2019)
- [A Primer in BERTology: What we know about how BERT works](https://mlsanity.com/paper/2002.12327/) (2020)
- [EDA: Easy Data Augmentation Techniques for Boosting Performance on Text Classification Tasks](https://mlsanity.com/paper/1901.11196/) (2019)
- [Counterfactual Fairness](https://mlsanity.com/paper/1703.06856/) (2017)
- [How Contextual are Contextualized Word Representations? Comparing the Geometry of BERT, ELMo, and GPT-2 Embeddings](https://mlsanity.com/paper/1909.00512/) (2019)
- [ClinicalBERT: Modeling Clinical Notes and Predicting Hospital Readmission](https://mlsanity.com/paper/1904.05342/) (2019)
- [Measuring Bias in Contextualized Word Representations](https://mlsanity.com/paper/1906.07337/) (2019)
- [Lipstick on a Pig: Debiasing Methods Cover up Systematic Gender Biases in Word Embeddings But do not Remove Them](https://mlsanity.com/paper/1903.03862/) (2019)
- [Contextual Augmentation: Data Augmentation by Words with Paradigmatic Relations](https://mlsanity.com/paper/1805.06201/) (2018)
- [Learning Gender-Neutral Word Embeddings](https://mlsanity.com/paper/1809.01496/) (2018)
- [Data Decisions and Theoretical Implications when Adversarially Learning Fair Representations](https://mlsanity.com/paper/1707.00075/) (2017)
- [QANet: Combining Local Convolution with Global Self-Attention for Reading Comprehension](https://mlsanity.com/paper/1804.09541/) (2018)
- [Black is to Criminal as Caucasian is to Police: Detecting and Removing Multiclass Bias in Word Embeddings](https://mlsanity.com/paper/1904.04047/) (2019)
- [Interpretable Machine Learning -- A Brief History, State-of-the-Art and Challenges](https://mlsanity.com/paper/2010.09337/) (2020)
- [De-identification of Patient Notes with Recurrent Neural Networks](https://mlsanity.com/paper/1606.03475/) (2016)
- [Toward Gender-Inclusive Coreference Resolution](https://mlsanity.com/paper/1910.13913/) (2019)
- [Hurtful Words: Quantifying Biases in Clinical Contextual Word Embeddings](https://mlsanity.com/paper/2003.11515/) (2020)
- [Out of Order: How Important Is The Sequential Order of Words in a Sentence in Natural Language Understanding Tasks?](https://mlsanity.com/paper/2012.15180/) (2020)
- [Clinical XLNet: Modeling Sequential Clinical Notes and Predicting Prolonged Mechanical Ventilation](https://mlsanity.com/paper/1912.11975/) (2019)
- [MOLIERE: Automatic Biomedical Hypothesis Generation System](https://mlsanity.com/paper/1702.06176/) (2017)
- [Privacy Guarantees for De-identifying Text Transformations](https://mlsanity.com/paper/2008.03101/) (2020)

## Built on by (most cited first, 3 of 3)

- [Theories of "Gender" in NLP Bias Research](https://mlsanity.com/paper/2205.02526/) (2022)
- [AMMU : A Survey of Transformer-based Biomedical Pretrained Language Models](https://mlsanity.com/paper/2105.00827/) (2021)
- [Fair Machine Learning in Healthcare: A Review](https://mlsanity.com/paper/2206.14397/) (2022)

## Abstract (arXiv)

Medical systems in general, and patient treatment decisions and outcomes in particular, are affected by bias based on gender and other demographic elements. As language models are increasingly applied to medicine, there is a growing interest in building algorithmic fairness into processes impacting patient care. Much of the work addressing this question has focused on biases encoded in language models -- statistical estimates of the relationships between concepts derived from distant reading of corpora. Building on this work, we investigate how word choices made by healthcare practitioners and language models interact with regards to bias. We identify and remove gendered language from two clinical-note datasets and describe a new debiasing procedure using BERT-based gender classifiers. We show minimal degradation in health condition classification tasks for low- to medium-levels of bias removal via data augmentation. Finally, we compare the bias semantically encoded in the language models with the bias empirically observed in health records. This work outlines an interpretable approach for using data augmentation to identify and reduce the potential for bias in natural language processing pipelines.