Fair Machine Learning in Healthcare: A Review

The digitization of healthcare data coupled with advances in computational capabilities has propelled the adoption of machine learning (ML) in healthcare. However, these methods can perpetuate or even exacerbate existing disparities, leading to fairness concerns such as the unequal distribution of resources and diagnostic inaccuracies among different demographic groups. Addressing these fairness problem is paramount to prevent further entrenchment of social injustices. In this survey, we analyze the intersection of fairness in machine learning and healthcare disparities. We adopt a framework based on the principles of distributive justice to categorize fairness concerns into two distinct classes: equal allocation and equal performance. We provide a critical review of the associated fairness metrics from a machine learning standpoint and examine biases and mitigation strategies across the stages of the ML lifecycle, discussing the relationship between biases and their countermeasures. The paper concludes with a discussion on the pressing challenges that remain unaddressed in ensuring fairness in healthcare ML, and proposes several new research directions that hold promise for developing ethical and equitable ML applications in healthcare.