# One Size Fits None: Rethinking Fairness in Medical AI

arXiv: https://arxiv.org/abs/2506.14400 · HTML: https://mlsanity.com/paper/2506.14400/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 7 of its 19 references that are in the map.
- First posted on arXiv 17 Jun 2025.

## Builds on (most cited first, 7 of 7)

- [A Survey on Bias and Fairness in Machine Learning](https://mlsanity.com/paper/1908.09635/) (2019)
- [CheXclusion: Fairness gaps in deep chest X-ray classifiers](https://mlsanity.com/paper/2003.00827/) (2020)
- [An Intersectional Definition of Fairness](https://mlsanity.com/paper/1807.08362/) (2018)
- [Towards Intersectionality in Machine Learning: Including More Identities, Handling Underrepresentation, and Performing Evaluation](https://mlsanity.com/paper/2205.04610/) (2022)
- [FairMedFM: Fairness Benchmarking for Medical Imaging Foundation Models](https://mlsanity.com/paper/2407.00983/) (2024)
- [How to Leverage Multimodal EHR Data for Better Medical Predictions?](https://mlsanity.com/paper/2110.15763/) (2021)
- [Improving Bias Correction Standards by Quantifying its Effects on Treatment Outcomes](https://mlsanity.com/paper/2407.14861/) (2024)

## Abstract (arXiv)

Machine learning (ML) models are increasingly used to support clinical decision-making. However, real-world medical datasets are often noisy, incomplete, and imbalanced, leading to performance disparities across patient subgroups. These differences raise fairness concerns, particularly when they reinforce existing disadvantages for marginalized groups. In this work, we analyze several medical prediction tasks and demonstrate how model performance varies with patient characteristics. While ML models may demonstrate good overall performance, we argue that subgroup-level evaluation is essential before integrating them into clinical workflows. By conducting a performance analysis at the subgroup level, differences can be clearly identified-allowing, on the one hand, for performance disparities to be considered in clinical practice, and on the other hand, for these insights to inform the responsible development of more effective models. Thereby, our work contributes to a practical discussion around the subgroup-sensitive development and deployment of medical ML models and the interconnectedness of fairness and transparency.