# Understanding Dataset Bias in Medical Imaging: A Case Study on Chest X-rays

arXiv: https://arxiv.org/abs/2507.07722 · HTML: https://mlsanity.com/paper/2507.07722/

## Key facts

- Cited by 1 papers in the map (data through 14 Oct 2026).
- Builds on 31 of its 62 references that are in the map.
- First posted on arXiv 10 Jul 2025.

## Builds on (most cited first, 30 of 31)

- [Deep Residual Learning for Image Recognition](https://mlsanity.com/paper/1512.03385/) (2015)
- [An Image is Worth 16x16 Words: Transformers for Image Recognition at Scale](https://mlsanity.com/paper/2010.11929/) (2020)
- [Grad-CAM: Visual Explanations from Deep Networks via Gradient-based Localization](https://mlsanity.com/paper/1610.02391/) (2016)
- [mixup: Beyond Empirical Risk Minimization](https://mlsanity.com/paper/1710.09412/) (2017)
- [Going Deeper with Convolutions](https://mlsanity.com/paper/1409.4842/) (2014)
- [CutMix: Regularization Strategy to Train Strong Classifiers with Localizable Features](https://mlsanity.com/paper/1905.04899/) (2019)
- [Learning Deep Features for Discriminative Localization](https://mlsanity.com/paper/1512.04150/) (2015)
- [RandAugment: Practical automated data augmentation with a reduced search space](https://mlsanity.com/paper/1909.13719/) (2019)
- [ImageNet-trained CNNs are biased towards texture; increasing shape bias improves accuracy and robustness](https://mlsanity.com/paper/1811.12231/) (2018)
- [CheXpert: A Large Chest Radiograph Dataset with Uncertainty Labels and Expert Comparison](https://mlsanity.com/paper/1901.07031/) (2019)
- [ChestX-ray8: Hospital-scale Chest X-ray Database and Benchmarks on Weakly-Supervised Classification and Localization of Common Thorax Diseases](https://mlsanity.com/paper/1705.02315/) (2017)
- [How to train your ViT? Data, Augmentation, and Regularization in Vision Transformers](https://mlsanity.com/paper/2106.10270/) (2021)
- [Intriguing Properties of Vision Transformers](https://mlsanity.com/paper/2105.10497/) (2021)
- [PadChest: A large chest x-ray image dataset with multi-label annotated reports](https://mlsanity.com/paper/1901.07441/) (2019)
- [VinDr-CXR: An open dataset of chest X-rays with radiologist's annotations](https://mlsanity.com/paper/2012.15029/) (2020)
- [Common pitfalls and recommendations for using machine learning to detect and prognosticate for COVID-19 using chest radiographs and CT scans](https://mlsanity.com/paper/2008.06388/) (2020)
- [TorchXRayVision: A library of chest X-ray datasets and models](https://mlsanity.com/paper/2111.00595/) (2021)
- [A Deeper Look at Dataset Bias](https://mlsanity.com/paper/1505.01257/) (2015)
- [A Survey on Bias in Visual Datasets](https://mlsanity.com/paper/2107.07919/) (2021)
- [The Effects of Regularization and Data Augmentation are Class Dependent](https://mlsanity.com/paper/2204.03632/) (2022)
- [Delving into Masked Autoencoders for Multi-Label Thorax Disease Classification](https://mlsanity.com/paper/2210.12843/) (2022)
- [A Decade's Battle on Dataset Bias: Are We There Yet?](https://mlsanity.com/paper/2403.08632/) (2024)
- [Long-Tailed Classification of Thorax Diseases on Chest X-Ray: A New Benchmark Study](https://mlsanity.com/paper/2208.13365/) (2022)
- [A Structure-Aware Relation Network for Thoracic Diseases Detection and Segmentation](https://mlsanity.com/paper/2104.10326/) (2021)
- [Risk of Bias in Chest Radiography Deep Learning Foundation Models](https://mlsanity.com/paper/2209.02965/) (2022)
- [Demographic Bias of Expert-Level Vision-Language Foundation Models in Medical Imaging](https://mlsanity.com/paper/2402.14815/) (2024)
- [Understanding Bias in Large-Scale Visual Datasets](https://mlsanity.com/paper/2412.01876/) (2024)
- [Debiasing Counterfactuals In the Presence of Spurious Correlations](https://mlsanity.com/paper/2308.10984/) (2023)
- ["Name that manufacturer". Relating image acquisition bias with task complexity when training deep learning models: experiments on head CT](https://mlsanity.com/paper/2008.08525/) (2020)
- [Unlearning Spurious Correlations in Chest X-ray Classification](https://mlsanity.com/paper/2308.01119/) (2023)

## Built on by (most cited first, 1 of 1)

- [Limitations of Public Chest Radiography Datasets for Artificial Intelligence: Label Quality, Domain Shift, Bias and Evaluation Challenges](https://mlsanity.com/paper/2509.15107/) (2025)

## Abstract (arXiv)

Recent works have revisited the infamous task ``Name That Dataset'', demonstrating that non-medical datasets contain underlying biases and that the dataset origin task can be solved with high accuracy. In this work, we revisit the same task applied to popular open-source chest X-ray datasets. Medical images are naturally more difficult to release for open-source due to their sensitive nature, which has led to certain open-source datasets being extremely popular for research purposes. By performing the same task, we wish to explore whether dataset bias also exists in these datasets. To extend our work, we apply simple transformations to the datasets, repeat the same task, and perform an analysis to identify and explain any detected biases. Given the importance of AI applications in medical imaging, it's vital to establish whether modern methods are taking shortcuts or are focused on the relevant pathology. We implement a range of different network architectures on the datasets: NIH, CheXpert, MIMIC-CXR and PadChest. We hope this work will encourage more explainable research being performed in medical imaging and the creation of more open-source datasets in the medical domain. Our code can be found here: https://github.com/eedack01/x_ray_ds_bias.