# Class Unbiasing for Generalization in Medical Diagnosis

arXiv: https://arxiv.org/abs/2508.06943 · HTML: https://mlsanity.com/paper/2508.06943/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 22 of its 47 references that are in the map.
- First posted on arXiv 9 Aug 2025.

## Builds on (most cited first, 22 of 22)

- [Shortcut Learning in Deep Neural Networks](https://mlsanity.com/paper/2004.07780/) (2020)
- [Invariant Risk Minimization](https://mlsanity.com/paper/1907.02893/) (2019)
- [Out-of-Distribution Generalization via Risk Extrapolation (REx)](https://mlsanity.com/paper/2003.00688/) (2020)
- [MedMNIST v2 -- A large-scale lightweight benchmark for 2D and 3D biomedical image classification](https://mlsanity.com/paper/2110.14795/) (2021)
- [Generalizing to Unseen Domains via Adversarial Data Augmentation](https://mlsanity.com/paper/1805.12018/) (2018)
- [Confounding variables can degrade generalization performance of radiological deep learning models](https://mlsanity.com/paper/1807.00431/) (2018)
- [Generalizing Across Domains via Cross-Gradient Training](https://mlsanity.com/paper/1804.10745/) (2018)
- [Gradient Matching for Domain Generalization](https://mlsanity.com/paper/2104.09937/) (2021)
- [Domain Generalization for Object Recognition with Multi-task Autoencoders](https://mlsanity.com/paper/1508.07680/) (2015)
- [Domain Generalization using Causal Matching](https://mlsanity.com/paper/2006.07500/) (2020)
- [Invariance Principle Meets Information Bottleneck for Out-of-Distribution Generalization](https://mlsanity.com/paper/2106.06607/) (2021)
- [Fishr: Invariant Gradient Variances for Out-of-Distribution Generalization](https://mlsanity.com/paper/2109.02934/) (2021)
- [DLOW: Domain Flow for Adaptation and Generalization](https://mlsanity.com/paper/1812.05418/) (2018)
- [Efficient Domain Generalization via Common-Specific Low-Rank Decomposition](https://mlsanity.com/paper/2003.12815/) (2020)
- [Structured Domain Randomization: Bridging the Reality Gap by Context-Aware Synthetic Data](https://mlsanity.com/paper/1810.10093/) (2018)
- [Deep Learning Predicts Hip Fracture using Confounding Patient and Healthcare Variables](https://mlsanity.com/paper/1811.03695/) (2018)
- [MODMA dataset: a Multi-modal Open Dataset for Mental-disorder Analysis](https://mlsanity.com/paper/2002.09283/) (2020)
- [Gender Bias in Depression Detection Using Audio Features](https://mlsanity.com/paper/2010.15120/) (2020)
- [RA-GCN: Graph Convolutional Network for Disease Prediction Problems with Imbalanced Data](https://mlsanity.com/paper/2103.00221/) (2021)
- [Decoupled Contrastive Learning for Long-Tailed Recognition](https://mlsanity.com/paper/2403.06151/) (2024)
- [Swin-BERT: A Feature Fusion System designed for Speech-based Alzheimer's Dementia Detection](https://mlsanity.com/paper/2410.07277/) (2024)
- [DICS: Find Domain-Invariant and Class-Specific Features for Out-of-Distribution Generalization](https://mlsanity.com/paper/2409.08557/) (2024)

## Abstract (arXiv)

Medical diagnosis might fail due to bias. In this work, we identified class-feature bias, which refers to models' potential reliance on features that are strongly correlated with only a subset of classes, leading to biased performance and poor generalization on other classes. We aim to train a class-unbiased model (Cls-unbias) that mitigates both class imbalance and class-feature bias simultaneously. Specifically, we propose a class-wise inequality loss which promotes equal contributions of classification loss from positive-class and negative-class samples. We propose to optimize a class-wise group distributionally robust optimization objective-a class-weighted training objective that upweights underperforming classes-to enhance the effectiveness of the inequality loss under class imbalance. Through synthetic and real-world datasets, we empirically demonstrate that class-feature bias can negatively impact model performance. Our proposed method effectively mitigates both class-feature bias and class imbalance, thereby improving the model's generalization ability.