# Subgroup Validity in Machine Learning for Echocardiogram Data

arXiv: https://arxiv.org/abs/2512.00976 · HTML: https://mlsanity.com/paper/2512.00976/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 10 of its 53 references that are in the map.
- First posted on arXiv 30 Nov 2025.

## Builds on (most cited first, 10 of 10)

- [Deep Learning for Segmentation using an Open Large-Scale Dataset in 2D Echocardiography](https://mlsanity.com/paper/1908.06948/) (2019)
- [No Classification without Representation: Assessing Geodiversity Issues in Open Data Sets for the Developing World](https://mlsanity.com/paper/1711.08536/) (2017)
- [High-Throughput Precision Phenotyping of Left Ventricular Hypertrophy with Cardiovascular Deep Learning](https://mlsanity.com/paper/2106.12511/) (2021)
- [A New Semi-supervised Learning Benchmark for Classifying View and Diagnosing Aortic Stenosis from Echocardiograms](https://mlsanity.com/paper/2108.00080/) (2021)
- [Coarse race data conceals disparities in clinical risk score performance](https://mlsanity.com/paper/2304.09270/) (2023)
- [Systematic comparison of semi-supervised and self-supervised learning for medical image classification](https://mlsanity.com/paper/2307.08919/) (2023)
- [In the Picture: Medical Imaging Datasets, Artifacts, and their Living Review](https://mlsanity.com/paper/2501.10727/) (2025)
- [Detecting Heart Disease from Multi-View Ultrasound Images via Supervised Attention Multiple Instance Learning](https://mlsanity.com/paper/2306.00003/) (2023)
- [Semi-Supervised Multimodal Multi-Instance Learning for Aortic Stenosis Diagnosis](https://mlsanity.com/paper/2403.06024/) (2024)
- [Development of Automated Neural Network Prediction for Echocardiographic Left ventricular Ejection Fraction](https://mlsanity.com/paper/2403.12152/) (2024)

## Abstract (arXiv)

Echocardiogram datasets enable training deep learning models to automate interpretation of cardiac ultrasound, thereby expanding access to accurate readings of diagnostically-useful images. However, the gender, sex, race, and ethnicity of the patients in these datasets are underreported and subgroup-specific predictive performance is unevaluated. These reporting deficiencies raise concerns about subgroup validity that must be studied and addressed before model deployment. In this paper, we show that current open echocardiogram datasets are unable to assuage subgroup validity concerns. We improve sociodemographic reporting for two datasets: TMED-2 and MIMIC-IV-ECHO. Analysis of six open datasets reveals no consideration of gender-diverse patients and insufficient patient counts for many racial and ethnic groups. We further perform an exploratory subgroup analysis of two published aortic stenosis detection models on TMED-2. We find insufficient evidence for subgroup validity for sex, racial, and ethnic subgroups. Our findings highlight that more data for underrepresented subgroups, improved demographic reporting, and subgroup-focused analyses are needed to prove subgroup validity in future work.