# Stride-Net: Fairness-Aware Disentangled Representation Learning for Chest X-Ray Diagnosis

arXiv: https://arxiv.org/abs/2602.10875 · HTML: https://mlsanity.com/paper/2602.10875/

## Key facts

- Cited by 1 papers in the map (data through 14 Oct 2026).
- Builds on 16 of its 23 references that are in the map.
- First posted on arXiv 11 Feb 2026.

## Builds on (most cited first, 16 of 16)

- [Deep Residual Learning for Image Recognition](https://mlsanity.com/paper/1512.03385/) (2015)
- [BioBERT: a pre-trained biomedical language representation model for biomedical text mining](https://mlsanity.com/paper/1901.08746/) (2019)
- [A Survey on Bias and Fairness in Machine Learning](https://mlsanity.com/paper/1908.09635/) (2019)
- [CheXpert: A Large Chest Radiograph Dataset with Uncertainty Labels and Expert Comparison](https://mlsanity.com/paper/1901.07031/) (2019)
- [Distributionally Robust Neural Networks for Group Shifts: On the Importance of Regularization for Worst-Case Generalization](https://mlsanity.com/paper/1911.08731/) (2019)
- [Just Train Twice: Improving Group Robustness without Training Group Information](https://mlsanity.com/paper/2107.09044/) (2021)
- [Fairness without Demographics through Adversarially Reweighted Learning](https://mlsanity.com/paper/2006.13114/) (2020)
- [CheXclusion: Fairness gaps in deep chest X-ray classifiers](https://mlsanity.com/paper/2003.00827/) (2020)
- [EnD: Entangling and Disentangling deep representations for bias correction](https://mlsanity.com/paper/2103.02023/) (2021)
- [Achieving Fairness through Adversarial Learning: an Application to Recidivism Prediction](https://mlsanity.com/paper/1807.00199/) (2018)
- [MEDFAIR: Benchmarking Fairness for Medical Imaging](https://mlsanity.com/paper/2210.01725/) (2022)
- [Leveling Down in Computer Vision: Pareto Inefficiencies in Fair Deep Classifiers](https://mlsanity.com/paper/2203.04913/) (2022)
- [An Empirical Characterization of Fair Machine Learning For Clinical Risk Prediction](https://mlsanity.com/paper/2007.10306/) (2020)
- [FairTune: Optimizing Parameter Efficient Fine Tuning for Fairness in Medical Image Analysis](https://mlsanity.com/paper/2310.05055/) (2023)
- [On the Robustness of Medical Vision-Language Models: Are they Truly Generalizable?](https://mlsanity.com/paper/2505.15425/) (2025)
- [Decoupling Clinical and Class-Agnostic Features for Reliable Few-Shot Adaptation under Shift](https://mlsanity.com/paper/2509.09397/) (2025)

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

- [Is invariance all you need for algorithmic fairness? Removing demographic information can create new bias](https://mlsanity.com/paper/2609.32004/) (2026)

## Abstract (arXiv)

Deep neural networks for chest X-ray classification achieve strong average performance, yet often underperform for specific demographic subgroups, raising critical concerns about clinical safety and equity. Existing debiasing methods frequently yield inconsistent improvements across datasets or attain fairness by degrading overall diagnostic utility, treating fairness as a post hoc constraint rather than a property of the learned representation. In this work, we propose Stride-Net (Sensitive Attribute Resilient Learning via Disentanglement and Learnable Masking with Embedding Alignment), a fairness-aware framework that learns disease-discriminative yet demographically invariant representations for chest X-ray analysis. Stride-Net operates at the patch level, using a learnable stride-based mask to select label-aligned image regions while suppressing sensitive attribute information through adversarial confusion loss. To anchor representations in clinical semantics and discourage shortcut learning, we further enforce semantic alignment between image features and BioBERT-based disease label embeddings via Group Optimal Transport. We evaluate Stride-Net on the MIMIC-CXR and CheXpert benchmarks across race and intersectional race-gender subgroups. Across architectures including ResNet and Vision Transformers, Stride-Net consistently improves fairness metrics while matching or exceeding baseline accuracy, achieving a more favorable accuracy-fairness trade-off than prior debiasing approaches. Our code is available at https://github.com/Daraksh/Fairness_StrideNet.