DFCA: Disentangled Feature Contrastive Learning and Augmentation for Fairer Dermatological Diagnostics

With the increasing integration of AI in medical research and applications, the issue of fairness has become as critical as diagnostic accuracy. In dermatology diagnosis, the challenge of class-imbalanced data, which is sometimes limited and contains demographic attributes, results in an imbalanced and insufficient representation within the feature space of deep learning models. Besides, feature entanglement within deep learning models confuses skin tone and disease condition information, impairing model performance among vulnerable groups. Moreover, feature entanglement often constrains the efforts to mitigate unfairness, entailing a trade-off between fairness and diagnostic accuracy. This paper introduces the Disentangled Feature Contrastive learning and Augmentation framework (DFCA), aiming to enhance fairness in dermatological diagnoses without compromising accuracy. Initially, DFCA disentangles skin images into disease related and skin-tone features. Subsequently, the two sets of features are projected into normalized spaces for contrastive learning, each modeled by a mixture of von Mises-Fisher (vMF) distributions. DFCA then samples from these vMF distributions to inversely augment the feature space. To further evaluate the fairness-accuracy balance, we propose a new metric, the Accuracy-Fairness Balance Degree (AFBD). Extensive experiments demonstrate that DFCA significantly improves both fairness and accuracy compared to state-of-the-art methods.