Stratification (seeds)

Medical imaging

Biology

Gene

Germination

Geodesy

Genotype

Machine learning

Cardiology

Population stratification

Benchmark (surveying)

Single-nucleotide polymorphism

Artificial intelligence

Geography

Chemistry

Risk stratification

Dormancy

Computer science

Botany

Biochemistry

Medicine

Seed dormancy

Spurious relationship

Machine learning models for medical image analysis often suffer from poor performance on important subsets of a population that are not identified during training or testing. For example, overall performance of a cancer detection model may be high, but the model may still consistently miss a rare but aggressive cancer subtype. We refer to this problem as hidden stratification, and observe that it results from incompletely describing the meaningful variation in a dataset. While hidden stratification can substantially reduce the clinical efficacy of machine learning models, its effects remain difficult to measure. In this work, we assess the utility of several possible techniques for measuring hidden stratification effects, and characterize these effects both via synthetic experiments on the CIFAR-100 benchmark dataset and on multiple real-world medical imaging datasets. Using these measurement techniques, we find evidence that hidden stratification can occur in unidentified imaging subsets with low prevalence, low label quality, subtle distinguishing features, or spurious correlates, and that it can result in relative performance differences of over 20% on clinically important subsets. Finally, we discuss the clinical implications of our findings, and suggest that evaluation of hidden stratification should be a critical component of any machine learning deployment in medical imaging.

Hidden stratification causes clinically meaningful failures in machine learning for medical imaging