In this paper, we presented the notion of positive-sum fairness and argued that larger disparities are not necessarily harmful, as long as it does not come at the expense of a specific subgroup performance. The general performance, standard fairness and positive-sum fairness of four models was analyzed, each leveraging sensitive attributes in a different way.
Our study highlights the need for a nuanced understanding of fairness metrics and their implications in real-world applications. Good incorporation of medical knowledge is crucial when utilizing sensitive information and evaluating fairness accurately, particularly in cases where models may show a large performance disparity.
When traditional methods often aim for equality, positive-sum fairness focuses on equity, pushing for each group to achieve its highest possible performance level. This can lead to better overall outcomes, as it encourages to address the specific needs and challenges of each group without diminishing the quality of care for others. But, being defined as an optimization problem, it could also have unintended side effects as it may inadvertently prioritize larger or more well-represented groups by focusing the efforts on the groups with the highest impact on the overall performance rather than those with the most critical needs. Therefore, it is to be noted that meeting the positivesum fairness criterion alone does not ensure a model to be fair from an egalitarian perspective, and the use of this notion in conjunction with other metrics can give a more holistic understanding of a model’s fairness.
As positive-sum fairness is a relative measure, it requires a baseline to be used. Further work in this area would include developing a more robust baseline or adapting the approach to remove the need for a baseline. It would also be worth it to compare out-of-domain tested models, include other sensitive attributes such as sex and age and take into account confounding factors.
Disclosure of Interests. The authors declare that there are no conflicts of interest regarding the publication of this paper.
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