Mohamed ElHabebe

Mohamed Elhabebe, Ayman El-Baz, Qing Liu

Automated glaucoma detection is critical for preventing irreversible vision loss and reducing the burden on healthcare systems. However, ensuring fairness across diverse patient populations remains a significant challenge. In this paper, we propose FairEnc, a fair pretraining method for vision-language models (VLMs) that enables simultaneous debiasing across multiple sensitive attributes. FairEnc jointly mitigates biases in both textual and visual modalities with respect to multiple sensitive attributes, including race, gender, ethnicity, and language. Specifically, for the textual encoder, we leverage a large language model to generate synthetic clinical descriptions with varied sensitive attributes while preserving disease semantics, and employ a contrastive alignment objective to encourage demographic-invariant representations. For the visual encoder, we propose a dual-level fairness strategy that combines mutual information regularization to reduce statistical dependence between learned features and demographic groups, with multi-discriminator adversarial debiasing. Comprehensive experiments on the publicly available Harvard-FairVLMed dataset demonstrate that FairEnc effectively reduces demographic disparity as measured by DPD and DEOdds while achieving strong diagnostic performance under both zero-shot and linear probing evaluations. Additional experiments on the private FairFundus dataset show that FairEnc consistently preserves fairness advantages under cross-domain and cross-modality settings and maintains diagnostic performance within a competitive range. These results highlight FairEnc's ability to generalize fairness under distribution shifts, supporting its potential for more equitable deployment in real-world clinical settings. Our codebase and synthetic clinical notes are available at https://github.com/Mohamed-Elhabebe/FairEnc

Youssof Nawar, Nouran Soliman, Moustafa Wassel et al.

Glaucoma is a progressive optic neuropathy characterized by structural damage to the optic nerve head and functional changes in the visual field. Detecting glaucoma early is crucial to preventing loss of eyesight. However, medical datasets often suffer from class imbalances, making detection more difficult for deep-learning algorithms. We use a generative-based framework to enhance glaucoma diagnosis, specifically addressing class imbalance through synthetic data generation. In addition, we collected the largest national dataset for glaucoma detection to support our study. The imbalance between normal and glaucomatous cases leads to performance degradation of classifier models. By combining our proposed framework leveraging diffusion models with a pretraining approach, we created a more robust classifier training process. This training process results in a better-performing classifier. The proposed approach shows promising results in improving the harmonic mean (sensitivity and specificity) and AUC for the roc for the glaucoma classifier. We report an improvement in the harmonic mean metric from 89.09% to 92.59% on the test set of our national dataset. We examine our method against other methods to overcome imbalance through extensive experiments. We report similar improvements on the AIROGS dataset. This study highlights that diffusion-based generation can be of great importance in tackling class imbalances in medical datasets to improve diagnostic performance.