David Rosewarne

Zheng Zhang, Wenjie Ai, Kevin Wells et al.

With the development of Human-AI Collaboration in Classification (HAI-CC), integrating users and AI predictions becomes challenging due to the complex decision-making process. This process has three options: 1) AI autonomously classifies, 2) learning to complement, where AI collaborates with users, and 3) learning to defer, where AI defers to users. Despite their interconnected nature, these options have been studied in isolation rather than as components of a unified system. In this paper, we address this weakness with the novel HAI-CC methodology, called Learning to Complement and to Defer to Multiple Users (LECODU). LECODU not only combines learning to complement and learning to defer strategies, but it also incorporates an estimation of the optimal number of users to engage in the decision process. The training of LECODU maximises classification accuracy and minimises collaboration costs associated with user involvement. Comprehensive evaluations across real-world and synthesized datasets demonstrate LECODU's superior performance compared to state-of-the-art HAI-CC methods. Remarkably, even when relying on unreliable users with high rates of label noise, LECODU exhibits significant improvement over both human decision-makers alone and AI alone.

Zheng Zhang, Milad Masroor, Cuong Nguyen et al.

Recent advances in data-centric medical AI have produced highly accurate diagnostic systems, but the emphasis on data curation and performance metrics has not translated into widespread clinical adoption. We conjecture that this limited uptake stems from insufficient attention dedicated to the optimisation of fair performance across diverse patient populations and to workflow integration: performance biases can create regulatory barriers, and poorly integrated automation can disrupt clinical routines, degrade the quality of human-AI collaboration, and reduce clinicians' willingness to adopt AI tools. Prior work on workflow integration (e.g., Learning to Defer (L2D) and Learning to Complement (L2C)) and AI fairness has typically examined these challenges in isolation, overlooking their natural interdependence and the practical constraints of clinical environments, such as restricted clinician availability. We propose People-Centred Medical Image Analysis (PecMan), a human-AI framework that jointly optimises fairness, diagnostic accuracy, and workflow effectiveness through a dynamic gating mechanism that assigns cases to AI, clinicians, or both under clinician workload constraints. We also introduce the Fairness and Human-Centred AI (FairHAI) benchmark for evaluating trade-offs between accuracy, fairness, and clinician workload. Experiments using this benchmark show that PecMan consistently outperforms existing methods, paving the way for more trustworthy and clinically viable AI systems. Code will be available upon paper acceptance.

Zheng Zhang, Cuong Nguyen, Kevin Wells et al.

Human-AI cooperative classification (HAI-CC) approaches aim to develop hybrid intelligent systems that enhance decision-making in various high-stakes real-world scenarios by leveraging both human expertise and AI capabilities. Current HAI-CC methods primarily focus on learning-to-defer (L2D), where decisions are deferred to human experts, and learning-to-complement (L2C), where AI and human experts make predictions cooperatively. However, a notable research gap remains in effectively exploring both L2D and L2C under diverse expert knowledge to improve decision-making, particularly when constrained by the cooperation cost required to achieve a target probability for AI-only selection (i.e., coverage). In this paper, we address this research gap by proposing the Coverage-constrained Learning to Defer and Complement with Specific Experts (CL2DC) method. CL2DC makes final decisions through either AI prediction alone or by deferring to or complementing a specific expert, depending on the input data. Furthermore, we propose a coverage-constrained optimisation to control the cooperation cost, ensuring it approximates a target probability for AI-only selection. This approach enables an effective assessment of system performance within a specified budget. Also, CL2DC is designed to address scenarios where training sets contain multiple noisy-label annotations without any clean-label references. Comprehensive evaluations on both synthetic and real-world datasets demonstrate that CL2DC achieves superior performance compared to state-of-the-art HAI-CC methods.

Milad Masroor, Tahir Hassan, Yu Tian et al.

Deep learning has achieved remarkable success in image classification and segmentation tasks. However, fairness concerns persist, as models often exhibit biases that disproportionately affect demographic groups defined by sensitive attributes such as race, gender, or age. Existing bias-mitigation techniques, including Subgroup Re-balancing, Adversarial Training, and Domain Generalization, aim to balance accuracy across demographic groups, but often fail to simultaneously improve overall accuracy, group-specific accuracy, and fairness due to conflicts among these interdependent objectives. We propose the Fair Distillation (FairDi) method, a novel fairness approach that decomposes these objectives by leveraging biased ``teacher'' models, each optimized for a specific demographic group. These teacher models then guide the training of a unified ``student'' model, which distills their knowledge to maximize overall and group-specific accuracies, while minimizing inter-group disparities. Experiments on medical imaging datasets show that FairDi achieves significant gains in both overall and group-specific accuracy, along with improved fairness, compared to existing methods. FairDi is adaptable to various medical tasks, such as classification and segmentation, and provides an effective solution for equitable model performance.

Zheng Zhang, Cuong C. Nguyen, David Rosewarne et al.

Learning to defer (L2D) enables human-AI cooperation by deciding when an AI system should act autonomously or defer to a human expert. Existing L2D methods, however, assume static human performance, contradicting well-established findings on fatigue-induced degradation. We propose Fatigue-Aware Learning to Defer via Constrained Optimisation (FALCON), which explicitly models workload-varying human performance using psychologically grounded fatigue curves. FALCON formulates L2D as a Constrained Markov Decision Process (CMDP) whose state includes both task features and cumulative human workload, and optimises accuracy under human-AI cooperation budgets via PPO-Lagrangian training. We further introduce FA-L2D, a benchmark that systematically varies fatigue dynamics from near-static to rapidly degrading regimes. Experiments across multiple datasets show that FALCON consistently outperforms state-of-the-art L2D methods across coverage levels, generalises zero-shot to unseen experts with different fatigue patterns, and demonstrates the advantage of adaptive human-AI collaboration over AI-only or human-only decision-making when coverage lies strictly between 0 and 1.