Kuniko Paxton

Mostafa Anoosha, Dhavalkumar Thakker, Kuniko Paxton et al.

Privacy-preserving medical inference must balance data locality, diagnostic reliability, and deployment efficiency. This paper presents EcoFair, a simulated vertically partitioned inference framework for dermatological diagnosis in which raw image and tabular data remain local and only modality-specific embeddings are transmitted for server-side multimodal fusion. EcoFair introduces a lightweight-first routing mechanism that selectively activates a heavier image encoder when local uncertainty or metadata-derived clinical risk indicates that additional computation is warranted. The routing decision combines predictive uncertainty, a safe--danger probability gap, and a tabular neurosymbolic risk score derived from patient age and lesion localisation. Experiments on three dermatology benchmarks show that EcoFair can substantially reduce edge-side inference energy in representative model pairings while remaining competitive in classification performance. The results further indicate that selective routing can improve subgroup-sensitive malignant-case behaviour in representative settings without modifying the global training objective. These findings position EcoFair as a practical framework for privacy-preserving and energy-aware medical inference under edge deployment constraints.

Kuniko Paxton, Medina Kapo, Amila Akagić et al.

Skin cancer, particularly melanoma, remains a major cause of morbidity and mortality, making early detection critical. AI-driven dermatology systems often rely on skin lesion segmentation as a preprocessing step to delineate the lesion from surrounding skin and support downstream analysis. While fairness concerns regarding skin tone have been widely studied for lesion classification, the influence of skin tone on the segmentation stage remains under-quantified and is frequently assessed using coarse, discrete skin tone categories. In this work, we evaluate three strong segmentation architectures (UNet, DeepLabV3 with a ResNet50 backbone, and DINOv2) on two public dermoscopic datasets (HAM10000 and ISIC2017) and introduce a continuous pigment or contrast analysis that treats pixel-wise ITA values as distributions. Using Wasserstein distances between within-image distributions for skin-only, lesion-only, and whole-image regions, we quantify lesion skin contrast and relate it to segmentation performance across multiple metrics. Within the range represented in these datasets, global skin tone metrics (Fitzpatrick grouping or mean ITA) show weak association with segmentation quality. In contrast, low lesion-skin contrast is consistently associated with larger segmentation errors in models, indicating that boundary ambiguity and low contrast are key drivers of failure. These findings suggest that fairness improvements in dermoscopic segmentation should prioritize robust handling of low-contrast lesions, and the distribution-based pigment measures provide a more informative audit signal than discrete skin-tone categories.

Kuniko Paxton, Koorosh Aslansefat, Dhavalkumar Thakker et al.

Fairness is a critical component of Trustworthy AI. In this paper, we focus on Machine Learning (ML) and the performance of model predictions when dealing with skin color. Unlike other sensitive attributes, the nature of skin color differs significantly. In computer vision, skin color is represented as tensor data rather than categorical values or single numerical points. However, much of the research on fairness across sensitive groups has focused on categorical features such as gender and race. This paper introduces a new technique for evaluating fairness in ML for image classification tasks, specifically without the use of annotation. To address the limitations of prior work, we handle tensor data, like skin color, without classifying it rigidly. Instead, we convert it into probability distributions and apply statistical distance measures. This novel approach allows us to capture fine-grained nuances in fairness both within and across what would traditionally be considered distinct groups. Additionally, we propose an innovative training method to mitigate the latent biases present in conventional skin tone categorization. This method leverages color distance estimates calculated through Bayesian regression with polynomial functions, ensuring a more nuanced and equitable treatment of skin color in ML models.

Kuniko Paxton, Koorosh Aslansefat, Dhavalkumar Thakker et al.

Recent advances in deep learning have significantly improved the accuracy of skin lesion classification models, supporting medical diagnoses and promoting equitable healthcare. However, concerns remain about potential biases related to skin color, which can impact diagnostic outcomes. Ensuring fairness is challenging due to difficulties in classifying skin tones, high computational demands, and the complexity of objectively verifying fairness. To address these challenges, we propose a fairness algorithm for skin lesion classification that overcomes the challenges associated with achieving diagnostic fairness across varying skin tones. By calculating the skewness of the feature map in the convolution layer of the VGG (Visual Geometry Group) network and the patches and the heads of the Vision Transformer, our method reduces unnecessary channels related to skin tone, focusing instead on the lesion area. This approach lowers computational costs and mitigates bias without relying on conventional statistical methods. It potentially reduces model size while maintaining fairness, making it more practical for real-world applications.

Kuniko Paxton, Koorosh Aslansefat, Amila Akagić et al.

Recent advancements in skin lesion classification models have significantly improved accuracy, with some models even surpassing dermatologists' diagnostic performance. However, in medical practice, distrust in AI models remains a challenge. Beyond high accuracy, trustworthy, explainable diagnoses are essential. Existing explainability methods have reliability issues, with LIME-based methods suffering from inconsistency, while CAM-based methods failing to consider all classes. To address these limitations, we propose Global Class Activation Probabilistic Map Evaluation, a method that analyses all classes' activation probability maps probabilistically and at a pixel level. By visualizing the diagnostic process in a unified manner, it helps reduce the risk of misdiagnosis. Furthermore, the application of SafeML enhances the detection of false diagnoses and issues warnings to doctors and patients as needed, improving diagnostic reliability and ultimately patient safety. We evaluated our method using the ISIC datasets with MobileNetV2 and Vision Transformers.