Papers › Disparate Censorship & Undertesting: A Source of Label Bias in Clinical Machine Learning
Disparate Censorship & Undertesting: A Source of Label Bias in Clinical Machine Learning
Trenton Chang, Michael W. Sjoding, Jenna Wiens
As machine learning (ML) models gain traction in clinical applications, understanding the impact of clinician and societal biases on ML models is increasingly important. While biases can arise in the labels used for model training, the many sources from which these biases arise are not yet well-studied. In this paper, we highlight disparate censorship (i.e., differences in testing rates across patient groups) as a source of label bias that clinical ML models may amplify, potentially causing harm. Many patient risk-stratification models are trained using the results of clinician-ordered diagnostic and laboratory tests of labels. Patients without test results are often assigned a negative label, which assumes that untested patients do not experience the outcome. Since orders are affected by clinical and resource considerations, testing may not be uniform in patient populations, giving rise to disparate censorship. Disparate censorship in patients of equivalent risk leads to undertesting in certain groups, and in turn, more biased labels for such groups. Using such biased labels in standard ML pipelines could contribute to gaps in model performance across patient groups. Here, we theoretically and empirically characterize conditions in which disparate censorship or undertesting affect model performance across subgroups. Our findings call attention to disparate censorship as a source of label bias in clinical ML models.
In Syntology View this paper on Syntology: its repositories, every harvested function with whether it ran, its licence and the call to fetch it.
Open this paper in Syntology's Atlas, the map of the papers in Syntology's graph and their citations.
Code
Repository list and official/mentioned flags are the archive's, frozen 2025-07-28. Reachability, where shown, is from one Syntology probe window (2026-09-16 to 2026-09-18); repositories not probed show nothing. GitHub stars are not tracked.
Code Syntology ran Syntology
Not run by Syntology. Nothing on this page verifies that the listed code works.
Tasks
Results from the paper archive 2025-07-28
No leaderboard rows for this paper in the archive.
Methods
Report a problem or propose a change · a person checks every report against the paper or source before anything changes; decisions are listed on /corrections