TY  - JOUR
AU  - Yaseliani, Mohammad
AU  - Noor-E-Alam, Md
AU  - Hasan, Md Mahmudul
PY  - 2024
DA  - 2024/8/20
TI  - Mitigating Sociodemographic Bias in Opioid Use Disorder Prediction: Fairness-Aware Machine Learning Framework
JO  - JMIR AI
SP  - e55820
VL  - 3
KW  - opioid use disorder
KW  - fairness and bias
KW  - bias mitigation
KW  - machine learning
KW  - majority voting
AB  - Background: Opioid use disorder (OUD) is a critical public health crisis in the United States, affecting >5.5 million Americans in 2021. Machine learning has been used to predict patient risk of incident OUD. However, little is known about the fairness and bias of these predictive models. Objective: The aims of this study are two-fold: (1) to develop a machine learning bias mitigation algorithm for sociodemographic features and (2) to develop a fairness-aware weighted majority voting (WMV) classifier for OUD prediction. Methods: We used the 2020 National Survey on Drug and Health data to develop a neural network (NN) model using stochastic gradient descent (SGD; NN-SGD) and an NN model using Adam (NN-Adam) optimizers and evaluated sociodemographic bias by comparing the area under the curve values. A bias mitigation algorithm, based on equality of odds, was implemented to minimize disparities in specificity and recall. Finally, a WMV classifier was developed for fairness-aware prediction of OUD. To further analyze bias detection and mitigation, we did a 1-N matching of OUD to non-OUD cases, controlling for socioeconomic variables, and evaluated the performance of the proposed bias mitigation algorithm and WMV classifier. Results: Our bias mitigation algorithm substantially reduced bias with NN-SGD, by 21.66% for sex, 1.48% for race, and 21.04% for income, and with NN-Adam by 16.96% for sex, 8.87% for marital status, 8.45% for working condition, and 41.62% for race. The fairness-aware WMV classifier achieved a recall of 85.37% and 92.68% and an accuracy of 58.85% and 90.21% using NN-SGD and NN-Adam, respectively. The results after matching also indicated remarkable bias reduction with NN-SGD and NN-Adam, respectively, as follows: sex (0.14% vs 0.97%), marital status (12.95% vs 10.33%), working condition (14.79% vs 15.33%), race (60.13% vs 41.71%), and income (0.35% vs 2.21%). Moreover, the fairness-aware WMV classifier achieved high performance with a recall of 100% and 85.37% and an accuracy of 73.20% and 89.38% using NN-SGD and NN-Adam, respectively. Conclusions: The application of the proposed bias mitigation algorithm shows promise in reducing sociodemographic bias, with the WMV classifier confirming bias reduction and high performance in OUD prediction. 
SN  - 2817-1705
UR  - https://ai.jmir.org/2024/1/e55820
UR  - https://doi.org/10.2196/55820
DO  - 10.2196/55820
ID  - info:doi/10.2196/55820
ER  -