Deep Learning failure cases are abundant, particularly in the medical area. Recent studies in out-of-distribution generalization have advanced considerably on well-controlled synthetic datasets, but they do not represent medical imaging contexts. We propose a pipeline that relies on artifacts annotation to enable generalization evaluation and debiasing for the challenging skin lesion analysis context. First, we partition the data into levels of increasingly higher biased training and test sets for better generalization assessment. Then, we create environments based on skin lesion artifacts to enable domain generalization methods. Finally, after robust training, we perform a test-time debiasing procedure, reducing spurious features in inference images. Our experiments show our pipeline improves performance metrics in biased cases, and avoids artifacts when using explanation methods. Still, when evaluating such models in out-of-distribution data, they did not prefer clinically-meaningful features. Instead, performance only improved in test sets that present similar artifacts from training, suggesting models learned to ignore the known set of artifacts. Our results raise a concern that debiasing models towards a single aspect may not be enough for fair skin lesion analysis.

提出了一种基于标注伪影的流程，用于深度学习在皮肤病变分析中的领域适应性评估与去偏倚。在具有不同程度偏差的数据集上进行建模，并利用基于皮肤病变的数据集进行域通用化。在测试时去除推理图像中的伪特征，实验表明该流程在有偏数据集的表现指标有所提高，且对于伪影的忽略具有较好的效果，但在外部数据集上的表现较差，尤其需要对于皮肤病变分析的公平性更加关注。

基于物品的皮肤病变模型领域泛化