Generative AI mitigates representation bias and improves model fairness through synthetic health data

Representation bias in health data can lead to unfair decisions and compromise the generalisability of research findings. As a consequence, underrepresented subpopulations, such as those from specific ethnic backgrounds or genders, do not benefit equally from clinical discoveries. Several approaches have been developed to mitigate representation bias, ranging from simple resampling methods, such as SMOTE, to recent approaches based on generative adversarial networks (GAN). However, generating high-dimensional time-series synthetic health data remains a significant challenge. In response, we devised a novel architecture (CA-GAN) that synthesises authentic, high-dimensional time series data. CA-GAN outperforms state-of-the-art methods in a qualitative and a quantitative evaluation while avoiding mode collapse, a serious GAN failure. We perform evaluation using 7535 patients with hypotension and sepsis from two diverse, real-world clinical datasets. We show that synthetic data generated by our CA-GAN improves model fairness in Black patients as well as female patients when evaluated separately for each subpopulation. Furthermore, CA-GAN generates authentic data of the minority class while faithfully maintaining the original distribution of data, resulting in improved performance in a downstream predictive task.