A single clinical algorithm can deliver unequal accuracy across patient groups, and concern about such disparity has grown as artificial intelligence (AI) spreads through clinical decision-making. In response, a liability rule introduced in the United States holds healthcare providers responsible when their reliance on disparate algorithms contributes to erroneous clinical decisions. We examine how such liability considerations reshape (i) an AI firm's algorithm design decisions that drive group-specific accuracy and (ii) a physician's decisions to use AI in healthcare delivery. The AI firm designs an algorithm for two patient groups, and improving accuracy for the disadvantaged group is more costly. The physician (who remains the accountable decision-maker) then decides whether to consult AI, weighing the reduction in clinical uncertainty against expected liability exposure when AI errors disproportionately affect the disadvantaged group. We find the liability rule can induce disparate use of AI: the physician may reduce AI use overall and, over an intermediate range of liability, rely on AI less for disadvantaged patients. The effect is non-monotone. As liability increases, the physician's use of AI for disadvantaged patients first declines, then rises as the firm reallocates investment toward reducing disparity or switches to an equal-accuracy design. Mandating equal algorithmic accuracy across patient groups can then inadvertently harm both groups, because a uniform accuracy requirement distorts the firm's investment incentives and the physician's equilibrium AI-use decisions.
When an AI system is deployed, the individuals who use and or are evaluated by it form beliefs about how the system operates and use those beliefs to strategically present their preferences, behaviors, or attributes. The system then responds with feedback or a decision outcome, thereby creating a human-AI interaction loop. This thesis studies how to design and shape such interactions to achieve three goals: (1) help individuals develop accurate beliefs about the AI systems so they can improve and or secure favorable outcomes at minimal cost, (2) encourage improvement and or discourage gaming behaviors, and (3) ensure that the AI system continues to achieve its intended objectives, such as maximizing accuracy. To address these goals, the thesis is organized into three complementary parts that examine and study human-AI interactions from the perspectives of both evaluated individuals and AI systems. Together, the work presented in this thesis advances human-centered machine learning by providing principles and methods for designing AI systems that align with human needs, values, and capabilities. Methodologically, this thesis integrates theoretical analysis, data-driven modeling, human-subject experiments, and empirical evaluations on real-world and semi-synthetic datasets.
This is an invited commentary on the Psychometrika focus article "Fairness Issues and Evaluation in Psychometrics and AI/ML: What Can We Learn from Each Field?" by Ying Cheng (2026, doi:10.1017/psy.2026.10110). Cheng offers a systematic comparison between long-standing test fairness and modern algorithmic fairness. Her mapping of the entire testing workflow onto the AI/ML fairness paradigm, rather than only the final selection stage, is a crucial contribution to interdisciplinary fairness research. This commentary extends her discussion by examining two conceptual issues: the distinction between equality and equity, and the role of causality in fairness research. Together, the focus article and this commentary point to directions for future fairness research across the psychometrics and AI/ML communities.
Nick Souligne, Isabella Mixton-Garcia, Vignesh Subbiancs.LG
Algorithmic fairness methods are increasingly used to identify and mitigate bias in machine learning models, yet most approaches are evaluated in isolation and along single demographic axes. This limits practical guidance for selecting fairness strategies, where disparities may arise across intersectional subgroups and across multiple stages of the modeling lifecycle. This work presents FairSelect, a toolkit for systematically evaluating fairness mitigation strategies applied individually and in combination across preprocessing, inprocessing, and postprocessing stages. FairSelect supports multiple model architectures, intersectional subgroup evaluation, and comparison of fairness utility tradeoffs across baseline, single method, and multi level configurations. The framework was validated using synthetic clinical datasets designed to represent specific bias mechanisms and a real-world replication of two-year stroke risk prediction among patients with atrial fibrillation. Synthetic experiments showed that targeted fairness methods generally reduced intended subgroup disparities, while combined strategies produced larger average fairness improvements with modest utility tradeoffs. In the clinical prediction task, mitigation effects were highly variable, with some combinations improving both fairness and predictive performance while others were ineffective or counterproductive. These findings demonstrate that fairness interventions interact in nonadditive and context dependent ways. FairSelect provides a practical framework for systematically identifying fairness strategies that improve subgroup equity while preserving model performance in clinical machine learning.
Modern machine learning systems have outgrown their origins as isolated predictive constructs, evolving into complex socio-technical architectures that actively mediate human opportunity. As algorithms increasingly determine access to economic and social opportunities, it has become widely recognized that these systems are deeply embedded with the structural inequalities and prejudices of their environments. The field of algorithmic fairness emerged in response to the growing recognition that models optimized for predictive accuracy can systematically disadvantage marginalized groups. Early mitigation strategies, however, rested on fragile simplifications that limited their effectiveness in complex socio-technical environments. This thesis identifies and addresses two fundamental limitations of contemporary fairness paradigms: the reliance on deterministic point estimates for auditing and the treatment of individuals as isolated entities devoid of structural context.