Sparsh Roy, Samuel Girmachew, Nishita Chavancs.LG q-bio.QM
Clinical risk models routinely achieve strong aggregate performance while producing materially different error rates across patient subgroups. Audit pipelines have been proposed to catch this, but their components are rarely stress-tested, so it is unclear which parts of an audit can be trusted and under what conditions. We present KAISEN, a five-phase audit pipeline covering subgroup stratification, disparity measurement, mechanism diagnostics, post-hoc mitigation, and drift monitoring, evaluated to the point of failure on a synthetic benchmark of 16 disease tasks, 15 social-determinant axes from Healthy People 2030, and three prespecified intersections. Four findings follow. (i) Significance tracks each axis's gap against its own minimum detectable effect: rank correlation between significance count and raw equalized-odds difference (EOD) across the 15 axes is rho = 0.56, rising to rho = 0.78 once EOD is standardized by that floor. (ii) Per-group threshold optimization reduces EOD in 48 of 48 held-out runs (paired delta = -0.285, 95% CI [-0.313, -0.252]), while group-wise Platt scaling -- the better calibrator -- behaves as a coin flip on EOD (19 of 48 runs improved, 95% CI [0.26, 0.55]) with mean effect near zero, so what an audit should report is the variance, not the average. (iii) The mechanism diagnostic classifies 144 of 144 controlled cases correctly but recovers none of 48 model-driven cases under proxy misspecification, with no signal that it failed. (iv) CUSUM failures and false alarms track cohort realization far more than disease: at the reference threshold, all 27 false alarms and 7 of 8 missed shifts come from different seeds (chi-squared p = 0.002), so a threshold tuned on one cohort fails to transfer. All results are synthetic with known ground truth and do not establish clinical validity. Code, artifacts, and scripts reproducing every number are released.
Machine learning models trained on sensitive data can inadvertently leak population-level information about their training distributions -- a threat known as distribution inference attack (DIA). An adversary with black-box access can infer sensitive demographic properties, such as subgroup proportions, without observing any training data directly. While defenses such as differential privacy and property unlearning have been proposed, the link between fairness constraints and distributional leakage remains unexplored. We propose Fair Fine-tuning (FFt): a trained model is fine-tuned on samples from the complementary distribution under an Equalized Odds (EO) constraint. We provide a complete theoretical characterization, proving the tight bound $\text{Adv}(\mathcal{A},M_f) \le Δ_{\text{EO}} \cdot W$, where $W$ quantifies how distinguishable the two training distributions are by their sensitive-attribute composition. We also establish a necessary condition for FFt to reduce adversarial advantage and prove tightness of the bound. We evaluate across six datasets spanning tabular (ACS Income, COMPAS, German Credit), image (UTKFaces), and NLP (Bias in Bios) modalities. Rehearsal-based FFt consistently reduces the adversarial accuracy gap below the detection threshold $τ!=!0.1$ across all settings; on ACS Income, the gap falls from $\sim!15%$ to under $4%$. Our work provides the first formal bound connecting a model's measured EO disparity directly to its adversarial advantage in the DIA game, opening a new avenue for unified fairness-and-privacy defenses.