In the data-driven era, large-scale datasets are routinely collected and analyzed using machine learning (ML) and artificial intelligence (AI) to inform decisions in high-stakes domains such as healthcare, employment, and criminal justice, raising concerns about the fairness behavior of these systems. Existing works in fair ML cover tasks such as bias detection, fair prediction, and fair decision-making, but largely focus on static settings. At the same time, fairness in temporal contexts, particularly survival/time-to-event (TTE) analysis, remains relatively underexplored, with current approaches to fair survival analysis adopting statistical fairness definitions, which, even with unlimited data, cannot disentangle the causal mechanisms that generate disparities. To address this gap, we develop a causal framework for fairness in TTE analysis, enabling the decomposition of disparities in survival into contributions from direct, indirect, and spurious pathways. This provides a human-understandable explanation of why disparities arise and how they evolve over time. Our non-parametric approach proceeds in four steps: (1) formalizing the necessary assumptions about censoring and lack of confounding using a graphical model; (2) recovering the conditional survival function given covariates; (3) applying the Causal Reduction Theorem to reframe the problem in a form amenable to causal pathway decomposition; (4) estimating the effects efficiently. Finally, our approach is used to analyze the temporal evolution of racial disparities in outcome after admission to an intensive care unit (ICU).

Hyponatremia: Predict whether a hyponatremia lab comes back as normal (>=135 mmol/L), mild (>=130 and <135 mmol/L), moderate (>=125 and <130 mmol/L), or severe (<125 mmol/L). We consider all lab results coded as LOINC/LG11363-5, LOINC/2951-2, or LOINC/2947-0. Anemia: Predict whether an anemia lab comes back as normal (>=120 g/L), mild (>=110 and <120 g/L), moderate (>=70 and <110 g/L), or severe (<70 g/L). We consider all lab results coded as LOINC/LP392452-1. Please note that for the results of our baseline experiments in Section 5, we reframe these lab value tasks as binary classification tasks, where a label is "negative" if the result is normal and "positive" otherwise.

A.1 Proof of Monotonicity and Submodularity In Equation (3a), we stated the objective of the knapsack cover to be Remark 1. f+M is monotonically increasing. A.2 Knapsack Cover To find a solution to problem 3, we use the greedy algorithm proposed by Badanidiyuru and Vondrák [2], which deals with submodular maximization subject to a system of lknapsack constraints and with pmatroid constraints. We present an adapted version of the algorithm in Algorithm 2 where l = 1. Theparameter allows us to 16 trade-off solution time and solution quality. In this work, we set = 0.2.

Understanding causal dependencies in observational data is critical for informing decision-making. These relationships are often modeled as Bayesian Networks (BNs) and Directed Acyclic Graphs (DAGs). Existing methods, such as NOTEARS and DAG-GNN, often face issues with scalability and stability in high-dimensional data, especially when there is a feature-sample imbalance. Here, we show that the denoising score matching objective of diffusion models could smooth the gradients for faster, more stable convergence. We also propose an adaptive k-hop acyclicity constraint that improves runtime over existing solutions that require matrix inversion. We name this framework Denoising Diffusion Causal Discovery (DDCD). Unlike generative diffusion models, DDCD utilizes the reverse denoising process to infer a parameterized causal structure rather than to generate data. We demonstrate the competitive performance of DDCDs on synthetic benchmarking data. We also show that our methods are practically useful by conducting qualitative analyses on two real-world examples. Code is available at this url: https://github.com/haozhu233/ddcd.

A.1 Motivation For what purpose was the dataset created?

This dataset covers various topics and is suitable for instruction-tuning general-purpose LLMs for diverse clinical use cases.