Advances in machine learning and the increasing availability of high-dimensional data have led to the proliferation of social science research that uses the predictions of machine learning models as proxies for measures of human activity or environmental outcomes. However, prediction errors from machine learning models can lead to bias in the estimates of regression coefficients. In this paper, we show how this bias can arise, propose a test for detecting bias, and demonstrate the use of an adversarial machine learning algorithm in order to de-bias predictions. These methods are applicable to any setting where machine-learned predictions are the dependent variable in a regression. We conduct simulations and empirical exercises using ground truth and satellite data on forest cover in Africa. Using the predictions from a naive machine learning model leads to biased parameter estimates, while the predictions from the adversarial model recover the true coefficients.

Self-supervised learning has revolutionized medical imaging by enabling efficient and generalizable feature extraction from large-scale unlabeled datasets. Recently, self-supervised foundation models have been extended to three-dimensional (3D) computed tomography (CT) data, generating compact, information-rich embeddings with 1408 features that achieve state-of-the-art performance on downstream tasks such as intracranial hemorrhage detection and lung cancer risk forecasting. However, these embeddings have been shown to encode demographic information, such as age, sex, and race, which poses a significant risk to the fairness of clinical applications. In this work, we propose a Variation Autoencoder (VAE) based adversarial debiasing framework to transform these embeddings into a new latent space where demographic information is no longer encoded, while maintaining the performance of critical downstream tasks. We validated our approach on the NLST lung cancer screening dataset, demonstrating that the debiased embeddings effectively eliminate multiple encoded demographic information and improve fairness without compromising predictive accuracy for lung cancer risk at 1-year and 2-year intervals. Additionally, our approach ensures the embeddings are robust against adversarial bias attacks. These results highlight the potential of adversarial debiasing techniques to ensure fairness and equity in clinical applications of self-supervised 3D CT embeddings, paving the way for their broader adoption in unbiased medical decision-making. The code is available at https://github.com/