Equitable Health Intelligence: An Open Benchmark of Multi-Population Machine Learning for Omics-Based Cancer Prognosis

Purpose: Machine learning (ML) models for omics-based cancer prognosis are often trained on data from predominantly European-ancestry populations, producing biased predictions for other populations and undermining equitable genomic medicine. Existing fairness benchmarks mainly focus on outcome parity rather than predictive performance parity across populations. Public benchmark resources are needed for systematically detecting and mitigating such performance disparities in multi-population cancer prognosis. Methods: We developed Equitable Health Intelligence (EHI, https://ehiportal.org), an open-source benchmark of multi-population ML for omics-based cancer prognosis. EHI contains 1,475 ML tasks across 40 cancer/pan-cancer types, 4 omics feature sets, 4 clinical endpoints, 5 event-time thresholds, and 3 data-disadvantaged population (DDP) groups relative to a majority European Ancestry population group. Deep neural network models are trained under three multi-population ML schemes (Mixture, Independent, and Transfer Learning), with Naive Transfer included as a no-adaptation control, comprising a total of 10,325 ML experiments. Results: The EHI platform provides an interactive environment with visualization and exploratory tools for users to inspect predictive performance disparities between the majority European-ancestry group and data-disadvantaged populations, evaluate the extent to which transfer learning mitigates these disparities, and examine the impact of feature engineering methods across cancer types, omics features, and clinical endpoints. Conclusion: EHI is an open, interactive, and extensible benchmark for identifying and addressing performance disparities in multi-population ML for omics-based cancer prognosis. It provides a foundation for a growing ecosystem of methods targeting ML performance disparities arising from biomedical data inequality and population-level distribution shifts, thereby advancing equitable AI in precision oncology.