Daily Papers

Interpreting chest X-rays is inherently challenging due to the overlap between anatomical structures and the subtle presentation of many clinically significant pathologies, making accurate diagnosis time-consuming even for experienced radiologists. Recent radiology-focused foundation models, such as LLaVA-Rad and Maira-2, have positioned multi-modal large language models (MLLMs) at the forefront of automated radiology report generation (RRG). However, despite these advances, current foundation models generate reports in a single forward pass. This decoding strategy diminishes attention to visual tokens and increases reliance on language priors as generation proceeds, which in turn introduces spurious pathology co-occurrences in the generated reports. To mitigate these limitations, we propose Category-Wise Contrastive Decoding (CWCD), a novel and modular framework designed to enhance structured radiology report generation (SRRG). Our approach introduces category-specific parameterization and generates category-wise reports by contrasting normal X-rays with masked X-rays using category-specific visual prompts. Experimental results demonstrate that CWCD consistently outperforms baseline methods across both clinical efficacy and natural language generation metrics. An ablation study further elucidates the contribution of each architectural component to overall performance.

Spurious bias, a tendency to exploit spurious correlations between superficial input attributes and prediction targets, has revealed a severe robustness pitfall in classical machine learning problems. Multimodal Large Language Models (MLLMs), which leverage pretrained vision and language models, have recently demonstrated strong capability in joint vision-language understanding. However, both the presence and severity of spurious biases in MLLMs remain poorly understood. In this work, we address this gap by analyzing the spurious biases in the multimodal setting and uncovering the specific inference-time data patterns that can manifest this problem. To support this analysis, we introduce MM-SpuBench, a comprehensive, human-verified benchmark dataset consisting of image-class pairs annotated with core and spurious attributes, grounded in our taxonomy of nine distinct types of spurious correlations. The benchmark is constructed using human-interpretable attribute information to capture a wide range of spurious patterns reflective of real-world knowledge. Leveraging this benchmark, we conduct a comprehensive evaluation of the state-of-the-art open-source and proprietary MLLMs with both standard accuracy and the proposed Conditional Generation Likelihood Advantage (CGLA). Our findings highlight the persistence of reliance on spurious correlations and the difficulty of mitigation on our benchmark. We hope this work can inspire new technical strides to mitigate these biases. Our benchmark is publicly available at https://huggingface.co/datasets/mmbench/MM-SpuBench.

Spurious correlations allow flexible models to predict well during training but poorly on related test distributions. Recent work has shown that models that satisfy particular independencies involving correlation-inducing nuisance variables have guarantees on their test performance. Enforcing such independencies requires nuisances to be observed during training. However, nuisances, such as demographics or image background labels, are often missing. Enforcing independence on just the observed data does not imply independence on the entire population. Here we derive mmd estimators used for invariance objectives under missing nuisances. On simulations and clinical data, optimizing through these estimates achieves test performance similar to using estimators that make use of the full data.

Machine learning systems are known to be sensitive to spurious correlations between biased features of the inputs (e.g., background, texture, and secondary objects) and the corresponding labels. These features and their correlations with the labels are known as "spurious" because they tend to change with shifts in real-world data distributions, which can negatively impact the model's generalization and robustness. In this survey, we provide a comprehensive review of this issue, along with a taxonomy of current state-of-the-art methods for addressing spurious correlations in machine learning models. Additionally, we summarize existing datasets, benchmarks, and metrics to aid future research. The paper concludes with a discussion of the recent advancements and future research challenges in this field, aiming to provide valuable insights for researchers in the related domains.

Despite alarm over the reliance of machine learning systems on so-called spurious patterns, the term lacks coherent meaning in standard statistical frameworks. However, the language of causality offers clarity: spurious associations are due to confounding (e.g., a common cause), but not direct or indirect causal effects. In this paper, we focus on natural language processing, introducing methods and resources for training models less sensitive to spurious patterns. Given documents and their initial labels, we task humans with revising each document so that it (i) accords with a counterfactual target label; (ii) retains internal coherence; and (iii) avoids unnecessary changes. Interestingly, on sentiment analysis and natural language inference tasks, classifiers trained on original data fail on their counterfactually-revised counterparts and vice versa. Classifiers trained on combined datasets perform remarkably well, just shy of those specialized to either domain. While classifiers trained on either original or manipulated data alone are sensitive to spurious features (e.g., mentions of genre), models trained on the combined data are less sensitive to this signal. Both datasets are publicly available.

Finetuning can cause spurious correlations to arise between non-essential features and the target labels, but benchmarks to study these effects involve contrived settings and narrow tasks. In contrast, we consider spurious correlations in multi-modal Large Vision Language Models (LVLMs) pretrained on extensive and diverse datasets without explicit task supervision. We develop a benchmark by sourcing GPT-4o errors on real-world visual-question-answering (VQA) benchmarks, then curating a subset through LVLM-human annotation and synthetic counterfactual evaluation to identify errors caused by spurious correlations. This process yields SpuriVerse, a novel benchmark comprised of 124 distinct types of spurious correlations extracted from real-world datasets, each containing 1 realistic and 10 synthetic VQA samples for a total of 1364 multiple choice questions. We evaluate 15 open and closed-source LVLMs on SpuriVerse, finding that even state-of-the-art closed-source models struggle significantly, achieving at best only 37.1% accuracy. Fine-tuning on synthetic examples that emphasize the spurious correlation improves performance to 78.40%, suggesting that training on diverse spurious patterns generalizes to unseen situations: models appear to learn to avoid "shortcuts" and attend to the overall image context.

Spurious correlations that degrade model generalization or lead the model to be right for the wrong reasons are one of the main robustness concerns for real-world deployments. However, mitigating these correlations during pre-training for large-scale models can be costly and impractical, particularly for those without access to high-performance computing resources. This paper proposes a novel approach to address spurious correlations during fine-tuning for a given domain of interest. With a focus on multi-modal models (e.g., CLIP), the proposed method leverages different modalities in these models to detect and explicitly set apart spurious attributes from the affected class, achieved through a multi-modal contrastive loss function that expresses spurious relationships through language. Our experimental results and in-depth visualizations on CLIP show that such an intervention can effectively i) improve the model's accuracy when spurious attributes are not present, and ii) directs the model's activation maps towards the actual class rather than the spurious attribute when present. In particular, on the Waterbirds dataset, our algorithm achieved a worst-group accuracy 23% higher than ERM on CLIP with a ResNet-50 backbone, and 32% higher on CLIP with a ViT backbone, while maintaining the same average accuracy as ERM.

Models driven by spurious correlations often yield poor generalization performance. We propose the counterfactual (CF) alignment method to detect and quantify spurious correlations of black box classifiers. Our methodology is based on counterfactual images generated with respect to one classifier being input into other classifiers to see if they also induce changes in the outputs of these classifiers. The relationship between these responses can be quantified and used to identify specific instances where a spurious correlation exists. This is validated by observing intuitive trends in face-attribute and waterbird classifiers, as well as by fabricating spurious correlations and detecting their presence, both visually and quantitatively. Furthermore, utilizing the CF alignment method, we demonstrate that we can evaluate robust optimization methods (GroupDRO, JTT, and FLAC) by detecting a reduction in spurious correlations.

Unimodal vision models are known to rely on spurious correlations, but it remains unclear to what extent Multimodal Large Language Models (MLLMs) exhibit similar biases despite language supervision. In this paper, we investigate spurious bias in MLLMs and introduce SpurLens, a pipeline that leverages GPT-4 and open-set object detectors to automatically identify spurious visual cues without human supervision. Our findings reveal that spurious correlations cause two major failure modes in MLLMs: (1) over-reliance on spurious cues for object recognition, where removing these cues reduces accuracy, and (2) object hallucination, where spurious cues amplify the hallucination by over 10x. We validate our findings in various MLLMs and datasets. Beyond diagnosing these failures, we explore potential mitigation strategies, such as prompt ensembling and reasoning-based prompting, and conduct ablation studies to examine the root causes of spurious bias in MLLMs. By exposing the persistence of spurious correlations, our study calls for more rigorous evaluation methods and mitigation strategies to enhance the reliability of MLLMs.

Benchmark performance of deep learning classifiers alone is not a reliable predictor for the performance of a deployed model. In particular, if the image classifier has picked up spurious features in the training data, its predictions can fail in unexpected ways. In this paper, we develop a framework that allows us to systematically identify spurious features in large datasets like ImageNet. It is based on our neural PCA components and their visualization. Previous work on spurious features often operates in toy settings or requires costly pixel-wise annotations. In contrast, we work with ImageNet and validate our results by showing that presence of the harmful spurious feature of a class alone is sufficient to trigger the prediction of that class. We introduce the novel dataset "Spurious ImageNet" which allows to measure the reliance of any ImageNet classifier on harmful spurious features. Moreover, we introduce SpuFix as a simple mitigation method to reduce the dependence of any ImageNet classifier on previously identified harmful spurious features without requiring additional labels or retraining of the model. We provide code and data at https://github.com/YanNeu/spurious_imagenet .

The development of larger models for medical image analysis has led to increased performance. However, it also affected our ability to explain and validate model decisions. Models can use non-relevant parts of images, also called spurious correlations or shortcuts, to obtain high performance on benchmark datasets but fail in real-world scenarios. In this work, we challenge the capacity of convolutional neural networks (CNN) to classify chest X-rays and eye fundus images while masking out clinically relevant parts of the image. We show that all models trained on the PadChest dataset, irrespective of the masking strategy, are able to obtain an Area Under the Curve (AUC) above random. Moreover, the models trained on full images obtain good performance on images without the region of interest (ROI), even superior to the one obtained on images only containing the ROI. We also reveal a possible spurious correlation in the Chaksu dataset while the performances are more aligned with the expectation of an unbiased model. We go beyond the performance analysis with the usage of the explainability method SHAP and the analysis of embeddings. We asked a radiology resident to interpret chest X-rays under different masking to complement our findings with clinical knowledge. Our code is available at https://github.com/TheoSourget/MMC_Masking and https://github.com/TheoSourget/MMC_Masking_EyeFundus

Deep neural networks often rely on spurious correlations to make predictions, which hinders generalization beyond training environments. For instance, models that associate cats with bed backgrounds can fail to predict the existence of cats in other environments without beds. Mitigating spurious correlations is crucial in building trustworthy models. However, the existing works lack transparency to offer insights into the mitigation process. In this work, we propose an interpretable framework, Discover and Cure (DISC), to tackle the issue. With human-interpretable concepts, DISC iteratively 1) discovers unstable concepts across different environments as spurious attributes, then 2) intervenes on the training data using the discovered concepts to reduce spurious correlation. Across systematic experiments, DISC provides superior generalization ability and interpretability than the existing approaches. Specifically, it outperforms the state-of-the-art methods on an object recognition task and a skin-lesion classification task by 7.5% and 9.6%, respectively. Additionally, we offer theoretical analysis and guarantees to understand the benefits of models trained by DISC. Code and data are available at https://github.com/Wuyxin/DISC.

Counterfactual data augmentation has recently emerged as a method to mitigate confounding biases in the training data for a machine learning model. These biases, such as spurious correlations, arise due to various observed and unobserved confounding variables in the data generation process. In this paper, we formally analyze how confounding biases impact downstream classifiers and present a causal viewpoint to the solutions based on counterfactual data augmentation. We explore how removing confounding biases serves as a means to learn invariant features, ultimately aiding in generalization beyond the observed data distribution. Additionally, we present a straightforward yet powerful algorithm for generating counterfactual images, which effectively mitigates the influence of confounding effects on downstream classifiers. Through experiments on MNIST variants and the CelebA datasets, we demonstrate the effectiveness and practicality of our approach.

Discriminative approaches to classification often learn shortcuts that hold in-distribution but fail even under minor distribution shift. This failure mode stems from an overreliance on features that are spuriously correlated with the label. We show that generative classifiers, which use class-conditional generative models, can avoid this issue by modeling all features, both core and spurious, instead of mainly spurious ones. These generative classifiers are simple to train, avoiding the need for specialized augmentations, strong regularization, extra hyperparameters, or knowledge of the specific spurious correlations to avoid. We find that diffusion-based and autoregressive generative classifiers achieve state-of-the-art performance on five standard image and text distribution shift benchmarks and reduce the impact of spurious correlations in realistic applications, such as medical or satellite datasets. Finally, we carefully analyze a Gaussian toy setting to understand the inductive biases of generative classifiers, as well as the data properties that determine when generative classifiers outperform discriminative ones.

Pathology Foundation Models (FMs) hold great promise for healthcare. Before they can be used in clinical practice, it is essential to ensure they are robust to variations between medical centers. We measure whether pathology FMs focus on biological features like tissue and cancer type, or on the well known confounding medical center signatures introduced by staining procedure and other differences. We introduce the Robustness Index. This novel robustness metric reflects to what degree biological features dominate confounding features. Ten current publicly available pathology FMs are evaluated. We find that all current pathology foundation models evaluated represent the medical center to a strong degree. Significant differences in the robustness index are observed. Only one model so far has a robustness index greater than one, meaning biological features dominate confounding features, but only slightly. A quantitative approach to measure the influence of medical center differences on FM-based prediction performance is described. We analyze the impact of unrobustness on classification performance of downstream models, and find that cancer-type classification errors are not random, but specifically attributable to same-center confounders: images of other classes from the same medical center. We visualize FM embedding spaces, and find these are more strongly organized by medical centers than by biological factors. As a consequence, the medical center of origin is predicted more accurately than the tissue source and cancer type. The robustness index introduced here is provided with the aim of advancing progress towards clinical adoption of robust and reliable pathology FMs.

Fine-tuned vision-language models (VLMs) often capture spurious correlations between image features and textual attributes, resulting in degraded zero-shot performance at test time. Existing approaches for addressing spurious correlations (i) primarily operate at the global image-level rather than intervening directly on fine-grained image features and (ii) are predominantly designed for unimodal settings. In this work, we present RaVL, which takes a fine-grained perspective on VLM robustness by discovering and mitigating spurious correlations using local image features rather than operating at the global image level. Given a fine-tuned VLM, RaVL first discovers spurious correlations by leveraging a region-level clustering approach to identify precise image features contributing to zero-shot classification errors. Then, RaVL mitigates the identified spurious correlation with a novel region-aware loss function that enables the VLM to focus on relevant regions and ignore spurious relationships during fine-tuning. We evaluate RaVL on 654 VLMs with various model architectures, data domains, and learned spurious correlations. Our results show that RaVL accurately discovers (191% improvement over the closest baseline) and mitigates (8.2% improvement on worst-group image classification accuracy) spurious correlations. Qualitative evaluations on general-domain and medical-domain VLMs confirm our findings.

Deep neural networks have demonstrated promising performance on image recognition tasks. However, they may heavily rely on confounding factors, using irrelevant artifacts or bias within the dataset as the cue to improve performance. When a model performs decision-making based on these spurious correlations, it can become untrustable and lead to catastrophic outcomes when deployed in the real-world scene. In this paper, we explore and try to solve this problem in the context of skin cancer diagnosis. We introduce a human-in-the-loop framework in the model training process such that users can observe and correct the model's decision logic when confounding behaviors happen. Specifically, our method can automatically discover confounding factors by analyzing the co-occurrence behavior of the samples. It is capable of learning confounding concepts using easily obtained concept exemplars. By mapping the black-box model's feature representation onto an explainable concept space, human users can interpret the concept and intervene via first order-logic instruction. We systematically evaluate our method on our newly crafted, well-controlled skin lesion dataset and several public skin lesion datasets. Experiments show that our method can effectively detect and remove confounding factors from datasets without any prior knowledge about the category distribution and does not require fully annotated concept labels. We also show that our method enables the model to focus on clinical-related concepts, improving the model's performance and trustworthiness during model inference.

Timely detection of concerning events is an important problem in clinical practice. In this paper, we consider the problem of conditional anomaly detection that aims to identify data instances with an unusual response, such as the omission of an important lab test. We develop a new non-parametric approach for conditional anomaly detection based on the soft harmonic solution, with which we estimate the confidence of the label to detect anomalous mislabeling. We further regularize the solution to avoid the detection of isolated examples and examples on the boundary of the distribution support. We demonstrate the efficacy of the proposed method in detecting unusual labels on a real-world electronic health record dataset and compare it to several baseline approaches.

Previous research on radiology report generation has made significant progress in terms of increasing the clinical accuracy of generated reports. In this paper, we emphasize another crucial quality that it should possess, i.e., inter-report consistency, which refers to the capability of generating consistent reports for semantically equivalent radiographs. This quality is even of greater significance than the overall report accuracy in terms of ensuring the system's credibility, as a system prone to providing conflicting results would severely erode users' trust. Regrettably, existing approaches struggle to maintain inter-report consistency, exhibiting biases towards common patterns and susceptibility to lesion variants. To address this issue, we propose ICON, which improves the inter-report consistency of radiology report generation. Aiming at enhancing the system's ability to capture the similarities in semantically equivalent lesions, our approach involves first extracting lesions from input images and examining their characteristics. Then, we introduce a lesion-aware mix-up augmentation technique to ensure that the representations of the semantically equivalent lesions align with the same attributes, by linearly interpolating them during the training phase. Extensive experiments on three publicly available chest X-ray datasets verify the effectiveness of our approach, both in terms of improving the consistency and accuracy of the generated reports.

Explaining deep learning models is essential for clinical integration of medical image analysis systems. A good explanation highlights if a model depends on spurious features that undermines generalization and harms a subset of patients or, conversely, may present novel biological insights. Although techniques like GradCAM can identify influential features, they are measurement tools that do not themselves form an explanation. We propose a human-machine-VLM interaction system tailored to explaining classifiers in computational pathology, including multi-instance learning for whole-slide images. Our proof of concept comprises (1) an AI-integrated slide viewer to run sliding-window experiments to test claims of an explanation, and (2) quantification of an explanation's predictiveness using general-purpose vision-language models. The results demonstrate that this allows us to qualitatively test claims of explanations and can quantifiably distinguish competing explanations. This offers a practical path from explainable AI to explained AI in digital pathology and beyond. Code and prompts are available at https://github.com/nki-ai/x2x.

Small sample sizes are common in many disciplines, which necessitates pooling roughly similar datasets across multiple institutions to study weak but relevant associations between images and disease outcomes. Such data often manifest shift/imbalance in covariates (i.e., secondary non-imaging data). Controlling for such nuisance variables is common within standard statistical analysis, but the ideas do not directly apply to overparameterized models. Consequently, recent work has shown how strategies from invariant representation learning provides a meaningful starting point, but the current repertoire of methods is limited to accounting for shifts/imbalances in just a couple of covariates at a time. In this paper, we show how viewing this problem from the perspective of Category theory provides a simple and effective solution that completely avoids elaborate multi-stage training pipelines that would otherwise be needed. We show the effectiveness of this approach via extensive experiments on real datasets. Further, we discuss how this style of formulation offers a unified perspective on at least 5+ distinct problem settings, from self-supervised learning to matching problems in 3D reconstruction.

Spurious correlations in the data, where multiple cues are predictive of the target labels, often lead to a phenomenon known as simplicity bias, where a model relies on erroneous, easy-to-learn cues while ignoring reliable ones. In this work, we propose an ensemble diversification framework exploiting Diffusion Probabilistic Models (DPMs) for shortcut bias mitigation. We show that at particular training intervals, DPMs can generate images with novel feature combinations, even when trained on images displaying correlated input features. We leverage this crucial property to generate synthetic counterfactuals to increase model diversity via ensemble disagreement. We show that DPM-guided diversification is sufficient to remove dependence on primary shortcut cues, without a need for additional supervised signals. We further empirically quantify its efficacy on several diversification objectives, and finally show improved generalization and diversification performance on par with prior work that relies on auxiliary data collection.

Despite the rapid development of machine learning algorithms for domain generalization (DG), there is no clear empirical evidence that the existing DG algorithms outperform the classic empirical risk minimization (ERM) across standard benchmarks. To better understand this phenomenon, we investigate whether there are benefits of DG algorithms over ERM through the lens of label noise. Specifically, our finite-sample analysis reveals that label noise exacerbates the effect of spurious correlations for ERM, undermining generalization. Conversely, we illustrate that DG algorithms exhibit implicit label-noise robustness during finite-sample training even when spurious correlation is present. Such desirable property helps mitigate spurious correlations and improve generalization in synthetic experiments. However, additional comprehensive experiments on real-world benchmark datasets indicate that label-noise robustness does not necessarily translate to better performance compared to ERM. We conjecture that the failure mode of ERM arising from spurious correlations may be less pronounced in practice.

We develop graph-based methods for semi-supervised learning based on label propagation on a data similarity graph. When data is abundant or arrive in a stream, the problems of computation and data storage arise for any graph-based method. We propose a fast approximate online algorithm that solves for the harmonic solution on an approximate graph. We show, both empirically and theoretically, that good behavior can be achieved by collapsing nearby points into a set of local representative points that minimize distortion. Moreover, we regularize the harmonic solution to achieve better stability properties. We also present graph-based methods for detecting conditional anomalies and apply them to the identification of unusual clinical actions in hospitals. Our hypothesis is that patient-management actions that are unusual with respect to the past patients may be due to errors and that it is worthwhile to raise an alert if such a condition is encountered. Conditional anomaly detection extends standard unconditional anomaly framework but also faces new problems known as fringe and isolated points. We devise novel nonparametric graph-based methods to tackle these problems. Our methods rely on graph connectivity analysis and soft harmonic solution. Finally, we conduct an extensive human evaluation study of our conditional anomaly methods by 15 experts in critical care.

To enhance group robustness to spurious correlations, prior work often relies on auxiliary annotations for groups or spurious features and assumes identical sets of groups across source and target domains. These two requirements are both unnatural and impractical in real-world settings. To overcome these limitations, we propose a method that leverages the semantic structure inherent in class labels--specifically, superclass information--to naturally reduce reliance on spurious features. Our model employs gradient-based attention guided by a pre-trained vision-language model to disentangle superclass-relevant and irrelevant features. Then, by promoting the use of all superclass-relevant features for prediction, our approach achieves robustness to more complex spurious correlations without the need to annotate any source samples. Experiments across diverse datasets demonstrate that our method significantly outperforms baselines in domain generalization tasks, with clear improvements in both quantitative metrics and qualitative visualizations.

Medical image segmentation exhibits intra- and inter-annotator variability due to ambiguous object boundaries, annotator preferences, expertise, and tools, among other factors. Lesions with ambiguous boundaries, e.g., spiculated or infiltrative nodules, or irregular borders per the ABCD rule, are particularly prone to disagreement and are often associated with malignancy. In this work, we curate IMA++, the largest multi-annotator skin lesion segmentation dataset, on which we conduct an in-depth study of variability due to annotator, malignancy, tool, and skill factors. We find a statistically significant (p<0.001) association between inter-annotator agreement (IAA), measured using Dice, and the malignancy of skin lesions. We further show that IAA can be accurately predicted directly from dermoscopic images, achieving a mean absolute error of 0.108. Finally, we leverage this association by utilizing IAA as a "soft" clinical feature within a multi-task learning objective, yielding a 4.2% improvement in balanced accuracy averaged across multiple model architectures and across IMA++ and four public dermoscopic datasets. The code is available at https://github.com/sfu-mial/skin-IAV.

Out-of-distribution (OOD) problems in few-shot classification (FSC) occur when novel classes sampled from testing distributions differ from base classes drawn from training distributions, which considerably degrades the performance of deep learning models deployed in real-world applications. Recent studies suggest that the OOD problems in FSC mainly including: (a) cross-domain few-shot classification (CD-FSC) and (b) spurious-correlation few-shot classification (SC-FSC). Specifically, CD-FSC occurs when a classifier learns transferring knowledge from base classes drawn from seen training distributions but recognizes novel classes sampled from unseen testing distributions. In contrast, SC-FSC arises when a classifier relies on non-causal features (or contexts) that happen to be correlated with the labels (or concepts) in base classes but such relationships no longer hold during the model deployment. Despite CD-FSC has been extensively studied, SC-FSC remains understudied due to lack of the corresponding evaluation benchmarks. To this end, we present Meta Concept Context (MetaCoCo), a benchmark with spurious-correlation shifts collected from real-world scenarios. Moreover, to quantify the extent of spurious-correlation shifts of the presented MetaCoCo, we further propose a metric by using CLIP as a pre-trained vision-language model. Extensive experiments on the proposed benchmark are performed to evaluate the state-of-the-art methods in FSC, cross-domain shifts, and self-supervised learning. The experimental results show that the performance of the existing methods degrades significantly in the presence of spurious-correlation shifts. We open-source all codes of our benchmark and hope that the proposed MetaCoCo can facilitate future research on spurious-correlation shifts problems in FSC. The code is available at: https://github.com/remiMZ/MetaCoCo-ICLR24.

Large language models (LLMs) often make factually incorrect responses despite their success in various applications. In this paper, we hypothesize that relying heavily on simple co-occurrence statistics of the pre-training corpora is one of the main factors that cause factual errors. Our results reveal that LLMs are vulnerable to the co-occurrence bias, defined as preferring frequently co-occurred words over the correct answer. Consequently, LLMs struggle to recall facts whose subject and object rarely co-occur in the pre-training dataset although they are seen during finetuning. We show that co-occurrence bias remains despite scaling up model sizes or finetuning. Therefore, we suggest finetuning on a debiased dataset to mitigate the bias by filtering out biased samples whose subject-object co-occurrence count is high. Although debiased finetuning allows LLMs to memorize rare facts in the training set, it is not effective in recalling rare facts unseen during finetuning. Further research in mitigation will help build reliable language models by preventing potential errors. The code is available at https://github.com/CheongWoong/impact_of_cooccurrence.

Medical image classification is a critical problem for healthcare, with the potential to alleviate the workload of doctors and facilitate diagnoses of patients. However, two challenges arise when deploying deep learning models to real-world healthcare applications. First, neural models tend to learn spurious correlations instead of desired features, which could fall short when generalizing to new domains (e.g., patients with different ages). Second, these black-box models lack interpretability. When making diagnostic predictions, it is important to understand why a model makes a decision for trustworthy and safety considerations. In this paper, to address these two limitations, we propose a new paradigm to build robust and interpretable medical image classifiers with natural language concepts. Specifically, we first query clinical concepts from GPT-4, then transform latent image features into explicit concepts with a vision-language model. We systematically evaluate our method on eight medical image classification datasets to verify its effectiveness. On challenging datasets with strong confounding factors, our method can mitigate spurious correlations thus substantially outperform standard visual encoders and other baselines. Finally, we show how classification with a small number of concepts brings a level of interpretability for understanding model decisions through case studies in real medical data.

Multiple Instance learning (MIL) models have been extensively used in pathology to predict biomarkers and risk-stratify patients from gigapixel-sized images. Machine learning problems in medical imaging often deal with rare diseases, making it important for these models to work in a label-imbalanced setting. In pathology images, there is another level of imbalance, where given a positively labeled Whole Slide Image (WSI), only a fraction of pixels within it contribute to the positive label. This compounds the severity of imbalance and makes imbalanced classification in pathology challenging. Furthermore, these imbalances can occur in out-of-distribution (OOD) datasets when the models are deployed in the real-world. We leverage the idea that decoupling feature and classifier learning can lead to improved decision boundaries for label imbalanced datasets. To this end, we investigate the integration of supervised contrastive learning with multiple instance learning (SC-MIL). Specifically, we propose a joint-training MIL framework in the presence of label imbalance that progressively transitions from learning bag-level representations to optimal classifier learning. We perform experiments with different imbalance settings for two well-studied problems in cancer pathology: subtyping of non-small cell lung cancer and subtyping of renal cell carcinoma. SC-MIL provides large and consistent improvements over other techniques on both in-distribution (ID) and OOD held-out sets across multiple imbalanced settings.

Despite achieving high accuracy on medical benchmarks, LLMs exhibit the Einstellung Effect in clinical diagnosis--relying on statistical shortcuts rather than patient-specific evidence, causing misdiagnosis in atypical cases. Existing benchmarks fail to detect this critical failure mode. We introduce MedEinst, a counterfactual benchmark with 5,383 paired clinical cases across 49 diseases. Each pair contains a control case and a "trap" case with altered discriminative evidence that flips the diagnosis. We measure susceptibility via Bias Trap Rate--probability of misdiagnosing traps despite correctly diagnosing controls. Extensive Evaluation of 17 LLMs shows frontier models achieve high baseline accuracy but severe bias trap rates. Thus, we propose ECR-Agent, aligning LLM reasoning with Evidence-Based Medicine standard via two components: (1) Dynamic Causal Inference (DCI) performs structured reasoning through dual-pathway perception, dynamic causal graph reasoning across three levels (association, intervention, counterfactual), and evidence audit for final diagnosis; (2) Critic-Driven Graph and Memory Evolution (CGME) iteratively refines the system by storing validated reasoning paths in an exemplar base and consolidating disease-specific knowledge into evolving illness graphs. Source code is to be released.

Neural image classifiers can often learn to make predictions by overly relying on non-predictive features that are spuriously correlated with the class labels in the training data. This leads to poor performance in real-world atypical scenarios where such features are absent. Supplementing the training dataset with images without such spurious features can aid robust learning against spurious correlations via better generalization. This paper presents ASPIRE (Language-guided data Augmentation for SPurIous correlation REmoval), a simple yet effective solution for expanding the training dataset with synthetic images without spurious features. ASPIRE, guided by language, generates these images without requiring any form of additional supervision or existing examples. Precisely, we employ LLMs to first extract foreground and background features from textual descriptions of an image, followed by advanced language-guided image editing to discover the features that are spuriously correlated with the class label. Finally, we personalize a text-to-image generation model to generate diverse in-domain images without spurious features. We demonstrate the effectiveness of ASPIRE on 4 datasets, including the very challenging Hard ImageNet dataset, and 9 baselines and show that ASPIRE improves the classification accuracy of prior methods by 1% - 38%. Code soon at: https://github.com/Sreyan88/ASPIRE.

Neural networks trained with ERM (empirical risk minimization) sometimes learn unintended decision rules, in particular when their training data is biased, i.e., when training labels are strongly correlated with undesirable features. To prevent a network from learning such features, recent methods augment training data such that examples displaying spurious correlations (i.e., bias-aligned examples) become a minority, whereas the other, bias-conflicting examples become prevalent. However, these approaches are sometimes difficult to train and scale to real-world data because they rely on generative models or disentangled representations. We propose an alternative based on mixup, a popular augmentation that creates convex combinations of training examples. Our method, coined SelecMix, applies mixup to contradicting pairs of examples, defined as showing either (i) the same label but dissimilar biased features, or (ii) different labels but similar biased features. Identifying such pairs requires comparing examples with respect to unknown biased features. For this, we utilize an auxiliary contrastive model with the popular heuristic that biased features are learned preferentially during training. Experiments on standard benchmarks demonstrate the effectiveness of the method, in particular when label noise complicates the identification of bias-conflicting examples.

To align conditional text generation model outputs with desired behaviors, there has been an increasing focus on training the model using reinforcement learning (RL) with reward functions learned from human annotations. Under this framework, we identify three common cases where high rewards are incorrectly assigned to undesirable patterns: noise-induced spurious correlation, naturally occurring spurious correlation, and covariate shift. We show that even though learned metrics achieve high performance on the distribution of the data used to train the reward function, the undesirable patterns may be amplified during RL training of the text generation model. While there has been discussion about reward gaming in the RL or safety community, in this discussion piece, we would like to highlight reward gaming in the natural language generation (NLG) community using concrete conditional text generation examples and discuss potential fixes and areas for future work.

Extracting causal relationships from observed correlations is a growing area in probabilistic reasoning, originating with the seminal work of Pearl and others from the early 1990s. This paper develops a new, categorically oriented view based on a clear distinction between syntax (string diagrams) and semantics (stochastic matrices), connected via interpretations as structure-preserving functors. A key notion in the identification of causal effects is that of an intervention, whereby a variable is forcefully set to a particular value independent of any prior propensities. We represent the effect of such an intervention as an endofunctor which performs `string diagram surgery' within the syntactic category of string diagrams. This diagram surgery in turn yields a new, interventional distribution via the interpretation functor. While in general there is no way to compute interventional distributions purely from observed data, we show that this is possible in certain special cases using a calculational tool called comb disintegration. We demonstrate the use of this technique on a well-known toy example, where we predict the causal effect of smoking on cancer in the presence of a confounding common cause. After developing this specific example, we show this technique provides simple sufficient conditions for computing interventions which apply to a wide variety of situations considered in the causal inference literature.

Multimodal Large Language Models have demonstrated impressive capabilities across tasks, yet they often exhibit difficulty in distinguishing task-relevant from irrelevant signals -- particularly in tasks like Visual Question Answering -- which can lead to susceptibility to misleading or spurious inputs. We refer to this broader limitation as the Cross-Modality Competency Problem -- the model's inability to fairly evaluate all modalities. This vulnerability becomes more evident in modality-specific tasks -- such as image classification or pure text question answering -- where models are expected to rely solely on one modality. In such tasks, spurious information from irrelevant modalities often leads to significant performance degradation. We refer to this failure as Modality Interference, which serves as a concrete and measurable instance of the cross-modality competency problem, and we further design a perturbation-based causal diagnostic experiment to verify and quantify this problem. To mitigate modality interference, we propose a novel framework to finetune MLLMs, including perturbation-based data augmentations with both heuristic perturbations and adversarial perturbations, and a consistency regularization strategy applying on model outputs with original and perturbed inputs. Experiments on multiple benchmark datasets (image-heavy, text-heavy and multimodal tasks) and multiple model families with different scales demonstrate significant improvements in robustness and cross-modality competency, indicating our method's effectiveness in boosting unimodal reasoning ability while enhancing performance on multimodal tasks.

Anomaly detection is the task of identifying examples that do not behave as expected. Because anomalies are rare and unexpected events, collecting real anomalous examples is often challenging in several applications. In addition, learning an anomaly detector with limited (or no) anomalies often yields poor prediction performance. One option is to employ auxiliary synthetic anomalies to improve the model training. However, synthetic anomalies may be of poor quality: anomalies that are unrealistic or indistinguishable from normal samples may deteriorate the detector's performance. Unfortunately, no existing methods quantify the quality of auxiliary anomalies. We fill in this gap and propose the expected anomaly posterior (EAP), an uncertainty-based score function that measures the quality of auxiliary anomalies by quantifying the total uncertainty of an anomaly detector. Experimentally on 40 benchmark datasets of images and tabular data, we show that EAP outperforms 12 adapted data quality estimators in the majority of cases.

Recent work has shown that models trained to the same objective, and which achieve similar measures of accuracy on consistent test data, may nonetheless behave very differently on individual predictions. This inconsistency is undesirable in high-stakes contexts, such as medical diagnosis and finance. We show that this inconsistent behavior extends beyond predictions to feature attributions, which may likewise have negative implications for the intelligibility of a model, and one's ability to find recourse for subjects. We then introduce selective ensembles to mitigate such inconsistencies by applying hypothesis testing to the predictions of a set of models trained using randomly-selected starting conditions; importantly, selective ensembles can abstain in cases where a consistent outcome cannot be achieved up to a specified confidence level. We prove that that prediction disagreement between selective ensembles is bounded, and empirically demonstrate that selective ensembles achieve consistent predictions and feature attributions while maintaining low abstention rates. On several benchmark datasets, selective ensembles reach zero inconsistently predicted points, with abstention rates as low 1.5%.

The rapid increase of computed tomography (CT) scans and their time-consuming manual analysis have created an urgent need for robust automated analysis techniques in clinical settings. These aim to assist radiologists and help them managing their growing workload. Existing methods typically generate entire reports directly from 3D CT images, without explicitly focusing on observed abnormalities. This unguided approach often results in repetitive content or incomplete reports, failing to prioritize anomaly-specific descriptions. We propose a new anomaly-guided report generation model, which first predicts abnormalities and then generates targeted descriptions for each. Evaluation on a public dataset demonstrates significant improvements in report quality and clinical relevance. We extend our work by conducting an ablation study to demonstrate its effectiveness.

This paper proposes one of the first clinical applications of multimodal large language models (LLMs) as an assistant for radiologists to check errors in their reports. We created an evaluation dataset from two real-world radiology datasets (MIMIC-CXR and IU-Xray), with 1,000 subsampled reports each. A subset of original reports was modified to contain synthetic errors by introducing various type of mistakes. The evaluation contained two difficulty levels: SIMPLE for binary error-checking and COMPLEX for identifying error types. LLaVA (Large Language and Visual Assistant) variant models, including our instruction-tuned model, were used for the evaluation. Additionally, a domain expert evaluation was conducted on a small test set. At the SIMPLE level, the LLaVA v1.5 model outperformed other publicly available models. Instruction tuning significantly enhanced performance by 47.4% and 25.4% on MIMIC-CXR and IU-Xray data, respectively. The model also surpassed the domain experts accuracy in the MIMIC-CXR dataset by 1.67%. Notably, among the subsets (N=21) of the test set where a clinician did not achieve the correct conclusion, the LLaVA ensemble mode correctly identified 71.4% of these cases. This study marks a promising step toward utilizing multi-modal LLMs to enhance diagnostic accuracy in radiology. The ensemble model demonstrated comparable performance to clinicians, even capturing errors overlooked by humans. Nevertheless, future work is needed to improve the model ability to identify the types of inconsistency.

Out-of-distribution (OOD) prediction is often approached by restricting models to causal or invariant covariates, avoiding non-causal spurious associations that may be unstable across environments. Despite its theoretical appeal, this strategy frequently underperforms empirical risk minimization (ERM) in practice. We investigate the source of this gap and show that such failures naturally arise when only a subset of the true causes of the outcome is observed. In these settings, non-causal spurious covariates can serve as informative proxies for unobserved causes and substantially improve prediction, except under distribution shifts that break these proxy relationships. Consequently, the optimal set of predictive covariates is neither universal nor necessarily exhibits invariant relationships with the outcome across all environments, but instead depends on the specific type of shift encountered. Crucially, we observe that different covariate shifts induce distinct, observable signatures in the covariate distribution itself. Moreover, these signatures can be extracted from unlabeled data in the target OOD environment and used to assess when proxy covariates remain reliable and when they fail. Building on this observation, we propose an environment-adaptive covariate selection (EACS) algorithm that maps environment-level covariate summaries to environment-specific covariate sets, while allowing the incorporation of prior causal knowledge as constraints. Across simulations and applied datasets, EACS consistently outperforms static causal, invariant, and ERM-based predictors under diverse distribution shifts.

Anomaly detection (AD) is a machine learning task that identifies anomalies by learning patterns from normal training data. In many real-world scenarios, anomalies vary in severity, from minor anomalies with little risk to severe abnormalities requiring immediate attention. However, existing models primarily operate in a binary setting, and the anomaly scores they produce are usually based on the deviation of data points from normal data, which may not accurately reflect practical severity. In this paper, we address this gap by making three key contributions. First, we propose a novel setting, Multilevel AD (MAD), in which the anomaly score represents the severity of anomalies in real-world applications, and we highlight its diverse applications across various domains. Second, we introduce a novel benchmark, MAD-Bench, that evaluates models not only on their ability to detect anomalies, but also on how effectively their anomaly scores reflect severity. This benchmark incorporates multiple types of baselines and real-world applications involving severity. Finally, we conduct a comprehensive performance analysis on MAD-Bench. We evaluate models on their ability to assign severity-aligned scores, investigate the correspondence between their performance on binary and multilevel detection, and study their robustness. This analysis offers key insights into improving AD models for practical severity alignment. The code framework and datasets used for the benchmark will be made publicly available.

The paradigm of worst-group loss minimization has shown its promise in avoiding to learn spurious correlations, but requires costly additional supervision on spurious attributes. To resolve this, recent works focus on developing weaker forms of supervision -- e.g., hyperparameters discovered with a small number of validation samples with spurious attribute annotation -- but none of the methods retain comparable performance to methods using full supervision on the spurious attribute. In this paper, instead of searching for weaker supervisions, we ask: Given access to a fixed number of samples with spurious attribute annotations, what is the best achievable worst-group loss if we "fully exploit" them? To this end, we propose a pseudo-attribute-based algorithm, coined Spread Spurious Attribute (SSA), for improving the worst-group accuracy. In particular, we leverage samples both with and without spurious attribute annotations to train a model to predict the spurious attribute, then use the pseudo-attribute predicted by the trained model as supervision on the spurious attribute to train a new robust model having minimal worst-group loss. Our experiments on various benchmark datasets show that our algorithm consistently outperforms the baseline methods using the same number of validation samples with spurious attribute annotations. We also demonstrate that the proposed SSA can achieve comparable performances to methods using full (100%) spurious attribute supervision, by using a much smaller number of annotated samples -- from 0.6% and up to 1.5%, depending on the dataset.

While deep learning has led to huge progress in complex image classification tasks like ImageNet, unexpected failure modes, e.g. via spurious features, call into question how reliably these classifiers work in the wild. Furthermore, for safety-critical tasks the black-box nature of their decisions is problematic, and explanations or at least methods which make decisions plausible are needed urgently. In this paper, we address these problems by generating images that optimize a classifier-derived objective using a framework for guided image generation. We analyze the decisions of image classifiers by visual counterfactual explanations (VCEs), detection of systematic mistakes by analyzing images where classifiers maximally disagree, and visualization of neurons and spurious features. In this way, we validate existing observations, e.g. the shape bias of adversarially robust models, as well as novel failure modes, e.g. systematic errors of zero-shot CLIP classifiers. Moreover, our VCEs outperform previous work while being more versatile.

We present a straightforward statistical test to detect certain violations of the assumption that the data are Independent and Identically Distributed (IID). The specific form of violation considered is common across real-world applications: whether the examples are ordered in the dataset such that almost adjacent examples tend to have more similar feature values (e.g. due to distributional drift, or attractive interactions between datapoints). Based on a k-Nearest Neighbors estimate, our approach can be used to audit any multivariate numeric data as well as other data types (image, text, audio, etc.) that can be numerically represented, perhaps with model embeddings. Compared with existing methods to detect drift or auto-correlation, our approach is both applicable to more types of data and also able to detect a wider variety of IID violations in practice. Code: https://github.com/cleanlab/cleanlab

Radiology reporting generative AI holds significant potential to alleviate clinical workloads and streamline medical care. However, achieving high clinical accuracy is challenging, as radiological images often feature subtle lesions and intricate structures. Existing systems often fall short, largely due to their reliance on fixed size, patch-level image features and insufficient incorporation of pathological information. This can result in the neglect of such subtle patterns and inconsistent descriptions of crucial pathologies. To address these challenges, we propose an innovative approach that leverages pathology-aware regional prompts to explicitly integrate anatomical and pathological information of various scales, significantly enhancing the precision and clinical relevance of generated reports. We develop an anatomical region detector that extracts features from distinct anatomical areas, coupled with a novel multi-label lesion detector that identifies global pathologies. Our approach emulates the diagnostic process of radiologists, producing clinically accurate reports with comprehensive diagnostic capabilities. Experimental results show that our model outperforms previous state-of-the-art methods on most natural language generation and clinical efficacy metrics, with formal expert evaluations affirming its potential to enhance radiology practice.

In this paper, we consider the problem of conditional anomaly detection that aims to identify data instances with an unusual response or a class label. We develop a new non-parametric approach for conditional anomaly detection based on the soft harmonic solution, with which we estimate the confidence of the label to detect anomalous mislabeling. We further regularize the solution to avoid the detection of isolated examples and examples on the boundary of the distribution support. We demonstrate the efficacy of the proposed method on several synthetic and UCI ML datasets in detecting unusual labels when compared to several baseline approaches. We also evaluate the performance of our method on a real-world electronic health record dataset where we seek to identify unusual patient-management decisions.

We study neural network loss landscapes through the lens of mode connectivity, the observation that minimizers of neural networks retrieved via training on a dataset are connected via simple paths of low loss. Specifically, we ask the following question: are minimizers that rely on different mechanisms for making their predictions connected via simple paths of low loss? We provide a definition of mechanistic similarity as shared invariances to input transformations and demonstrate that lack of linear connectivity between two models implies they use dissimilar mechanisms for making their predictions. Relevant to practice, this result helps us demonstrate that naive fine-tuning on a downstream dataset can fail to alter a model's mechanisms, e.g., fine-tuning can fail to eliminate a model's reliance on spurious attributes. Our analysis also motivates a method for targeted alteration of a model's mechanisms, named connectivity-based fine-tuning (CBFT), which we analyze using several synthetic datasets for the task of reducing a model's reliance on spurious attributes.

A comparison of the distances to the Huanan Seafood Market of early Covid cases with known links to the market versus cases without known links shows results apparently incompatible with a location model lacking proximity ascertainment bias. The sign of the difference instead agrees with a model in which such ascertainment bias is large. In the presence of such bias inferences based on the clustering of case locations become unreliable.