A Monte Carlo Framework for Calibrated Uncertainty Estimation in Sequence Prediction

Probabilistic prediction of sequences from images and other high-dimensional data is a key challenge, particularly in risk-sensitive applications. In these settings, it is often desirable to quantify the uncertainty associated with the prediction (instead of just determining the most likely sequence, as in language modeling). In this paper, we propose a Monte Carlo framework to estimate probabilities and confidence intervals associated with the distribution of a discrete sequence. Our framework uses a Monte Carlo simulator, implemented as an autoregressively trained neural network, to sample sequences conditioned on an image input. We then use these samples to estimate the probabilities and confidence intervals. Experiments on synthetic and real data show that the framework produces accurate discriminative predictions, but can suffer from miscalibration. In order to address this shortcoming, we propose a time-dependent regularization method, which is shown to produce calibrated predictions.

Multi-modal AI for comprehensive breast cancer prognostication

Treatment selection in breast cancer is guided by molecular subtypes and clinical characteristics. Recurrence risk assessment plays a crucial role in personalizing treatment. Current methods, including genomic assays, have limited accuracy and clinical utility, leading to suboptimal decisions for many patients. We developed a test for breast cancer patient stratification based on digital pathology and clinical characteristics using novel AI methods. Specifically, we utilized a vision transformer-based pan-cancer foundation model trained with self-supervised learning to extract features from digitized H&E-stained slides. These features were integrated with clinical data to form a multi-modal AI test predicting cancer recurrence and death. The test was developed and evaluated using data from a total of 8,161 breast cancer patients across 15 cohorts originating from seven countries. Of these, 3,502 patients from five cohorts were used exclusively for evaluation, while the remaining patients were used for training. Our test accurately predicted our primary endpoint, disease-free interval, in the five external cohorts (C-index: 0.71 [0.68-0.75], HR: 3.63 [3.02-4.37, p<0.01]). In a direct comparison (N=858), the AI test was more accurate than Oncotype DX, the standard-of-care 21-gene assay, with a C-index of 0.67 [0.61-0.74] versus 0.61 [0.49-0.73], respectively. Additionally, the AI test added independent information to Oncotype DX in a multivariate analysis (HR: 3.11 [1.91-5.09, p<0.01)]). The test demonstrated robust accuracy across all major breast cancer subtypes, including TNBC (C-index: 0.71 [0.62-0.81], HR: 3.81 [2.35-6.17, p=0.02]), where no diagnostic tools are currently recommended by clinical guidelines. These results suggest that our AI test can improve accuracy, extend applicability to a wider range of patients, and enhance access to treatment selection tools.

Understanding differences in applying DETR to natural and medical images

Transformer-based detectors have shown success in computer vision tasks with natural images. These models, exemplified by the Deformable DETR, are optimized through complex engineering strategies tailored to the typical characteristics of natural scenes. However, medical imaging data presents unique challenges such as extremely large image sizes, fewer and smaller regions of interest, and object classes which can be differentiated only through subtle differences. This study evaluates the applicability of these transformer-based design choices when applied to a screening mammography dataset that represents these distinct medical imaging data characteristics. Our analysis reveals that common design choices from the natural image domain, such as complex encoder architectures, multi-scale feature fusion, query initialization, and iterative bounding box refinement, do not improve and sometimes even impair object detection performance in medical imaging. In contrast, simpler and shallower architectures often achieve equal or superior results. This finding suggests that the adaptation of transformer models for medical imaging data requires a reevaluation of standard practices, potentially leading to more efficient and specialized frameworks for medical diagnosis.

Making Self-supervised Learning Robust to Spurious Correlation via Learning-speed Aware Sampling

Self-supervised learning (SSL) has emerged as a powerful technique for learning rich representations from unlabeled data. The data representations are able to capture many underlying attributes of data, and be useful in downstream prediction tasks. In real-world settings, spurious correlations between some attributes (e.g. race, gender and age) and labels for downstream tasks often exist, e.g. cancer is usually more prevalent among elderly patients. In this paper, we investigate SSL in the presence of spurious correlations and show that the SSL training loss can be minimized by capturing only a subset of the conspicuous features relevant to those sensitive attributes, despite the presence of other important predictive features for the downstream tasks. To address this issue, we investigate the learning dynamics of SSL and observe that the learning is slower for samples that conflict with such correlations (e.g. elder patients without cancer). Motivated by these findings, we propose a learning-speed aware SSL (LA-SSL) approach, in which we sample each training data with a probability that is inversely related to its learning speed. We evaluate LA-SSL on three datasets that exhibit spurious correlations between different attributes, demonstrating that it improves the robustness of pretrained representations on downstream classification tasks.

Quantifying Impairment and Disease Severity Using AI Models Trained on Healthy Subjects

Automatic assessment of impairment and disease severity is a key challenge in data-driven medicine. We propose a novel framework to address this challenge, which leverages AI models trained exclusively on healthy individuals. The COnfidence-Based chaRacterization of Anomalies (COBRA) score exploits the decrease in confidence of these models when presented with impaired or diseased patients to quantify their deviation from the healthy population. We applied the COBRA score to address a key limitation of current clinical evaluation of upper-body impairment in stroke patients. The gold-standard Fugl-Meyer Assessment (FMA) requires in-person administration by a trained assessor for 30-45 minutes, which restricts monitoring frequency and precludes physicians from adapting rehabilitation protocols to the progress of each patient. The COBRA score, computed automatically in under one minute, is shown to be strongly correlated with the FMA on an independent test cohort for two different data modalities: wearable sensors ($\rho = 0.845$, 95% CI [0.743,0.908]) and video ($\rho = 0.746$, 95% C.I [0.594, 0.847]). To demonstrate the generalizability of the approach to other conditions, the COBRA score was also applied to quantify severity of knee osteoarthritis from magnetic-resonance imaging scans, again achieving significant correlation with an independent clinical assessment ($\rho = 0.644$, 95% C.I [0.585,0.696]).

Principled and Efficient Transfer Learning of Deep Models via Neural Collapse

With the ever-growing model size and the limited availability of labeled training data, transfer learning has become an increasingly popular approach in many science and engineering domains. For classification problems, this work delves into the mystery of transfer learning through an intriguing phenomenon termed neural collapse (NC), where the last-layer features and classifiers of learned deep networks satisfy: (i) the within-class variability of the features collapses to zero, and (ii) the between-class feature means are maximally and equally separated. Through the lens of NC, our findings for transfer learning are the following: (i) when pre-training models, preventing intra-class variability collapse (to a certain extent) better preserves the intrinsic structures of the input data, so that it leads to better model transferability; (ii) when fine-tuning models on downstream tasks, obtaining features with more NC on downstream data results in better test accuracy on the given task. The above results not only demystify many widely used heuristics in model pre-training (e.g., data augmentation, projection head, self-supervised learning), but also leads to more efficient and principled fine-tuning method on downstream tasks that we demonstrate through extensive experimental results.

Avoiding spurious correlations via logit correction

Empirical studies suggest that machine learning models trained with empirical risk minimization (ERM) often rely on attributes that may be spuriously correlated with the class labels. Such models typically lead to poor performance during inference for data lacking such correlations. In this work, we explicitly consider a situation where potential spurious correlations are present in the majority of training data. In contrast with existing approaches, which use the ERM model outputs to detect the samples without spurious correlations, and either heuristically upweighting or upsampling those samples; we propose the logit correction (LC) loss, a simple yet effective improvement on the softmax cross-entropy loss, to correct the sample logit. We demonstrate that minimizing the LC loss is equivalent to maximizing the group-balanced accuracy, so the proposed LC could mitigate the negative impacts of spurious correlations. Our extensive experimental results further reveal that the proposed LC loss outperforms the SoTA solutions on multiple popular benchmarks by a large margin, an average 5.5% absolute improvement, without access to spurious attribute labels. LC is also competitive with oracle methods that make use of the attribute labels. Code is available at https://github.com/shengliu66/LC.

Multiple Instance Learning via Iterative Self-Paced Supervised Contrastive Learning

Learning representations for individual instances when only bag-level labels are available is a fundamental challenge in multiple instance learning (MIL). Recent works have shown promising results using contrastive self-supervised learning (CSSL), which learns to push apart representations corresponding to two different randomly-selected instances. Unfortunately, in real-world applications such as medical image classification, there is often class imbalance, so randomly-selected instances mostly belong to the same majority class, which precludes CSSL from learning inter-class differences. To address this issue, we propose a novel framework, Iterative Self-paced Supervised Contrastive Learning for MIL Representations (ItS2CLR), which improves the learned representation by exploiting instance-level pseudo labels derived from the bag-level labels. The framework employs a novel self-paced sampling strategy to ensure the accuracy of pseudo labels. We evaluate ItS2CLR on three medical datasets, showing that it improves the quality of instance-level pseudo labels and representations, and outperforms existing MIL methods in terms of both bag and instance level accuracy.

Evaluating Unsupervised Denoising Requires Unsupervised Metrics

Unsupervised denoising is a crucial challenge in real-world imaging applications. Unsupervised deep-learning methods have demonstrated impressive performance on benchmarks based on synthetic noise. However, no metrics are available to evaluate these methods in an unsupervised fashion. This is highly problematic for the many practical applications where ground-truth clean images are not available. In this work, we propose two novel metrics: the unsupervised mean squared error (MSE) and the unsupervised peak signal-to-noise ratio (PSNR), which are computed using only noisy data. We provide a theoretical analysis of these metrics, showing that they are asymptotically consistent estimators of the supervised MSE and PSNR. Controlled numerical experiments with synthetic noise confirm that they provide accurate approximations in practice. We validate our approach on real-world data from two imaging modalities: videos in raw format and transmission electron microscopy. Our results demonstrate that the proposed metrics enable unsupervised evaluation of denoising methods based exclusively on noisy data.

Interpretable Prediction of Lung Squamous Cell Carcinoma Recurrence With Self-supervised Learning

Lung squamous cell carcinoma (LSCC) has a high recurrence and metastasis rate. Factors influencing recurrence and metastasis are currently unknown and there are no distinct histopathological or morphological features indicating the risks of recurrence and metastasis in LSCC. Our study focuses on the recurrence prediction of LSCC based on H&E-stained histopathological whole-slide images (WSI). Due to the small size of LSCC cohorts in terms of patients with available recurrence information, standard end-to-end learning with various convolutional neural networks for this task tends to overfit. Also, the predictions made by these models are hard to interpret. Histopathology WSIs are typically very large and are therefore processed as a set of smaller tiles. In this work, we propose a novel conditional self-supervised learning (SSL) method to learn representations of WSI at the tile level first, and leverage clustering algorithms to identify the tiles with similar histopathological representations. The resulting representations and clusters from self-supervision are used as features of a survival model for recurrence prediction at the patient level. Using two publicly available datasets from TCGA and CPTAC, we show that our LSCC recurrence prediction survival model outperforms both LSCC pathological stage-based approach and machine learning baselines such as multiple instance learning. The proposed method also enables us to explain the recurrence histopathological risk factors via the derived clusters. This can help pathologists derive new hypotheses regarding morphological features associated with LSCC recurrence.