arXiv AI

Benchmarking Classification Tasks of Chest X-ray AI Across Multinational Public and Private Datasets: a retrospective diagnostic accuracy study

The study evaluated ten chest X‑ray AI classification models on 12 datasets from six countries, focusing on image‑level classification and measuring specificity at 95% sensitivity. MAVL and MedKLIP achieved the highest specificity (≈0.37) but still produced many false positives, with performance dropping on institutional cohorts compared to public benchmarks. No single model excelled across all findings, countries, or lesion types, highlighting limited generalisability.

arXiv Machine Learning
Sep 21

Beyond Benchmark Scores: Auditing Medical Vision-Language Models for Chest X-Ray Tuberculosis Screening

The study evaluates the robustness of medical vision‑language models for tuberculosis screening on chest X‑rays by testing them across multiple datasets, prompts, and evaluation settings. Three specialized models (BioMedCLIP, CheXficient, MedSigLIP) and a general OpenCLIP model were audited on 12,200 images, producing 244,000 model–image–prompt scores. Results show that no model consistently outperforms others across all cohorts and reliability criteria, with prompt changes and control group composition significantly affecting AUROC, and that high training‑set performance does not reliably transfer to external cohorts.

By Mushir Akhtar, M. Tanveer, Mohd. Arshad
arXiv AI
Sep 25

Med-AR: Autoregressive Vision-Language Pretraining for Long-Tailed Chest X-Ray Classification and Uncertainty-Aware Evaluation

Med-AR introduces two autoregressive vision‑language models, Med‑AR‑8B and Med‑AR‑2B, pretrained on structured radiology reports, abnormality‑focused text, and region annotations to address long‑tailed chest X‑ray classification. The models outperform existing contrastive, self‑supervised, and supervised encoders—including Med‑CLIP, CheXFound, EVA‑Base, ARK, and BioViL‑T—across PadChest, MIMIC‑CXR, and CheXpert, achieving higher mean AUROC and AUPRC for head, medium, and tail findings and lower excess area under the risk‑coverage curve. Med‑AR also demonstrates improved selective‑prediction performance, with Med‑AR‑8B raising tail‑label mean AUPRC on MIMIC‑CXR from 0.1033 to 0.1441 and Med‑AR‑2B delivering the strongest discrimination on PadChest.

By Janhavi Prabhu, Sahil, Akshay V, Shivam Shukla, Manoj Tadepalli, Preetham Putha
arXiv Machine Learning
Jul 30

Rethinking Clinical Relevance in Chest X-ray Machine Learning: How Evaluation References Define Performance

arXiv:2607. 26333v1 Announce Type: cross Abstract: Chest X-ray (CXR) machine learning relies heavily on automated evaluation using reference standards that aim to approximate clinical judgment.

By Panagiotis Fytas, Ian Selby, Clemens Karner, Judith Babar, Simon Baker, Jake Beckford, Timothy J. Sadler, Shahab Shahipasand, Arthikkaa Thavakumar, John Li Chen, Alex Sawer, Michael Roberts, Jonathan Weir-McCall, J. H. F. Rudd, Carola-Bibiane Sch\"onlieb, Anna Korhonen, Anna Breger
arXiv Machine Learning
Aug 11

Auditing Medical Vision-Language Models on Chest Radiographs: Estimating Reference Agreement Across Institutions

arXiv:2608. 07550v1 Announce Type: cross Abstract: Vision-language models return structured chest-radiograph findings through interfaces exposing no confidence score, so a receiving institution cannot read off how far to trust an individual judgment.

By Pengyang Yu, Yiou Wang, Zhongping Dong, Sahraoui Dhelim, Chun-Mei Feng, M. Tahar Kechadi
arXiv Machine Learning
Oct 23

The Value of System 1 Models in Medicine

The study evaluates four zero‑shot System 1 models on 86 public clinical tasks across 14 domains and 20 languages, measuring performance via AUROC. The best models achieved high AUROC scores—0.94 for medical knowledge, 0.93 for text understanding, 0.83 for clinical judgement from text, 0.89 for image perception, 0.84 for 2D image findings, and 0.69 for volumetric findings—yet performed worse on imaging tasks and varied significantly with language. System 1 models were fast (0.34–0.44 s) and energy‑efficient (24–81 J) but lagged behind clinicians on triage and were outperformed by generative models in some metrics.

By Xiufeng Yang, Konstantinos Vrettos, Zeineb Ben Chaaben, Fabian Drexel, Jannik L\"ubberstedt, Johannes Moll, Anirudh Narayanan, Frederike Stumpf, Cosmin I. Bercea, Jiawen Wang, Evangelia E. Vassalou, Krischan Braitsch, Sebastian Ziegelmayer, Markus Graf, Marcus R. Makowski, Lisa Adams, Nassir Navab, Michail E. Klontzas, Keno Bressem
arXiv Computer Vision
Sep 4

Subgroup performance analysis of adaptation strategies for chest X-ray foundation models

The study examines how three parameter‑efficient adaptation methods—linear heads on the raw CLS token, an MLP, and an attention‑pooling module—affect pathology classification accuracy and subgroup fairness when applied to a frozen Rad‑DINO chest X‑ray encoder. Using the MIMIC‑CXR dataset, the authors evaluate eight pathologies across race, sex, and imaging‑view subgroups, finding that attention pooling yields the best overall performance and encodes protected attributes most strongly, yet higher performance does not consistently reduce subgroup disparities. The results show that attribute encoding strength and layer choice do not reliably predict fairness outcomes, indicating that fairness must be assessed directly for each task.

By Dhruv Gupta, Emma A. M. Stanley, Fabio De Sousa Ribeiro, Sujal R. Desai, Ben Glocker
Hugging Face Trending Papers
Sep 4

Cross-dataset transportability of pediatric chest X-ray deep learning across three countries: discrimination, calibration, operating-point failure, and limited-label recovery

The study evaluates a deep‑learning model for pediatric pneumonia detection across three countries, testing not only discrimination but also probability calibration, fixed operating‑point transport, shortcut signals, and limited‑label recoverability. Using a DenseNet121 ensemble trained on Guangzhou data, the model achieved high internal AUROC (0.976) but performance dropped to 0.798 and 0.742 on Bangladeshi and Vietnamese datasets, respectively. Limited‑label adaptation with Platt recalibration restored sensitivity but introduced significant specificity variability, highlighting the need for comprehensive cross‑dataset evaluation.