arXiv Machine Learning

Revisiting Performance Claims for Chest X-Ray Models Using Clinical Context

arXiv:2509. 19671v3 Announce Type: replace Abstract: Public datasets of Chest X-Rays (CXRs) have long been a popular benchmark for developing machine learning (ML) computer vision models in healthcare.

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

C$^2$A: Coupling Spatial Evidence with Clinical Priors via Co-occurrence Aware Class Attention for Multi-Label Chest X-Ray Classification

arXiv:2608. 09774v1 Announce Type: cross Abstract: Thoracic pathologies rarely occur in isolation, yet standard multi-label classifiers rely on shared global descriptors, discarding \emph{where} findings lie and \emph{how} they co-occur.

By Akash Gogineni, Nagur Shareef Shaik, Aasrith Mandava, Adnan Masood, Dong Hye Ye
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
Hugging Face Trending Papers
Jun 29

SHOVIR: A Benchmark for Evaluating Vision Shortcut Learning in Radiology Report Generation

Current evaluation protocols for Vision-Language Models (VLMs) in Radiology Report Generation (RRG) rely on report-level metrics that measure lexical overlap or aggregate clinical correctness. However, such metrics do not test whether individual diagnostic statements stem from the actual pathological evidence visible in the image.

arXiv Computer Vision
Sep 22

CXR-LT 2026 Challenge: Multi-Center Long-Tailed and Zero Shot Chest X-ray Classification

The CXR‑LT 2026 Challenge introduces a multi‑center, long‑tailed chest X‑ray classification benchmark with over 145,000 radiologist‑annotated images from PadChest and NIH datasets. It defines two core tasks: robust multi‑label classification on 30 known classes and open‑world generalization to 6 unseen rare disease classes. The paper outlines data collection, annotation, solution strategies, and evaluates performance across head‑vs‑tail, calibration, and cross‑center gaps, noting that vision‑language models improve in‑distribution and zero‑shot performance but rare‑finding detection under multi‑center shift remains difficult.

By Hexin Dong, Yi Lin, Pengyu Zhou, Fengnian Zhao, Alan Clint Legasto, Juno Cho, Dohui Kim, Justin Namuk Kim, Mingeon Kim, Sunwoo Kwak, Gabriel Moy\`a-Alcover, Ky Trung Nguyen, Thanh-Huy Nguyen, Ha-Hieu Pham, Huy-Hieu Pham, Huy Le Pham, Nikhileswara Rao Sulake, Aina Tur-Serrano, Ruichi Zhang, Ang Zu, Adam E. Flanders, Zhiyong Lu, Ronald M. Summers, Mingquan Lin, Hao Chen, Yuzhe Yang, George Shih, Yifan Peng
arXiv AI
Sep 17

Reporting Practice Matters: The Impact of Reference Choice on Chest X-ray Report Evaluation

The study examines how differences in radiologists’ reporting styles—such as terminology, shorthand, formatting, and detail—affect the evaluation of AI-generated chest X‑ray reports. By quantifying the sensitivity of common metrics to these variations, the authors show that changes in reference reports can shift model rankings. They introduce a taxonomy of reporting variations and a rewriting method, ReRef, that preserves clinical meaning while altering style, and release a validated dataset of paired reference reports to aid future research.

By Daniel P. Jeong, Charles Q. Li, Hossein Hosseiny, Nitya M. Bhalla, Fatma Uyar Morency, Pradeep Ravikumar, Zachary C. Lipton, Michael Oberst
arXiv Machine Learning
Aug 7

Positive-Unlabeled Preference Optimization For Chest X-ray Report Generation

arXiv:2608. 05341v1 Announce Type: cross Abstract: Vision-Language Models (VLMs) for radiology report generation are typically trained on retrospective clinical reports, which suffer from omission noise: clinically present findings are left unreported due to the omission of subtle findings.

By Yuta Kobayashi, Pradyun Ramesh, Muhammad Ahmed Chaudhry, Vincent Jeanselme, Judy Wawira Gichoya, Sanmi Koyejo, Kathleen Capaccione, Shalmali Joshi
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 Computer Vision
Aug 27

Label-Free Foundational Model Selection for Medical Image Classification under Distribution Shift via Pseudo Label Discrepancy

The paper introduces a label‑free method called AURCC for selecting the best foundational model for medical image classification when the target domain lacks labels. AURCC uses a pseudo‑label discrepancy computed by the SUDO framework to score models without fine‑tuning. Experiments on chest X‑ray data across three inter‑hospital shifts show that AURCC closely matches the true model ranking, outperforming simple source‑accuracy baselines especially when source data are limited.

By Juan I\~naki Larrea, Lucas Mansilla, Enzo Ferrante
arXiv Machine Learning
Aug 18

CoM$^3$eT: A foundation model for medical image analysis through federated, multidimensional context integration

arXiv:2608. 16268v1 Announce Type: cross Abstract: Medical foundation models improve generalization when training AI models with limited labeled data, but remain confined to a single specialty, such as pathology or radiology, and to either sparse or dense outputs, such as classification or segmentation.

By J. Raphael Sch\"afer, Kai Geissler, Till Nicke, Chiara Tappermann, Karoline Heber, Eike Petersen, Habib Mergan, Lars Ole Schwen, Nick Weiss, Annika Gerken, Jan Hendrik Moltz, Tom Bisson, Isil Dogan O, Tim-Rasmus Kiehl, Norman Zerbe, Sefer Elezkurtaj, Robin S. Mayer, Nadine Flinner, Peter Wild, Isabel Dahm, Felix Peisen, Heinrich von Busch, Robert Grimm, Sebastian Arndt, Lisa Siegler, Matthias Stefan May, Antje Prasse, Natalia Artysh, Fabian Kiessling, Johannes Lotz