Leakage- and Label-Aware Benchmarking of Class-Imbalance Strategies for Multimodal Chest X-Ray and EHR Classification
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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.
The study evaluates how well different medical foundation models agree on image embeddings by measuring mutual k‑nearest‑neighbor overlap across 750,000 images from 14 datasets and 18 public models. Results show that label‑supervised models converge the least, sharing only 6–10% of nearest neighbors, whereas models trained with self‑distillation, masked image modeling, or contrastive pretraining share up to 80%. The authors suggest that developers can select pretraining objectives to control convergence and recommend testing unlabeled images for nearest‑neighbor consistency before replacing a model.
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.
The study evaluates a deep‑learning model for pediatric pneumonia detection across chest X‑ray datasets from three countries, assessing discrimination, calibration, operating‑point transport, shortcut signals, and limited‑label recovery. Using a frozen DenseNet121 ensemble trained on Guangzhou data, the model achieved high internal AUROC (0.976) but performance dropped when applied zero‑shot to Bangladesh (AUROC 0.798) and Vietnam (AUROC 0.742). Limited‑label adaptation with Platt recalibration restored sensitivity but introduced significant specificity variability, highlighting the need to evaluate multiple performance dimensions in cross‑dataset transport studies.
The paper introduces MedDream, a radiographic world model that learns a shared continuous latent state from paired chest radiograph-text observations. MedDream outperforms existing diagnostic and generative AI models across eight clinical datasets, improving diagnostic reasoning, resident concordance, and evidence generation. Targeted synthetic augmentation guided by subgroup performance gaps further enhances model performance, particularly for Asian patients.
arXiv:2607. 05628v1 Announce Type: cross Abstract: Accurate and efficient classification of thoracic diseases in chest X-ray (CXR) images is crucial for timely diagnosis and treatment.