While deep networks have achieved broad success in analyzing natural images, when applied to medical scans, they often fail in unexcepted situations. We investigate this challenge and focus on model sensitivity to domain shifts, such as data sampled from different hospitals or data confounded by demographic variables such as sex, race, etc, in the context of chest X-rays and skin lesion images. A key finding we show empirically is that existing visual backbones lack an appropriate prior from the architecture for reliable generalization in these settings. Taking inspiration from medical training, we propose giving deep networks a prior grounded in explicit medical knowledge communicated in natural language. To this end, we introduce Knowledge-enhanced Bottlenecks (KnoBo), a class of concept bottleneck models that incorporates knowledge priors that constrain it to reason with clinically relevant factors found in medical textbooks or PubMed. KnoBo uses retrieval-augmented language models to design an appropriate concept space paired with an automatic training procedure for recognizing the concept. We evaluate different resources of knowledge and recognition architectures on a broad range of domain shifts across 20 datasets. In our comprehensive evaluation with two imaging modalities, KnoBo outperforms fine-tuned models on confounded datasets by 32.4% on average. Finally, evaluations reveal that PubMed is a promising resource for making medical models less sensitive to domain shift, outperforming other resources on both diversity of information and final prediction performance.

A fundamental characteristic common to both human vision and natural language is their compositional nature. Yet, despite the performance gains contributed by large vision and language pretraining, we find that-across 7 architectures trained with 4 algorithms on massive datasets-they struggle at compositionality. To arrive at this conclusion, we introduce a new compositionality evaluation benchmark, @ CREPE, which measures two important aspects of compositionality identified by cognitive science literature: system-aticity and productivity. To measure systematicity, CREPE consists of a test dataset containing over 370K image-text pairs and three different seen-unseen splits. The three splits are designed to test models trained on three popular training datasets: CC-12M, YFCC-15M, and LAION-400M. We also generate 325K, 316K, and 309K hard negative captions for a subset of the pairs. To test productivity, CREPE contains 17 K image-text pairs with nine different complexities plus 278K hard negative captions with atomic, swapping and negation foils. The datasets are generated by repurposing the Visual Genome scene graphs and region descriptions and applying handcrafted templates and GPT-3. For systematicity, we find that model performance decreases consistently when novel compositions dominate the retrieval set, with Recall@1 dropping by up to 9%. For productivity, models' retrieval success decays as complexity increases, frequently nearing random chance at high complexity. These results hold regardless of model and training dataset size.

Recent video question answering benchmarks indicate that state-of-the-art models struggle to answer compositional questions. However, it remains unclear which types of compositional reasoning cause models to mispredict. Furthermore, it is difficult to discern whether models arrive at answers using compositional reasoning or by leveraging data biases. In this paper, we develop a question decomposition engine that programmatically deconstructs a compositional question into a directed acyclic graph of sub-questions. The graph is designed such that each parent question is a composition of its children. We present AGQA-Decomp, a benchmark containing 2.3M question graphs, with an average of 11.49 sub-questions per graph, and 4.55M total new sub-questions. Using question graphs, we evaluate three state-of-the-art models with a suite of novel compositional consistency metrics. We find that models either cannot reason correctly through most compositions or are reliant on incorrect reasoning to reach answers, frequently contradicting themselves or achieving high accuracies when failing at intermediate reasoning steps.