Standard training via empirical risk minimization (ERM) can produce models that achieve low error on average but high error on minority groups, especially in the presence of spurious correlations between the input and label. Prior approaches to this problem, like group distributionally robust optimization (group DRO), generally require group annotations for every training point. On the other hand, approaches that do not use group annotations generally do not improve minority performance. For example, we find that joint DRO, which dynamically upweights examples with high training loss, tends to optimize for examples that are irrelevant to the specific groups we seek to do well on. In this paper, we propose a simple two-stage approach, JTT, that achieves comparable performance to group DRO while only requiring group annotations on a significantly smaller validation set. JTT first attempts to identify informative training examples, which are often minority examples, by training an initial ERM classifier and selecting the examples with high training loss. Then, it trains a final classifier by upsampling the selected examples. Crucially, unlike joint DRO, JTT does not iteratively upsample examples that have high loss under the final classifier. On four image classification and natural language processing tasks with spurious correlations, we show that JTT closes 85% of the gap in accuracy on the worst group between ERM and group DRO.

Large, labeled datasets have driven deep learning methods to achieve expert-level performance on a variety of medical imaging tasks. We present CheXpert, a large dataset that contains 224,316 chest radiographs of 65,240 patients. We design a labeler to automatically detect the presence of 14 observations in radiology reports, capturing uncertainties inherent in radiograph interpretation. We investigate different approaches to using the uncertainty labels for training convolutional neural networks that output the probability of these observations given the available frontal and lateral radiographs. On a validation set of 200 chest radiographic studies which were manually annotated by 3 board-certified radiologists, we find that different uncertainty approaches are useful for different pathologies. We then evaluate our best model on a test set composed of 500 chest radiographic studies annotated by a consensus of 5 board-certified radiologists, and compare the performance of our model to that of 3 additional radiologists in the detection of 5 selected pathologies. On Cardiomegaly, Edema, and Pleural Effusion, the model ROC and PR curves lie above all 3 radiologist operating points. We release the dataset to the public as a standard benchmark to evaluate performance of chest radiograph interpretation models.