Ensembling strategies for Large Language Models (LLMs) have demonstrated significant potential in improving performance across various tasks by combining the strengths of individual models. However, identifying the most effective ensembling method remains an open challenge, as neither maximizing output consistency through self-consistency decoding nor enhancing model diversity via frameworks like "Mixture of Agents" has proven universally optimal. Motivated by this, we propose a unified framework to examine the trade-offs between task performance, model diversity, and output consistency in ensembles. More specifically, we introduce a consistency score that defines a gating mechanism for mixtures of agents and an algorithm for mixture refinement to investigate these trade-offs at the semantic and model levels, respectively. We incorporate our insights into a novel inference-time LLM ensembling strategy called the Dynamic Mixture of Agents (DMoA) and demonstrate that it achieves a new state-of-the-art result in the challenging Big Bench Hard mixed evaluations benchmark. Our analysis reveals that cross-validation bias can enhance performance, contingent on the expertise of the constituent models. We further demonstrate that distinct reasoning tasks—such as arithmetic reasoning, commonsense reasoning, and instruction following—require different model capabilities, leading to inherent task-dependent trade-offs that DMoA balances effectively.

We investigate the prominent class of fair representation learning methods for bias mitigation. Using causal reasoning to define and formalise different sources of dataset bias, we reveal important implicit assumptions inherent to these methods. We prove fundamental limitations on fair representation learning when evaluation data is drawn from the same distribution as training data and run experiments across a range of medical modalities to examine the performance of fair representation learning under distribution shifts. Our results explain apparent contradictions in the existing literature and reveal how rarely considered causal and statistical aspects of the underlying data affect the validity of fair representation learning. We raise doubts about current evaluation practices and the applicability of fair representation learning methods in performance-sensitive settings. We argue that fine-grained analysis of dataset biases should play a key role in the field moving forward.

Nasogastric tubes (NGTs) are feeding tubes that are inserted through the nose into the stomach to deliver nutrition or medication. If not placed correctly, they can cause serious harm, even death to patients. Recent AI developments demonstrate the feasibility of robustly detecting NGT placement from Chest X-ray images to reduce risks of sub-optimally or critically placed NGTs being missed or delayed in their detection, but gaps remain in clinical practice integration. In this study, we present a human-centered approach to the problem and describe insights derived following contextual inquiry and in-depth interviews with 15 clinical stakeholders. The interviews helped understand challenges in existing workflows, and how best to align technical capabilities with user needs and expectations. We discovered the tradeoffs and complexities that need consideration when choosing suitable workflow stages, target users, and design configurations for different AI proposals. We explored how to balance AI benefits and risks for healthcare staff and patients within broader organizational, technical, and medical-legal constraints. We also identified data issues related to edge cases and data biases that affect model training and evaluation; how data documentation practices influence data preparation and labeling; and how to measure relevant AI outcomes reliably in future evaluations. We discuss how our work informs design and development of AI applications that are clinically useful, ethical, and acceptable in real-world healthcare services.

Recent advances in AI combine large language models (LLMs) with vision encoders that bring forward unprecedented technical capabilities to leverage for a wide range of healthcare applications. Focusing on the domain of radiology, vision-language models (VLMs) achieve good performance results for tasks such as generating radiology findings based on a patient’s medical image, or answering visual questions (e.g., “Where are the nodules in this chest X-ray?”). However, the clinical utility of potential applications of these capabilities is currently underexplored. We engaged in an iterative, multidisciplinary design process to envision clinically relevant VLM interactions, and co-designed four VLM use concepts: Draft Report Generation, Augmented Report Review, Visual Search and Querying, and Patient Imaging History Highlights. We studied these concepts with 13 radiologists and clinicians who assessed the VLM concepts as valuable, yet articulated many design considerations. Reflecting on our findings, we discuss implications for integrating VLM capabilities in radiology, and for healthcare AI more generally.

Scientific discovery hinges on the effective integration of metadata, which refers to a set of 'cognitive' operations such as determining what information is relevant for inquiry, and data, which encompasses physical operations such as observation and experimentation. This paper introduces the Causal Modelling Agent (CMA), a novel framework that synergizes the metadata-based reasoning capabilities of Large Language Models (LLMs) with the data-driven modelling of Deep Structural Causal Models (DSCMs) for the task of causal discovery. We evaluate the CMA's performance on a number of benchmarks, as well as on the real-world task of modelling the clinical and radiological phenotype of Alzheimer's Disease (AD). Our experimental results indicate that the CMA can outperform previous data-driven or metadata-driven approaches to causal discovery. In our real-world application, we use the CMA to derive new insights into the causal relationships among biomarkers of AD.

Self-supervised learning in vision-language processing (VLP) exploits semantic alignment between imaging and text modalities. Prior work in biomedical VLP has mostly relied on the alignment of single image and report pairs even though clinical notes commonly refer to prior images. This does not only introduce poor alignment between the modalities but also a missed opportunity to exploit rich self-supervision through existing temporal content in the data. In this work, we explicitly account for prior images and reports when available during both training and fine-tuning. Our approach, named BioViL-T, uses a CNN-Transformer hybrid multi-image encoder trained jointly with a text model. It is designed to be versatile to arising challenges such as pose variations and missing input images across time. The resulting model excels on downstream tasks both in single- and multi-image setups, achieving state-of-the-art (SOTA) performance on (I) progression classification, (II) phrase grounding, and (III) report generation, whilst offering consistent improvements on disease classification and sentence-similarity tasks. We release a novel multi-modal temporal benchmark dataset, MS-CXR-T, to quantify the quality of vision-language representations in terms of temporal semantics. Our experimental results show the advantages of incorporating prior images and reports to make most use of the data.

Qianchu Liu, Stephanie Hyland, Shruthi Bannur, Kenza Bouzid, Daniel Castro, Maria Wetscherek, Robert Tinn, Harshita Sharma, Fernando Pérez-García, Anton Schwaighofer, Pranav Rajpurkar, Sameer Khanna, Hoifung Poon, Naoto Usuyama, Anja Thieme, Aditya Nori, Matthew Lungren, Ozan Oktay, Javier Alvarez-Valle. Proceedings of the 2023 Conference on Empirical Methods in Natural Language Processing. 2023.

In image segmentation, there is often more than one plausible solution for a given input. In medical imaging, for example, experts will often disagree about the exact location of object boundaries. Estimating this inherent uncertainty and predicting multiple plausible hypotheses is of great interest in many applications, yet this ability is lacking in most current deep learning methods. In this paper, we introduce stochastic segmentation networks (SSNs), an efficient probabilistic method for modelling aleatoric uncertainty with any image segmentation network architecture. In contrast to approaches that produce pixel-wise estimates, SSNs model joint distributions over entire label maps and thus can generate multiple spatially coherent hypotheses for a single image. By using a low-rank multivariate normal distribution over the logit space to model the probability of the label map given the image, we obtain a spatially consistent probability distribution that can be efficiently computed by a neural network without any changes to the underlying architecture. We tested our method on the segmentation of real-world medical data, including lung nodules in 2D CT and brain tumours in 3D multimodal MRI scans. SSNs outperform state-of-the-art for modelling correlated uncertainty in ambiguous images while being much simpler, more flexible, and more efficient.

We formulate a general framework for building structural causal models (SCMs) with deep learning components. The proposed approach employs normalising flows and variational inference to enable tractable inference of exogenous noise variables - a crucial step for counterfactual inference that is missing from existing deep causal learning methods. Our framework is validated on a synthetic dataset built on MNIST as well as on a real-world medical dataset of brain MRI scans. Our experimental results indicate that we can successfully train deep SCMs that are capable of all three levels of Pearl's ladder of causation: association, intervention, and counterfactuals, giving rise to a powerful new approach for answering causal questions in imaging applications and beyond.

Generalization capability to unseen domains is crucial for machine learning models when deploying to real-world conditions. We investigate the challenging problem of domain generalization, i.e., training a model on multi-domain source data such that it can directly generalize to target domains with unknown statistics. We adopt a model-agnostic learning paradigm with gradient-based meta-train and meta-test procedures to expose the optimization to domain shift. Further, we introduce two complementary losses which explicitly regularize the semantic structure of the feature space. Globally, we align a derived soft confusion matrix to preserve general knowledge of inter-class relationships. Locally, we promote domain-independent class-specific cohesion and separation of sample features with a metric-learning component. The effectiveness of our method is demonstrated with new state-of-the-art results on two common object recognition benchmarks. Our method also shows consistent improvement on a medical image segmentation task.

Revealing latent structure in data is an active field of research, having introduced exciting technologies such as variational autoencoders and adversarial networks, and is essential to push machine learning towards unsupervised knowledge discovery. However, a major challenge is the lack of suitable benchmarks for an objective and quantitative evaluation of learned representations. To address this issue we introduce Morpho-MNIST, a framework that aims to answer: “to what extent has my model learned to represent specific factors of variation in the data? We extend the popular MNIST dataset by adding a morphometric analysis enabling quantitative comparison of trained models, identification of the roles of latent variables, and characterisation of sample diversity. We further propose a set of quantifiable perturbations to assess the performance of unsupervised and supervised methods on challenging tasks such as outlier detection and domain adaptation. Data and code are available at https://github.com/dccastro/Morpho-MNIST.

We present a novel cost function for semi-supervised learning of neural networks that encourages compact clustering of the latent space to facilitate separation. The key idea is to dynamically create a graph over embeddings of labeled and unlabeled samples of a training batch to capture underlying structure in feature space, and use label propagation to estimate its high and low density regions. We then devise a cost function based on Markov chains on the graph that regularizes the latent space to form a single compact cluster per class, while avoiding to disturb existing clusters during optimization. We evaluate our approach on three benchmarks and compare to state-of-the art with promising results. Our approach combines the benefits of graph-based regularization with efficient, inductive inference, does not require modifications to a network architecture, and can thus be easily applied to existing networks to enable an effective use of unlabeled data.