Diffusion Counterfactual Generation with Semantic Abduction

Counterfactual image generation presents significant challenges, including preserving identity, maintaining perceptual quality, and ensuring faithfulness to an underlying causal model. While existing auto-encoding frameworks admit semantic latent spaces which can be manipulated for causal control, they struggle with scalability and fidelity. Advancements in diffusion models present opportunities for improving counterfactual image editing, having demonstrated state-of-the-art visual quality, human-aligned perception and representation learning capabilities. Here, we present a suite of diffusion-based causal mechanisms, introducing the notions of spatial, semantic and dynamic abduction. We propose a general framework that integrates semantic representations into diffusion models through the lens of Pearlian causality to edit images via a counterfactual reasoning process. To our knowledge, this is the first work to consider high-level semantic identity preservation for diffusion counterfactuals and to demonstrate how semantic control enables principled trade-offs between faithful causal control and identity preservation.

Identifiable Object Representations under Spatial Ambiguities

Modular object-centric representations are essential for *human-like reasoning* but are challenging to obtain under spatial ambiguities, *e.g. due to occlusions and view ambiguities*. However, addressing challenges presents both theoretical and practical difficulties. We introduce a novel multi-view probabilistic approach that aggregates view-specific slots to capture *invariant content* information while simultaneously learning disentangled global *viewpoint-level* information. Unlike prior single-view methods, our approach resolves spatial ambiguities, provides theoretical guarantees for identifiability, and requires *no viewpoint annotations*. Extensive experiments on standard benchmarks and novel complex datasets validate our method's robustness and scalability.

Average Calibration Losses for Reliable Uncertainty in Medical Image Segmentation

Deep neural networks for medical image segmentation are often overconfident, compromising both reliability and clinical utility. In this work, we propose differentiable formulations of marginal L1 Average Calibration Error (mL1-ACE) as an auxiliary loss that can be computed on a per-image basis. We compare both hard- and soft-binning approaches to directly improve pixel-wise calibration. Our experiments on four datasets (ACDC, AMOS, KiTS, BraTS) demonstrate that incorporating mL1-ACE significantly reduces calibration errors, particularly Average Calibration Error (ACE) and Maximum Calibration Error (MCE), while largely maintaining high Dice Similarity Coefficients (DSCs). We find that the soft-binned variant yields the greatest improvements in calibration, over the Dice plus cross-entropy loss baseline, but often compromises segmentation performance, with hard-binned mL1-ACE maintaining segmentation performance, albeit with weaker calibration improvement. To gain further insight into calibration performance and its variability across an imaging dataset, we introduce dataset reliability histograms, an aggregation of per-image reliability diagrams. The resulting analysis highlights improved alignment between predicted confidences and true accuracies. Overall, our approach not only enhances the trustworthiness of segmentation predictions but also shows potential for safer integration of deep learning methods into clinical workflows. We share our code here: https://github.com/cai4cai/Average-Calibration-Losses

Subgroups Matter for Robust Bias Mitigation

Despite the constant development of new bias mitigation methods for machine learning, no method consistently succeeds, and a fundamental question remains unanswered: when and why do bias mitigation techniques fail? In this paper, we hypothesise that a key factor may be the often-overlooked but crucial step shared by many bias mitigation methods: the definition of subgroups. To investigate this, we conduct a comprehensive evaluation of state-of-the-art bias mitigation methods across multiple vision and language classification tasks, systematically varying subgroup definitions, including coarse, fine-grained, intersectional, and noisy subgroups. Our results reveal that subgroup choice significantly impacts performance, with certain groupings paradoxically leading to worse outcomes than no mitigation at all. Our findings suggest that observing a disparity between a set of subgroups is not a sufficient reason to use those subgroups for mitigation. Through theoretical analysis, we explain these phenomena and uncover a counter-intuitive insight that, in some cases, improving fairness with respect to a particular set of subgroups is best achieved by using a different set of subgroups for mitigation. Our work highlights the importance of careful subgroup definition in bias mitigation and presents it as an alternative lever for improving the robustness and fairness of machine learning models.

Calibration and Uncertainty for multiRater Volume Assessment in multiorgan Segmentation (CURVAS) challenge results

Deep learning (DL) has become the dominant approach for medical image segmentation, yet ensuring the reliability and clinical applicability of these models requires addressing key challenges such as annotation variability, calibration, and uncertainty estimation. This is why we created the Calibration and Uncertainty for multiRater Volume Assessment in multiorgan Segmentation (CURVAS), which highlights the critical role of multiple annotators in establishing a more comprehensive ground truth, emphasizing that segmentation is inherently subjective and that leveraging inter-annotator variability is essential for robust model evaluation. Seven teams participated in the challenge, submitting a variety of DL models evaluated using metrics such as Dice Similarity Coefficient (DSC), Expected Calibration Error (ECE), and Continuous Ranked Probability Score (CRPS). By incorporating consensus and dissensus ground truth, we assess how DL models handle uncertainty and whether their confidence estimates align with true segmentation performance. Our findings reinforce the importance of well-calibrated models, as better calibration is strongly correlated with the quality of the results. Furthermore, we demonstrate that segmentation models trained on diverse datasets and enriched with pre-trained knowledge exhibit greater robustness, particularly in cases deviating from standard anatomical structures. Notably, the best-performing models achieved high DSC and well-calibrated uncertainty estimates. This work underscores the need for multi-annotator ground truth, thorough calibration assessments, and uncertainty-aware evaluations to develop trustworthy and clinically reliable DL-based medical image segmentation models.

Combining imaging and shape features for prediction tasks of Alzheimer's disease classification and brain age regression

We investigate combining imaging and shape features extracted from MRI for the clinically relevant tasks of brain age prediction and Alzheimer's disease classification. Our proposed model fuses ResNet-extracted image embeddings with shape embeddings from a bespoke graph neural network. The shape embeddings are derived from surface meshes of 15 brain structures, capturing detailed geometric information. Combined with the appearance features from T1-weighted images, we observe improvements in the prediction performance on both tasks, with substantial gains for classification. We evaluate the model using public datasets, including CamCAN, IXI, and OASIS3, demonstrating the effectiveness of fusing imaging and shape features for brain analysis.

Continuous Bayesian Model Selection for Multivariate Causal Discovery

Current causal discovery approaches require restrictive model assumptions or assume access to interventional data to ensure structure identifiability. These assumptions often do not hold in real-world applications leading to a loss of guarantees and poor accuracy in practice. Recent work has shown that, in the bivariate case, Bayesian model selection can greatly improve accuracy by exchanging restrictive modelling for more flexible assumptions, at the cost of a small probability of error. We extend the Bayesian model selection approach to the important multivariate setting by making the large discrete selection problem scalable through a continuous relaxation. We demonstrate how for our choice of Bayesian non-parametric model, the Causal Gaussian Process Conditional Density Estimator (CGP-CDE), an adjacency matrix can be constructed from the model hyperparameters. This adjacency matrix is then optimised using the marginal likelihood and an acyclicity regulariser, outputting the maximum a posteriori causal graph. We demonstrate the competitiveness of our approach on both synthetic and real-world datasets, showing it is possible to perform multivariate causal discovery without infeasible assumptions using Bayesian model selection.

Automatic dataset shift identification to support root cause analysis of AI performance drift

Shifts in data distribution can substantially harm the performance of clinical AI models. Hence, various methods have been developed to detect the presence of such shifts at deployment time. However, root causes of dataset shifts are varied, and the choice of shift mitigation strategies is highly dependent on the precise type of shift encountered at test time. As such, detecting test-time dataset shift is not sufficient: precisely identifying which type of shift has occurred is critical. In this work, we propose the first unsupervised dataset shift identification framework, effectively distinguishing between prevalence shift (caused by a change in the label distribution), covariate shift (caused by a change in input characteristics) and mixed shifts (simultaneous prevalence and covariate shifts). We discuss the importance of self-supervised encoders for detecting subtle covariate shifts and propose a novel shift detector leveraging both self-supervised encoders and task model outputs for improved shift detection. We report promising results for the proposed shift identification framework across three different imaging modalities (chest radiography, digital mammography, and retinal fundus images) on five types of real-world dataset shifts, using four large publicly available datasets.

Rethinking Fair Representation Learning for Performance-Sensitive Tasks

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.

Radio-opaque artefacts in digital mammography: automatic detection and analysis of downstream effects

This study investigates the effects of radio-opaque artefacts, such as skin markers, breast implants, and pacemakers, on mammography classification models. After manually annotating 22,012 mammograms from the publicly available EMBED dataset, a robust multi-label artefact detector was developed to identify five distinct artefact types (circular and triangular skin markers, breast implants, support devices and spot compression structures). Subsequent experiments on two clinically relevant tasks $-$ breast density assessment and cancer screening $-$ revealed that these artefacts can significantly affect model performance, alter classification thresholds, and distort output distributions. These findings underscore the importance of accurate automatic artefact detection for developing reliable and robust classification models in digital mammography. To facilitate future research our annotations, code, and model predictions are made publicly available.