On the Challenges and Opportunities in Generative AI

The field of deep generative modeling has grown rapidly and consistently over the years. With the availability of massive amounts of training data coupled with advances in scalable unsupervised learning paradigms, recent large-scale generative models show tremendous promise in synthesizing high-resolution images and text, as well as structured data such as videos and molecules. However, we argue that current large-scale generative AI models do not sufficiently address several fundamental issues that hinder their widespread adoption across domains. In this work, we aim to identify key unresolved challenges in modern generative AI paradigms that should be tackled to further enhance their capabilities, versatility, and reliability. By identifying these challenges, we aim to provide researchers with valuable insights for exploring fruitful research directions, thereby fostering the development of more robust and accessible generative AI solutions.

Robust Anomaly Detection for Particle Physics Using Multi-Background Representation Learning

Anomaly, or out-of-distribution, detection is a promising tool for aiding discoveries of new particles or processes in particle physics. In this work, we identify and address two overlooked opportunities to improve anomaly detection for high-energy physics. First, rather than train a generative model on the single most dominant background process, we build detection algorithms using representation learning from multiple background types, thus taking advantage of more information to improve estimation of what is relevant for detection. Second, we generalize decorrelation to the multi-background setting, thus directly enforcing a more complete definition of robustness for anomaly detection. We demonstrate the benefit of the proposed robust multi-background anomaly detection algorithms on a high-dimensional dataset of particle decays at the Large Hadron Collider.

When accurate prediction models yield harmful self-fulfilling prophecies

Prediction models are popular in medical research and practice. By predicting an outcome of interest for specific patients, these models may help inform difficult treatment decisions, and are often hailed as the poster children for personalized, data-driven healthcare. We show however, that using prediction models for decision making can lead to harmful decisions, even when the predictions exhibit good discrimination after deployment. These models are harmful self-fulfilling prophecies: their deployment harms a group of patients but the worse outcome of these patients does not invalidate the predictive power of the model. Our main result is a formal characterization of a set of such prediction models. Next we show that models that are well calibrated before and after deployment are useless for decision making as they made no change in the data distribution. These results point to the need to revise standard practices for validation, deployment and evaluation of prediction models that are used in medical decisions.

Quantifying Impairment and Disease Severity Using AI Models Trained on Healthy Subjects

Automatic assessment of impairment and disease severity is a key challenge in data-driven medicine. We propose a novel framework to address this challenge, which leverages AI models trained exclusively on healthy individuals. The COnfidence-Based chaRacterization of Anomalies (COBRA) score exploits the decrease in confidence of these models when presented with impaired or diseased patients to quantify their deviation from the healthy population. We applied the COBRA score to address a key limitation of current clinical evaluation of upper-body impairment in stroke patients. The gold-standard Fugl-Meyer Assessment (FMA) requires in-person administration by a trained assessor for 30-45 minutes, which restricts monitoring frequency and precludes physicians from adapting rehabilitation protocols to the progress of each patient. The COBRA score, computed automatically in under one minute, is shown to be strongly correlated with the FMA on an independent test cohort for two different data modalities: wearable sensors ($\rho = 0.845$, 95% CI [0.743,0.908]) and video ($\rho = 0.746$, 95% C.I [0.594, 0.847]). To demonstrate the generalizability of the approach to other conditions, the COBRA score was also applied to quantify severity of knee osteoarthritis from magnetic-resonance imaging scans, again achieving significant correlation with an independent clinical assessment ($\rho = 0.644$, 95% C.I [0.585,0.696]).

Stochastic interpolants with data-dependent couplings

Generative models inspired by dynamical transport of measure -- such as flows and diffusions -- construct a continuous-time map between two probability densities. Conventionally, one of these is the target density, only accessible through samples, while the other is taken as a simple base density that is data-agnostic. In this work, using the framework of stochastic interpolants, we formalize how to \textit{couple} the base and the target densities. This enables us to incorporate information about class labels or continuous embeddings to construct dynamical transport maps that serve as conditional generative models. We show that these transport maps can be learned by solving a simple square loss regression problem analogous to the standard independent setting. We demonstrate the usefulness of constructing dependent couplings in practice through experiments in super-resolution and in-painting.

Don't blame Dataset Shift! Shortcut Learning due to Gradients and Cross Entropy

Common explanations for shortcut learning assume that the shortcut improves prediction under the training distribution but not in the test distribution. Thus, models trained via the typical gradient-based optimization of cross-entropy, which we call default-ERM, utilize the shortcut. However, even when the stable feature determines the label in the training distribution and the shortcut does not provide any additional information, like in perception tasks, default-ERM still exhibits shortcut learning. Why are such solutions preferred when the loss for default-ERM can be driven to zero using the stable feature alone? By studying a linear perception task, we show that default-ERM's preference for maximizing the margin leads to models that depend more on the shortcut than the stable feature, even without overparameterization. This insight suggests that default-ERM's implicit inductive bias towards max-margin is unsuitable for perception tasks. Instead, we develop an inductive bias toward uniform margins and show that this bias guarantees dependence only on the perfect stable feature in the linear perception task. We develop loss functions that encourage uniform-margin solutions, called margin control (MARG-CTRL). MARG-CTRL mitigates shortcut learning on a variety of vision and language tasks, showing that better inductive biases can remove the need for expensive two-stage shortcut-mitigating methods in perception tasks.

When More is Less: Incorporating Additional Datasets Can Hurt Performance By Introducing Spurious Correlations

In machine learning, incorporating more data is often seen as a reliable strategy for improving model performance; this work challenges that notion by demonstrating that the addition of external datasets in many cases can hurt the resulting model's performance. In a large-scale empirical study across combinations of four different open-source chest x-ray datasets and 9 different labels, we demonstrate that in 43% of settings, a model trained on data from two hospitals has poorer worst group accuracy over both hospitals than a model trained on just a single hospital's data. This surprising result occurs even though the added hospital makes the training distribution more similar to the test distribution. We explain that this phenomenon arises from the spurious correlation that emerges between the disease and hospital, due to hospital-specific image artifacts. We highlight the trade-off one encounters when training on multiple datasets, between the obvious benefit of additional data and insidious cost of the introduced spurious correlation. In some cases, balancing the dataset can remove the spurious correlation and improve performance, but it is not always an effective strategy. We contextualize our results within the literature on spurious correlations to help explain these outcomes. Our experiments underscore the importance of exercising caution when selecting training data for machine learning models, especially in settings where there is a risk of spurious correlations such as with medical imaging. The risks outlined highlight the need for careful data selection and model evaluation in future research and practice.

An Effective Meaningful Way to Evaluate Survival Models

One straightforward metric to evaluate a survival prediction model is based on the Mean Absolute Error (MAE) -- the average of the absolute difference between the time predicted by the model and the true event time, over all subjects. Unfortunately, this is challenging because, in practice, the test set includes (right) censored individuals, meaning we do not know when a censored individual actually experienced the event. In this paper, we explore various metrics to estimate MAE for survival datasets that include (many) censored individuals. Moreover, we introduce a novel and effective approach for generating realistic semi-synthetic survival datasets to facilitate the evaluation of metrics. Our findings, based on the analysis of the semi-synthetic datasets, reveal that our proposed metric (MAE using pseudo-observations) is able to rank models accurately based on their performance, and often closely matches the true MAE -- in particular, is better than several alternative methods.

A dynamic risk score for early prediction of cardiogenic shock using machine learning

Myocardial infarction and heart failure are major cardiovascular diseases that affect millions of people in the US. The morbidity and mortality are highest among patients who develop cardiogenic shock. Early recognition of cardiogenic shock is critical. Prompt implementation of treatment measures can prevent the deleterious spiral of ischemia, low blood pressure, and reduced cardiac output due to cardiogenic shock. However, early identification of cardiogenic shock has been challenging due to human providers' inability to process the enormous amount of data in the cardiac intensive care unit (ICU) and lack of an effective risk stratification tool. We developed a deep learning-based risk stratification tool, called CShock, for patients admitted into the cardiac ICU with acute decompensated heart failure and/or myocardial infarction to predict onset of cardiogenic shock. To develop and validate CShock, we annotated cardiac ICU datasets with physician adjudicated outcomes. CShock achieved an area under the receiver operator characteristic curve (AUROC) of 0.820, which substantially outperformed CardShock (AUROC 0.519), a well-established risk score for cardiogenic shock prognosis. CShock was externally validated in an independent patient cohort and achieved an AUROC of 0.800, demonstrating its generalizability in other cardiac ICUs.