Uncovering Overconfident Failures in CXR Models via Augmentation-Sensitivity Risk Scoring

Deep learning models achieve strong performance in chest radiograph (CXR) interpretation, yet fairness and reliability concerns persist. Models often show uneven accuracy across patient subgroups, leading to hidden failures not reflected in aggregate metrics. Existing error detection approaches -- based on confidence calibration or out-of-distribution (OOD) detection -- struggle with subtle within-distribution errors, while image- and representation-level consistency-based methods remain underexplored in medical imaging. We propose an augmentation-sensitivity risk scoring (ASRS) framework to identify error-prone CXR cases. ASRS applies clinically plausible rotations ($\pm 15^\circ$/$\pm 30^\circ$) and measures embedding shifts with the RAD-DINO encoder. Sensitivity scores stratify samples into stability quartiles, where highly sensitive cases show substantially lower recall ($-0.2$ to $-0.3$) despite high AUROC and confidence. ASRS provides a label-free means for selective prediction and clinician review, improving fairness and safety in medical AI.

WorldMedQA-V: a multilingual, multimodal medical examination dataset for multimodal language models evaluation

Multimodal/vision language models (VLMs) are increasingly being deployed in healthcare settings worldwide, necessitating robust benchmarks to ensure their safety, efficacy, and fairness. Multiple-choice question and answer (QA) datasets derived from national medical examinations have long served as valuable evaluation tools, but existing datasets are largely text-only and available in a limited subset of languages and countries. To address these challenges, we present WorldMedQA-V, an updated multilingual, multimodal benchmarking dataset designed to evaluate VLMs in healthcare. WorldMedQA-V includes 568 labeled multiple-choice QAs paired with 568 medical images from four countries (Brazil, Israel, Japan, and Spain), covering original languages and validated English translations by native clinicians, respectively. Baseline performance for common open- and closed-source models are provided in the local language and English translations, and with and without images provided to the model. The WorldMedQA-V benchmark aims to better match AI systems to the diverse healthcare environments in which they are deployed, fostering more equitable, effective, and representative applications.