Janet Wang

Janet Wang, Yunbei Zhang, Zhengming Ding et al.

The development of reliable and fair diagnostic systems is often constrained by the scarcity of labeled data. To address this challenge, our work explores the feasibility of unsupervised domain adaptation (UDA) to integrate large external datasets for developing reliable classifiers. The adoption of UDA with multiple sources can simultaneously enrich the training set and bridge the domain gap between different skin lesion datasets, which vary due to distinct acquisition protocols. Particularly, UDA shows practical promise for improving diagnostic reliability when training with a custom skin lesion dataset, where only limited labeled data are available from the target domain. In this study, we investigate three UDA training schemes based on source data utilization: single-source, combined-source, and multi-source UDA. Our findings demonstrate the effectiveness of applying UDA on multiple sources for binary and multi-class classification. A strong correlation between test error and label shift in multi-class tasks has been observed in the experiment. Crucially, our study shows that UDA can effectively mitigate bias against minority groups and enhance fairness in diagnostic systems, while maintaining superior classification performance. This is achieved even without directly implementing fairness-focused techniques. This success is potentially attributed to the increased and well-adapted demographic information obtained from multiple sources.

Xin Hu, Janet Wang, Jihun Hamm et al.

Current AI-assisted skin image diagnosis has achieved dermatologist-level performance in classifying skin cancer, driven by rapid advancements in deep learning architectures. However, unlike traditional vision tasks, skin images in general present unique challenges due to the limited availability of well-annotated datasets, complex variations in conditions, and the necessity for detailed interpretations to ensure patient safety. Previous segmentation methods have sought to reduce image noise and enhance diagnostic performance, but these techniques require fine-grained, pixel-level ground truth masks for training. In contrast, with the rise of foundation models, the Segment Anything Model (SAM) has been introduced to facilitate promptable segmentation, enabling the automation of the segmentation process with simple yet effective prompts. Efforts applying SAM predominantly focus on dermatoscopy images, which present more easily identifiable lesion boundaries than clinical photos taken with smartphones. This limitation constrains the practicality of these approaches to real-world applications. To overcome the challenges posed by noisy clinical photos acquired via non-standardized protocols and to improve diagnostic accessibility, we propose a novel Cross-Attentive Fusion framework for interpretable skin lesion diagnosis. Our method leverages SAM to generate visual concepts for skin diseases using prompts, integrating local visual concepts with global image features to enhance model performance. Extensive evaluation on two skin disease datasets demonstrates our proposed method's effectiveness on lesion diagnosis and interpretability.

Xiao Wang, Zezhong Zhang, Isaac Lyngaas et al.

Accurate weather and climate prediction relies on data assimilation (DA), which estimates the Earth system state by integrating observations with models. While exascale computing has significantly advanced earth simulation, scalable and accurate inference of the Earth system state remains a fundamental bottleneck, limiting uncertainty quantification and prediction of extreme events. We introduce a unified one-stage generative DA framework that reformulates assimilation as Bayesian posterior sampling, replacing the conventional forecast-update cycle with compute-dense, GPU-efficient inference. At the core is STORM, a novel spatiotemporal transformer with a global attention linear-complexity scaling algorithm that breaks the quadratic attention barrier. On 32,768 GPUs of the Frontier supercomputer, our method achieves 63% strong scaling efficiency and 1.6 ExaFLOP sustained performance. We further scale to 20 billion spatiotemporal tokens, enabling km-scale global modeling over 177k temporal frames, regimes previously unreachable, establishing a new paradigm for Earth system prediction.

Yunbei Zhang, Janet Wang, Yingqiang Ge et al.

This position paper argues that, for long-horizon tasks evaluated across models with comparable frontier capability, the agent execution harness, namely the infrastructure layer that governs context construction, tool interaction, orchestration, and verification around a language model, is often a stronger determinant of agent performance than the model it wraps. We formalize and defend the Binding Constraint Thesis: in this regime, performance variance is governed more by harness configuration than by model choice, and current evaluation protocols therefore systematically misattribute harness-level gains to model improvements. We support this thesis along three lines. First, a control-theoretic formalization treats the harness as the controller of a closed-loop dynamical system and the LLM as the stochastic policy it governs, which explains why small harness changes can produce performance shifts that exceed those obtained by substituting one model for another. Second, published benchmarks, industry deployments, and a controlled variance decomposition show that harness-induced variance can substantially exceed model-induced variance, including cases of model ranking reversal. Third, we propose a harness-aware evaluation framework with a disclosure standard and a variance decomposition protocol. Until harness specifications are disclosed, leaderboard comparisons for long-horizon agents should be treated as incomplete and potentially misleading.

Xi Xiao, Yunbei Zhang, Thanh-Huy Nguyen et al.

Localized image captioning has made significant progress with models like the Describe Anything Model (DAM), which can generate detailed region-specific descriptions without explicit region-text supervision. However, such capabilities have yet to be widely applied to specialized domains like medical imaging, where diagnostic interpretation relies on subtle regional findings rather than global understanding. To mitigate this gap, we propose MedDAM, the first comprehensive framework leveraging large vision-language models for region-specific captioning in medical images. MedDAM employs medical expert-designed prompts tailored to specific imaging modalities and establishes a robust evaluation benchmark comprising a customized assessment protocol, data pre-processing pipeline, and specialized QA template library. This benchmark evaluates both MedDAM and other adaptable large vision-language models, focusing on clinical factuality through attribute-level verification tasks, thereby circumventing the absence of ground-truth region-caption pairs in medical datasets. Extensive experiments on the VinDr-CXR, LIDC-IDRI, and SkinCon datasets demonstrate MedDAM's superiority over leading peers (including GPT-4o, Claude 3.7 Sonnet, LLaMA-3.2 Vision, Qwen2.5-VL, GPT-4Rol, and OMG-LLaVA) in the task, revealing the importance of region-level semantic alignment in medical image understanding and establishing MedDAM as a promising foundation for clinical vision-language integration.

Janet Wang, Yunbei Zhang, Zhengming Ding et al.

Paucity of medical data severely limits the generalizability of diagnostic ML models, as the full spectrum of disease variability can not be represented by a small clinical dataset. To address this, diffusion models (DMs) have been considered as a promising avenue for synthetic image generation and augmentation. However, they frequently produce medically inaccurate images, deteriorating the model performance. Expert domain knowledge is critical for synthesizing images that correctly encode clinical information, especially when data is scarce and quality outweighs quantity. Existing approaches for incorporating human feedback, such as reinforcement learning (RL) and Direct Preference Optimization (DPO), rely on robust reward functions or demand labor-intensive expert evaluations. Recent progress in Multimodal Large Language Models (MLLMs) reveals their strong visual reasoning capabilities, making them adept candidates as evaluators. In this work, we propose a novel framework, coined MAGIC (Medically Accurate Generation of Images through AI-Expert Collaboration), that synthesizes clinically accurate skin disease images for data augmentation. Our method creatively translates expert-defined criteria into actionable feedback for image synthesis of DMs, significantly improving clinical accuracy while reducing the direct human workload. Experiments demonstrate that our method greatly improves the clinical quality of synthesized skin disease images, with outputs aligning with dermatologist assessments. Additionally, augmenting training data with these synthesized images improves diagnostic accuracy by +9.02% on a challenging 20-condition skin disease classification task, and by +13.89% in the few-shot setting.

Janet Wang, Xin Hu, Yunbei Zhang et al.

Skin Neglected Tropical Diseases (NTDs) impose severe health and socioeconomic burdens in impoverished tropical communities. Yet, advancements in AI-driven diagnostic support are hindered by data scarcity, particularly for underrepresented populations and rare manifestations of NTDs. Existing dermatological datasets often lack the demographic and disease spectrum crucial for developing reliable recognition models of NTDs. To address this, we introduce eSkinHealth, a novel dermatological dataset collected on-site in Côte d'Ivoire and Ghana. Specifically, eSkinHealth contains 5,623 images from 1,639 cases and encompasses 47 skin diseases, focusing uniquely on skin NTDs and rare conditions among West African populations. We further propose an AI-expert collaboration paradigm to implement foundation language and segmentation models for efficient generation of multimodal annotations, under dermatologists' guidance. In addition to patient metadata and diagnosis labels, eSkinHealth also includes semantic lesion masks, instance-specific visual captions, and clinical concepts. Overall, our work provides a valuable new resource and a scalable annotation framework, aiming to catalyze the development of more equitable, accurate, and interpretable AI tools for global dermatology.

Janet Wang, Yunsung Chung, Zhengming Ding et al.

AI-based diagnoses have demonstrated dermatologist-level performance in classifying skin cancer. However, such systems are prone to under-performing when tested on data from minority groups that lack sufficient representation in the training sets. Although data collection and annotation offer the best means for promoting minority groups, these processes are costly and time-consuming. Prior works have suggested that data from majority groups may serve as a valuable information source to supplement the training of diagnosis tools for minority groups. In this work, we propose an effective diffusion-based augmentation framework that maximizes the use of rich information from majority groups to benefit minority groups. Using groups with different skin types as a case study, our results show that the proposed framework can generate synthetic images that improve diagnostic results for the minority groups, even when there is little or no reference data from these target groups. The practical value of our work is evident in medical imaging analysis, where under-diagnosis persists as a problem for certain groups due to insufficient representation.