Anita Kriz

Amar Kumar, Anita Kriz, Mohammad Havaei et al.

Developing reliable and generalizable deep learning systems for medical imaging faces significant obstacles due to spurious correlations, data imbalances, and limited text annotations in datasets. Addressing these challenges requires architectures that are robust to the unique complexities posed by medical imaging data. Rapid advancements in vision-language foundation models within the natural image domain prompt the question of how they can be adapted for medical imaging tasks. In this work, we present PRISM, a framework that leverages foundation models to generate high-resolution, language-guided medical image counterfactuals using Stable Diffusion. Our approach demonstrates unprecedented precision in selectively modifying spurious correlations (the medical devices) and disease features, enabling the removal and addition of specific attributes while preserving other image characteristics. Through extensive evaluation, we show how PRISM advances counterfactual generation and enables the development of more robust downstream classifiers for clinically deployable solutions. To facilitate broader adoption and research, we make our code publicly available at https://github.com/Amarkr1/PRISM.

Anita Kriz, Elizabeth Laura Janes, Xing Shen et al.

Multimodal large language models (MLLMs) hold considerable promise for applications in healthcare. However, their deployment in safety-critical settings is hindered by two key limitations: (i) sensitivity to prompt design, and (ii) a tendency to generate incorrect responses with high confidence. As clinicians may rely on a model's stated confidence to gauge the reliability of its predictions, it is especially important that when a model expresses high confidence, it is also highly accurate. We introduce Prompt4Trust, the first reinforcement learning (RL) framework for prompt augmentation targeting confidence calibration in MLLMs. A lightweight LLM is trained to produce context-aware auxiliary prompts that guide a downstream task MLLM to generate responses in which the expressed confidence more accurately reflects predictive accuracy. Unlike conventional calibration techniques, Prompt4Trust specifically prioritizes aspects of calibration most critical for safe and trustworthy clinical decision-making. Beyond improvements driven by this clinically motivated calibration objective, our proposed method also improves task accuracy, achieving state-of-the-art medical visual question answering (VQA) performance on the PMC-VQA benchmark, which is composed of multiple-choice questions spanning diverse medical imaging modalities. Moreover, our framework trained with a small downstream task MLLM showed promising zero-shot generalization to larger MLLMs in our experiments, suggesting the potential for scalable calibration without the associated computational costs. This work demonstrates the potential of automated yet human-aligned prompt engineering for improving the the trustworthiness of MLLMs in safety critical settings. Our codebase can be found at https://github.com/xingbpshen/prompt4trust.

Nicolás Astorga, Anita Kriz, Mihaela van der Schaar

Despite surpassing human performance across mathematics, coding, and other knowledge-intensive tasks, large language models (LLMs) continue to struggle with causal reasoning. A core obstacle is the target data itself: causal systems are complex and often expressed in non-executable forms, while ground-truth answers to causal queries are inherently scarce. We introduce CauSim, a framework that turns causal reasoning from a scarce-label problem into a scalable supervised one. CauSim constructs increasingly complex causal simulators: executable structural causal models (SCMs), incrementally built by LLMs, that scale to globally complex systems while maintaining verifiable answers to causal queries. CauSim operates across representations by formalizing non-executable causal knowledge into code, enabling data augmentation, and translating executable SCMs into natural language, enabling supervision in previously difficult-to-supervise representations. We structure our research into two parts: (1) how to construct increasingly complex causal simulators, and (2) a systematic study of what CauSim enables, demonstrating generalization across representations, consistent gains from curriculum scaling and data volume, LLM self-improvement through self-generated simulators, and data augmentation via formalization of existing domain knowledge.

Amar Kumar, Anita Kriz, Barak Pertzov et al.

Vision-language foundation models (VLMs) have shown impressive performance in guiding image generation through text, with emerging applications in medical imaging. In this work, we are the first to investigate the question: 'Can fine-tuned foundation models help identify critical, and possibly unknown, data properties?' By evaluating our proposed method on a chest x-ray dataset, we show that these models can generate high-resolution, precisely edited images compared to methods that rely on Structural Causal Models (SCMs) according to numerous metrics. For the first time, we demonstrate that fine-tuned VLMs can reveal hidden data relationships that were previously obscured due to available metadata granularity and model capacity limitations. Our experiments demonstrate both the potential of these models to reveal underlying dataset properties while also exposing the limitations of fine-tuned VLMs for accurate image editing and susceptibility to biases and spurious correlations.