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.

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.