Fredrik K. Gustafsson

Ziwei Luo, Fredrik K. Gustafsson, Zheng Zhao et al.

This paper presents a stochastic differential equation (SDE) approach for general-purpose image restoration. The key construction consists in a mean-reverting SDE that transforms a high-quality image into a degraded counterpart as a mean state with fixed Gaussian noise. Then, by simulating the corresponding reverse-time SDE, we are able to restore the origin of the low-quality image without relying on any task-specific prior knowledge. Crucially, the proposed mean-reverting SDE has a closed-form solution, allowing us to compute the ground truth time-dependent score and learn it with a neural network. Moreover, we propose a maximum likelihood objective to learn an optimal reverse trajectory that stabilizes the training and improves the restoration results. The experiments show that our proposed method achieves highly competitive performance in quantitative comparisons on image deraining, deblurring, and denoising, setting a new state-of-the-art on two deraining datasets. Finally, the general applicability of our approach is further demonstrated via qualitative results on image super-resolution, inpainting, and dehazing. Code is available at https://github.com/Algolzw/image-restoration-sde.

Fredrik K. Gustafsson, Martin Danelljan, Thomas B. Schön

Many important computer vision applications are naturally formulated as regression problems. Within medical imaging, accurate regression models have the potential to automate various tasks, helping to lower costs and improve patient outcomes. Such safety-critical deployment does however require reliable estimation of model uncertainty, also under the wide variety of distribution shifts that might be encountered in practice. Motivated by this, we set out to investigate the reliability of regression uncertainty estimation methods under various real-world distribution shifts. To that end, we propose an extensive benchmark of 8 image-based regression datasets with different types of challenging distribution shifts. We then employ our benchmark to evaluate many of the most common uncertainty estimation methods, as well as two state-of-the-art uncertainty scores from the task of out-of-distribution detection. We find that while methods are well calibrated when there is no distribution shift, they all become highly overconfident on many of the benchmark datasets. This uncovers important limitations of current uncertainty estimation methods, and the proposed benchmark therefore serves as a challenge to the research community. We hope that our benchmark will spur more work on how to develop truly reliable regression uncertainty estimation methods. Code is available at https://github.com/fregu856/regression_uncertainty.

Ziwei Luo, Fredrik K. Gustafsson, Zheng Zhao et al.

Vision-language models such as CLIP have shown great impact on diverse downstream tasks for zero-shot or label-free predictions. However, when it comes to low-level vision such as image restoration their performance deteriorates dramatically due to corrupted inputs. In this paper, we present a degradation-aware vision-language model (DA-CLIP) to better transfer pretrained vision-language models to low-level vision tasks as a multi-task framework for image restoration. More specifically, DA-CLIP trains an additional controller that adapts the fixed CLIP image encoder to predict high-quality feature embeddings. By integrating the embedding into an image restoration network via cross-attention, we are able to pilot the model to learn a high-fidelity image reconstruction. The controller itself will also output a degradation feature that matches the real corruptions of the input, yielding a natural classifier for different degradation types. In addition, we construct a mixed degradation dataset with synthetic captions for DA-CLIP training. Our approach advances state-of-the-art performance on both \emph{degradation-specific} and \emph{unified} image restoration tasks, showing a promising direction of prompting image restoration with large-scale pretrained vision-language models. Our code is available at https://github.com/Algolzw/daclip-uir.

Ziwei Luo, Fredrik K. Gustafsson, Zheng Zhao et al.

This work aims to improve the applicability of diffusion models in realistic image restoration. Specifically, we enhance the diffusion model in several aspects such as network architecture, noise level, denoising steps, training image size, and optimizer/scheduler. We show that tuning these hyperparameters allows us to achieve better performance on both distortion and perceptual scores. We also propose a U-Net based latent diffusion model which performs diffusion in a low-resolution latent space while preserving high-resolution information from the original input for the decoding process. Compared to the previous latent-diffusion model which trains a VAE-GAN to compress the image, our proposed U-Net compression strategy is significantly more stable and can recover highly accurate images without relying on adversarial optimization. Importantly, these modifications allow us to apply diffusion models to various image restoration tasks, including real-world shadow removal, HR non-homogeneous dehazing, stereo super-resolution, and bokeh effect transformation. By simply replacing the datasets and slightly changing the noise network, our model, named Refusion, is able to deal with large-size images (e.g., 6000 x 4000 x 3 in HR dehazing) and produces good results on all the above restoration problems. Our Refusion achieves the best perceptual performance in the NTIRE 2023 Image Shadow Removal Challenge and wins 2nd place overall.

Philipp Von Bachmann, Daniel Gedon, Fredrik K. Gustafsson et al.

Objective: Imbalances of the electrolyte concentration levels in the body can lead to catastrophic consequences, but accurate and accessible measurements could improve patient outcomes. While blood tests provide accurate measurements, they are invasive and the laboratory analysis can be slow or inaccessible. In contrast, an electrocardiogram (ECG) is a widely adopted tool which is quick and simple to acquire. However, the problem of estimating continuous electrolyte concentrations directly from ECGs is not well-studied. We therefore investigate if regression methods can be used for accurate ECG-based prediction of electrolyte concentrations. Methods: We explore the use of deep neural networks (DNNs) for this task. We analyze the regression performance across four electrolytes, utilizing a novel dataset containing over 290000 ECGs. For improved understanding, we also study the full spectrum from continuous predictions to binary classification of extreme concentration levels. To enhance clinical usefulness, we finally extend to a probabilistic regression approach and evaluate different uncertainty estimates. Results: We find that the performance varies significantly between different electrolytes, which is clinically justified in the interplay of electrolytes and their manifestation in the ECG. We also compare the regression accuracy with that of traditional machine learning models, demonstrating superior performance of DNNs. Conclusion: Discretization can lead to good classification performance, but does not help solve the original problem of predicting continuous concentration levels. While probabilistic regression demonstrates potential practical usefulness, the uncertainty estimates are not particularly well-calibrated. Significance: Our study is a first step towards accurate and reliable ECG-based prediction of electrolyte concentration levels.

Ziwei Luo, Fredrik K. Gustafsson, Zheng Zhao et al.

Diffusion models have achieved remarkable progress in generative modelling, particularly in enhancing image quality to conform to human preferences. Recently, these models have also been applied to low-level computer vision for photo-realistic image restoration (IR) in tasks such as image denoising, deblurring, dehazing, etc. In this review paper, we introduce key constructions in diffusion models and survey contemporary techniques that make use of diffusion models in solving general IR tasks. Furthermore, we point out the main challenges and limitations of existing diffusion-based IR frameworks and provide potential directions for future work.

Edward Phillips, Fredrik K. Gustafsson, Sean Wu et al.

Selective prediction systems can mitigate harms resulting from language model hallucinations by abstaining from answering in high-risk cases. Uncertainty quantification techniques are often employed to identify such cases, but are rarely evaluated in the context of the wider selective prediction policy and its ability to operate at low target error rates. We identify a model-dependent failure mode of entropy-based uncertainty methods that leads to unreliable abstention behaviour, and address it by combining entropy scores with a correctness probe signal. We find that across three QA benchmarks (TriviaQA, BioASQ, MedicalQA) and four model families, the combined score generally improves both the risk--coverage trade-off and calibration performance relative to entropy-only baselines. Our results highlight the importance of deployment-facing evaluation of uncertainty methods, using metrics that directly reflect whether a system can be trusted to operate at a stated risk level.

Fredrik K. Gustafsson, Xiao Gu, Mattia Carletti et al.

Recent biosignal foundation models (FMs) have demonstrated promising performance across diverse clinical prediction tasks, yet systematic evaluation on long-duration multimodal data remains limited. We introduce SignalMC-MED, a benchmark for evaluating biosignal FMs on synchronized single-lead electrocardiogram (ECG) and photoplethysmogram (PPG) data. Derived from the MC-MED dataset, SignalMC-MED comprises 22,256 visits with 10-minute overlapping ECG and PPG signals, and includes 20 clinically relevant tasks spanning prediction of demographics, emergency department disposition, laboratory value regression, and detection of prior ICD-10 diagnoses. Using this benchmark, we perform a systematic evaluation of representative time-series and biosignal FMs across ECG-only, PPG-only, and ECG + PPG settings. We find that domain-specific biosignal FMs consistently outperform general time-series models, and that multimodal ECG + PPG fusion yields robust improvements over unimodal inputs. Moreover, using the full 10-minute signal consistently outperforms shorter segments, and larger model variants do not reliably outperform smaller ones. Hand-crafted ECG domain features provide a strong baseline and offer complementary value when combined with learned FM representations. Together, these results establish SignalMC-MED as a standardized benchmark and provide practical guidance for evaluating and deploying biosignal FMs.

Wei Tang, Jinpei Han, Kangning Cui et al.

Electrocardiogram (ECG) foundation models pretrained on typical diagnostic 10-second ECG segments, have demonstrated strong transferability across a range of clinical applications. However, many real-world applications produce recordings that are typically longer, and are varied in duration during inference time. These 10-second models have no built-in way to combine information across time. Extending them to longer horizons introduces two challenges: structural incompatibilities arising from input-length disparities, and semantic challenges that limit meaningful temporal aggregation. We propose a parameter-efficient framework that extends pretrained ECG foundation models to longer and variable-length ECGs without retraining the backbone. Guided by a frozen pretrained 10-second model, we introduce a lightweight plug-in module that extends the model in two complementary ways: (i) structurally compatible long-sequence processing and (ii) semantically informed temporal modeling. Experiments on multiple long-horizon ECG tasks, datasets, and foundation model backbones demonstrate that our method enables robust long-horizon extension from pretrained snapshot models, consistently outperforming sliding-window and pooling-based baselines with strong parameter efficiency.

Fredrik K. Gustafsson, Mattias Rantalainen

Pathology foundation models (PFMs) have emerged as powerful pretrained encoders for computational pathology, but their robustness under clinically relevant distribution shifts remains insufficiently understood. We benchmark the robustness of recent PFMs in the setting of prostate cancer grading from whole-slide images (WSIs). Using the PANDA dataset, we evaluate PFMs as frozen patch-level feature extractors within weakly supervised slide-level grading models, and assess robustness to two important forms of distribution shift: shifts in WSI image appearance across collection sites, and shifts in the label distribution over cancer grade groups. Across in-distribution settings, PFMs consistently achieve strong performance and clearly outperform a natural-image baseline. Under cross-site transfer from Radboud to Karolinska, however, performance drops substantially for all models, showing that large-scale pretraining alone does not guarantee robust downstream generalization. In contrast, PFMs are less sensitive to label-distribution shift, indicating that visually grounded domain shift is the dominant challenge. Representation analysis further supports these findings by revealing persistent domain separation between sites across all PFMs. While grade-related structure is present, it is comparatively weak, indicating that domain-related variation dominates in the learned feature space. Together, these results provide a comprehensive benchmark of PFMs under distribution shift and highlight an important practical message: although PFMs provide strong representations, generalizability remains constrained by the quality and diversity of the data used to train downstream prediction models.

Ziwei Luo, Fredrik K. Gustafsson, Jens Sjölund et al.

This work presents a forward-only diffusion (FoD) approach for generative modelling. In contrast to traditional diffusion models that rely on a coupled forward-backward diffusion scheme, FoD directly learns data generation through a single forward diffusion process, yielding a simple yet efficient generative framework. The core of FoD is a state-dependent stochastic differential equation that involves a mean-reverting term in both the drift and diffusion functions. This mean-reversion property guarantees the convergence to clean data, naturally simulating a stochastic interpolation between source and target distributions. More importantly, FoD is analytically tractable and is trained using a simple stochastic flow matching objective, enabling a few-step non-Markov chain sampling during inference. The proposed FoD model, despite its simplicity, achieves state-of-the-art performance on various image restoration tasks. Its general applicability on image-conditioned generation is also demonstrated via qualitative results on image-to-image translation. Our code is available at https://github.com/Algolzw/FoD.

Fredrik K. Gustafsson, Martin Danelljan, Thomas B. Schön

Energy-based models (EBMs) have experienced a resurgence within machine learning in recent years, including as a promising alternative for probabilistic regression. However, energy-based regression requires a proposal distribution to be manually designed for training, and an initial estimate has to be provided at test-time. We address both of these issues by introducing a conceptually simple method to automatically learn an effective proposal distribution, which is parameterized by a separate network head. To this end, we derive a surprising result, leading to a unified training objective that jointly minimizes the KL divergence from the proposal to the EBM, and the negative log-likelihood of the EBM. At test-time, we can then employ importance sampling with the trained proposal to efficiently evaluate the learned EBM and produce stand-alone predictions. Furthermore, we utilize our derived training objective to learn mixture density networks (MDNs) with a jointly trained energy-based teacher, consistently outperforming conventional MDN training on four real-world regression tasks within computer vision. Code is available at https://github.com/fregu856/ebms_proposals.

Fredrik K. Gustafsson, Martin Danelljan, Thomas B. Schön

Accurate 3D object detection (3DOD) is crucial for safe navigation of complex environments by autonomous robots. Regressing accurate 3D bounding boxes in cluttered environments based on sparse LiDAR data is however a highly challenging problem. We address this task by exploring recent advances in conditional energy-based models (EBMs) for probabilistic regression. While methods employing EBMs for regression have demonstrated impressive performance on 2D object detection in images, these techniques are not directly applicable to 3D bounding boxes. In this work, we therefore design a differentiable pooling operator for 3D bounding boxes, serving as the core module of our EBM network. We further integrate this general approach into the state-of-the-art 3D object detector SA-SSD. On the KITTI dataset, our proposed approach consistently outperforms the SA-SSD baseline across all 3DOD metrics, demonstrating the potential of EBM-based regression for highly accurate 3DOD. Code is available at https://github.com/fregu856/ebms_3dod.

Fredrik K. Gustafsson, Martin Danelljan, Radu Timofte et al.

Energy-based models (EBMs) have become increasingly popular within computer vision in recent years. While they are commonly employed for generative image modeling, recent work has applied EBMs also for regression tasks, achieving state-of-the-art performance on object detection and visual tracking. Training EBMs is however known to be challenging. While a variety of different techniques have been explored for generative modeling, the application of EBMs to regression is not a well-studied problem. How EBMs should be trained for best possible regression performance is thus currently unclear. We therefore accept the task of providing the first detailed study of this problem. To that end, we propose a simple yet highly effective extension of noise contrastive estimation, and carefully compare its performance to six popular methods from literature on the tasks of 1D regression and object detection. The results of this comparison suggest that our training method should be considered the go-to approach. We also apply our method to the visual tracking task, achieving state-of-the-art performance on five datasets. Notably, our tracker achieves 63.7% AUC on LaSOT and 78.7% Success on TrackingNet. Code is available at https://github.com/fregu856/ebms_regression.

Fredrik K. Gustafsson, Martin Danelljan, Goutam Bhat et al.

While deep learning-based classification is generally tackled using standardized approaches, a wide variety of techniques are employed for regression. In computer vision, one particularly popular such technique is that of confidence-based regression, which entails predicting a confidence value for each input-target pair (x,y). While this approach has demonstrated impressive results, it requires important task-dependent design choices, and the predicted confidences lack a natural probabilistic meaning. We address these issues by proposing a general and conceptually simple regression method with a clear probabilistic interpretation. In our proposed approach, we create an energy-based model of the conditional target density p(y|x), using a deep neural network to predict the un-normalized density from (x,y). This model of p(y|x) is trained by directly minimizing the associated negative log-likelihood, approximated using Monte Carlo sampling. We perform comprehensive experiments on four computer vision regression tasks. Our approach outperforms direct regression, as well as other probabilistic and confidence-based methods. Notably, our model achieves a 2.2% AP improvement over Faster-RCNN for object detection on the COCO dataset, and sets a new state-of-the-art on visual tracking when applied for bounding box estimation. In contrast to confidence-based methods, our approach is also shown to be directly applicable to more general tasks such as age and head-pose estimation. Code is available at https://github.com/fregu856/ebms_regression.

Fredrik K. Gustafsson, Martin Danelljan, Thomas B. Schön

While deep neural networks have become the go-to approach in computer vision, the vast majority of these models fail to properly capture the uncertainty inherent in their predictions. Estimating this predictive uncertainty can be crucial, for example in automotive applications. In Bayesian deep learning, predictive uncertainty is commonly decomposed into the distinct types of aleatoric and epistemic uncertainty. The former can be estimated by letting a neural network output the parameters of a certain probability distribution. Epistemic uncertainty estimation is a more challenging problem, and while different scalable methods recently have emerged, no extensive comparison has been performed in a real-world setting. We therefore accept this task and propose a comprehensive evaluation framework for scalable epistemic uncertainty estimation methods in deep learning. Our proposed framework is specifically designed to test the robustness required in real-world computer vision applications. We also apply this framework to provide the first properly extensive and conclusive comparison of the two current state-of-the-art scalable methods: ensembling and MC-dropout. Our comparison demonstrates that ensembling consistently provides more reliable and practically useful uncertainty estimates. Code is available at https://github.com/fregu856/evaluating_bdl.

Erik Thiringer, Fredrik K. Gustafsson, Kajsa Ledesma Eriksson et al.

Pathology foundation models (PFMs) have become central to computational pathology, aiming to offer general encoders for feature extraction from whole-slide images (WSIs). Despite strong benchmark performance, PFM robustness to real-world technical domain shifts, such as variability from whole-slide scanner devices, remains poorly understood. We systematically evaluated the robustness of 14 PFMs to scanner-induced variability, including state-of-the-art models, earlier self-supervised models, and a baseline trained on natural images. Using a multiscanner dataset of 384 breast cancer WSIs scanned on five devices, we isolated scanner effects independently from biological and laboratory confounders. Robustness is assessed via complementary unsupervised embedding analyses and a set of clinicopathological supervised prediction tasks. Our results demonstrate that current PFMs are not invariant to scanner-induced domain shifts. Most models encode pronounced scanner-specific variability in their embedding spaces. While AUC often remains stable, this masks a critical failure mode: scanner variability systematically alters the embedding space and impacts calibration of downstream model predictions, resulting in scanner-dependent bias that can impact reliability in clinical use cases. We further show that robustness is not a simple function of training data scale, model size, or model recency. None of the models provided reliable robustness against scanner-induced variability. While the models trained on the most diverse data, here represented by vision-language models, appear to have an advantage with respect to robustness, they underperformed on downstream supervised tasks. We conclude that development and evaluation of PFMs requires moving beyond accuracy-centric benchmarks toward explicit evaluation and optimisation of embedding stability and calibration under realistic acquisition variability.

Ziwei Luo, Fredrik K. Gustafsson, Zheng Zhao et al.

Though diffusion models have been successfully applied to various image restoration (IR) tasks, their performance is sensitive to the choice of training datasets. Typically, diffusion models trained in specific datasets fail to recover images that have out-of-distribution degradations. To address this problem, this work leverages a capable vision-language model and a synthetic degradation pipeline to learn image restoration in the wild (wild IR). More specifically, all low-quality images are simulated with a synthetic degradation pipeline that contains multiple common degradations such as blur, resize, noise, and JPEG compression. Then we introduce robust training for a degradation-aware CLIP model to extract enriched image content features to assist high-quality image restoration. Our base diffusion model is the image restoration SDE (IR-SDE). Built upon it, we further present a posterior sampling strategy for fast noise-free image generation. We evaluate our model on both synthetic and real-world degradation datasets. Moreover, experiments on the unified image restoration task illustrate that the proposed posterior sampling improves image generation quality for various degradations.

Fredrik K. Gustafsson, Constance Boissin, Johan Vallon-Christersson et al.

Pathology foundation models (PFMs) have recently emerged as powerful pretrained encoders for computational pathology, enabling transfer learning across a wide range of downstream tasks. However, systematic comparisons of these models for clinically meaningful prediction problems remain limited, especially in the context of survival prediction under external validation. In this study, we benchmark widely used and recently proposed PFMs for breast cancer survival prediction from whole-slide histopathology images. Using a standardized pipeline based on patch-level feature extraction and a unified survival modeling framework, we evaluate model representations across three independent clinical cohorts comprising more than 5,400 patients with long-term follow-up. Models are trained on one cohort and evaluated on two independent external cohorts, enabling a rigorous assessment of cross-dataset generalization. Overall, H-optimus-1 achieves the strongest survival prediction performance. More broadly, we observe consistent generational improvements across model families, with second-generation PFMs outperforming their first-generation counterparts. However, absolute performance differences between many recent PFMs remain modest, suggesting diminishing returns from further scaling of pretraining data or model size alone. Notably, the compact distilled model H0-mini slightly outperforms its larger teacher model H-optimus-0, despite using fewer than 8% of the parameters and enabling significantly faster feature extraction. Together, these results provide the first large-scale, externally validated benchmark of PFMs for breast cancer survival prediction, and offer practical guidance for efficient deployment of PFMs in clinical workflows.

Sean Wu, Fredrik K. Gustafsson, Edward Phillips et al.

Large language models (LLMs) often produce confident but incorrect answers in settings where abstention would be safer. Standard evaluation protocols, however, require a response and do not account for how confidence should guide decisions under different risk preferences. To address this gap, we introduce the Behavioral Alignment Score (BAS), a decision-theoretic metric for evaluating how well LLM confidence supports abstention-aware decision making. BAS is derived from an explicit answer-or-abstain utility model and aggregates realized utility across a continuum of risk thresholds, yielding a measure of decision-level reliability that depends on both the magnitude and ordering of confidence. We show theoretically that truthful confidence estimates uniquely maximize expected BAS utility, linking calibration to decision-optimal behavior. BAS is related to proper scoring rules such as log loss, but differs structurally: log loss penalizes underconfidence and overconfidence symmetrically, whereas BAS imposes an asymmetric penalty that strongly prioritizes avoiding overconfident errors. Using BAS alongside widely used metrics such as ECE and AURC, we then construct a benchmark of self-reported confidence reliability across multiple LLMs and tasks. Our results reveal substantial variation in decision-useful confidence, and while larger and more accurate models tend to achieve higher BAS, even frontier models remain prone to severe overconfidence. Importantly, models with similar ECE or AURC can exhibit very different BAS due to highly overconfident errors, highlighting limitations of standard metrics. We further show that simple interventions, such as top-$k$ confidence elicitation and post-hoc calibration, can meaningfully improve confidence reliability. Overall, our work provides both a principled metric and a comprehensive benchmark for evaluating LLM confidence reliability.

Taro Langner, Fredrik K. Gustafsson, Benny Avelin et al.

Along with rich health-related metadata, medical images have been acquired for over 40,000 male and female UK Biobank participants, aged 44-82, since 2014. Phenotypes derived from these images, such as measurements of body composition from MRI, can reveal new links between genetics, cardiovascular disease, and metabolic conditions. In this work, six measurements of body composition and adipose tissues were automatically estimated by image-based, deep regression with ResNet50 neural networks from neck-to-knee body MRI. Despite the potential for high speed and accuracy, these networks produce no output segmentations that could indicate the reliability of individual measurements. The presented experiments therefore examine uncertainty quantification with mean-variance regression and ensembling to estimate individual measurement errors and thereby identify potential outliers, anomalies, and other failure cases automatically. In 10-fold cross-validation on data of about 8,500 subjects, mean-variance regression and ensembling showed complementary benefits, reducing the mean absolute error across all predictions by 12%. Both improved the calibration of uncertainties and their ability to identify high prediction errors. With intra-class correlation coefficients (ICC) above 0.97, all targets except the liver fat content yielded relative measurement errors below 5%. Testing on another 1,000 subjects showed consistent performance, and the method was finally deployed for inference to 30,000 subjects with missing reference values. The results indicate that deep regression ensembles could ultimately provide automated, uncertainty-aware measurements of body composition for more than 120,000 UK Biobank neck-to-knee body MRI that are to be acquired within the coming years.

Johannes N. Hendriks, Fredrik K. Gustafsson, Antônio H. Ribeiro et al.

This paper is directed towards the problem of learning nonlinear ARX models based on system input--output data. In particular, our interest is in learning a conditional distribution of the current output based on a finite window of past inputs and outputs. To achieve this, we consider the use of so-called energy-based models, which have been developed in allied fields for learning unknown distributions based on data. This energy-based model relies on a general function to describe the distribution, and here we consider a deep neural network for this purpose. The primary benefit of this approach is that it is capable of learning both simple and highly complex noise models, which we demonstrate on simulated and experimental data.