Susu Xu

LG
h-index26
21papers
242citations
Novelty56%
AI Score56

21 Papers

LGOct 2, 2023
Causality-informed Rapid Post-hurricane Building Damage Detection in Large Scale from InSAR Imagery

Chenguang Wang, Yepeng Liu, Xiaojian Zhang et al.

Timely and accurate assessment of hurricane-induced building damage is crucial for effective post-hurricane response and recovery efforts. Recently, remote sensing technologies provide large-scale optical or Interferometric Synthetic Aperture Radar (InSAR) imagery data immediately after a disastrous event, which can be readily used to conduct rapid building damage assessment. Compared to optical satellite imageries, the Synthetic Aperture Radar can penetrate cloud cover and provide more complete spatial coverage of damaged zones in various weather conditions. However, these InSAR imageries often contain highly noisy and mixed signals induced by co-occurring or co-located building damage, flood, flood/wind-induced vegetation changes, as well as anthropogenic activities, making it challenging to extract accurate building damage information. In this paper, we introduced an approach for rapid post-hurricane building damage detection from InSAR imagery. This approach encoded complex causal dependencies among wind, flood, building damage, and InSAR imagery using a holistic causal Bayesian network. Based on the causal Bayesian network, we further jointly inferred the large-scale unobserved building damage by fusing the information from InSAR imagery with prior physical models of flood and wind, without the need for ground truth labels. Furthermore, we validated our estimation results in a real-world devastating hurricane -- the 2022 Hurricane Ian. We gathered and annotated building damage ground truth data in Lee County, Florida, and compared the introduced method's estimation results with the ground truth and benchmarked it against state-of-the-art models to assess the effectiveness of our proposed method. Results show that our method achieves rapid and accurate detection of building damage, with significantly reduced processing time compared to traditional manual inspection methods.

LGOct 20, 2023
Normalizing flow-based deep variational Bayesian network for seismic multi-hazards and impacts estimation from InSAR imagery

Xuechun Li, Paula M. Burgi, Wei Ma et al.

Onsite disasters like earthquakes can trigger cascading hazards and impacts, such as landslides and infrastructure damage, leading to catastrophic losses; thus, rapid and accurate estimates are crucial for timely and effective post-disaster responses. Interferometric Synthetic aperture radar (InSAR) data is important in providing high-resolution onsite information for rapid hazard estimation. Most recent methods using InSAR imagery signals predict a single type of hazard and thus often suffer low accuracy due to noisy and complex signals induced by co-located hazards, impacts, and irrelevant environmental changes (e.g., vegetation changes, human activities). We introduce a novel stochastic variational inference with normalizing flows derived to jointly approximate posteriors of multiple unobserved hazards and impacts from noisy InSAR imagery.

AIFeb 24, 2025Code
From Perceptions to Decisions: Wildfire Evacuation Decision Prediction with Behavioral Theory-informed LLMs

Ruxiao Chen, Chenguang Wang, Yuran Sun et al.

Evacuation decision prediction is critical for efficient and effective wildfire response by helping emergency management anticipate traffic congestion and bottlenecks, allocate resources, and minimize negative impacts. Traditional statistical methods for evacuation decision prediction fail to capture the complex and diverse behavioral logic of different individuals. In this work, for the first time, we introduce FLARE, short for facilitating LLM for advanced reasoning on wildfire evacuation decision prediction, a Large Language Model (LLM)-based framework that integrates behavioral theories and models to streamline the Chain-of-Thought (CoT) reasoning and subsequently integrate with memory-based Reinforcement Learning (RL) module to provide accurate evacuation decision prediction and understanding. Our proposed method addresses the limitations of using existing LLMs for evacuation behavioral predictions, such as limited survey data, mismatching with behavioral theory, conflicting individual preferences, implicit and complex mental states, and intractable mental state-behavior mapping. Experiments on three post-wildfire survey datasets show an average of 20.47% performance improvement over traditional theory-informed behavioral models, with strong cross-event generalizability. Our complete code is publicly available at https://github.com/SusuXu-s-Lab/FLARE

CVDec 18, 2025
QUIDS: Quality-informed Incentive-driven Multi-agent Dispatching System for Mobile Crowdsensing

Nan Zhou, Zuxin Li, Fanhang Man et al.

This paper addresses the challenge of achieving optimal Quality of Information (QoI) in non-dedicated vehicular mobile crowdsensing (NVMCS) systems. The key obstacles are the interrelated issues of sensing coverage, sensing reliability, and the dynamic participation of vehicles. To tackle these, we propose QUIDS, a QUality-informed Incentive-driven multi-agent Dispatching System, which ensures high sensing coverage and reliability under budget constraints. QUIDS introduces a novel metric, Aggregated Sensing Quality (ASQ), to quantitatively capture QoI by integrating both coverage and reliability. We also develop a Mutually Assisted Belief-aware Vehicle Dispatching algorithm that estimates sensing reliability and allocates incentives under uncertainty, further improving ASQ. Evaluation using real-world data from a metropolitan NVMCS deployment shows QUIDS improves ASQ by 38% over non-dispatching scenarios and by 10% over state-of-the-art methods. It also reduces reconstruction map errors by 39-74% across algorithms. By jointly optimizing coverage and reliability via a quality-informed incentive mechanism, QUIDS enables low-cost, high-quality urban monitoring without dedicated infrastructure, applicable to smart-city scenarios like traffic and environmental sensing.

AIMar 20
Learning Dynamic Belief Graphs for Theory-of-mind Reasoning

Ruxiao Chen, Xilei Zhao, Thomas J. Cova et al.

Theory of Mind (ToM) reasoning with Large Language Models (LLMs) requires inferring how people's implicit, evolving beliefs shape what they seek and how they act under uncertainty -- especially in high-stakes settings such as disaster response, emergency medicine, and human-in-the-loop autonomy. Prior approaches either prompt LLMs directly or use latent-state models that treat beliefs as static and independent, often producing incoherent mental models over time and weak reasoning in dynamic contexts. We introduce a structured cognitive trajectory model for LLM-based ToM that represents mental state as a dynamic belief graph, jointly inferring latent beliefs, learning their time-varying dependencies, and linking belief evolution to information seeking and decisions. Our model contributes (i) a novel projection from textualized probabilistic statements to consistent probabilistic graphical model updates, (ii) an energy-based factor graph representation of belief interdependencies, and (iii) an ELBO-based objective that captures belief accumulation and delayed decisions. Across multiple real-world disaster evacuation datasets, our model significantly improves action prediction and recovers interpretable belief trajectories consistent with human reasoning, providing a principled module for augmenting LLMs with ToM in high-uncertainty environment. https://anonymous.4open.science/r/ICML_submission-6373/

LGMar 12
Multi-Task Anti-Causal Learning for Reconstructing Urban Events from Residents' Reports

Liangkai Zhou, Susu Xu, Shuqi Zhong et al.

Many real-world machine learning tasks are anti-causal: they require inferring latent causes from observed effects. In practice, we often face multiple related tasks where part of the forward causal mechanism is invariant across tasks, while other components are task-specific. We propose Multi-Task Anti-Causal learning (MTAC), a framework for estimating causes from outcomes and confounders by explicitly exploiting such cross-task invariances. MTAC first performs causal discovery to learn a shared causal graph and then instantiates a structured multi-task structural equation model (SEM) that factorizes the outcome-generation process into (i) a task-invariant mechanism and (ii) task-specific mechanisms via a shared backbone with task-specific heads. Building on the learned forward model, MTAC performs maximum A posteriori (MAP)based inference to reconstruct causes by jointly optimizing latent mechanism variables and cause magnitudes under the learned causal structure. We evaluate MTAC on the application of urban event reconstruction from resident reports, spanning three tasks:parking violations, abandoned properties, and unsanitary conditions. On real-world data collected from Manhattan and the city of Newark, MTAC consistently improves reconstruction accuracy over strong baselines, achieving up to 34.61\% MAE reduction and demonstrating the benefit of learning transferable causal mechanisms across tasks.

CLJan 7
Persona-aware and Explainable Bikeability Assessment: A Vision-Language Model Approach

Yilong Dai, Ziyi Wang, Chenguang Wang et al.

Bikeability assessment is essential for advancing sustainable urban transportation and creating cyclist-friendly cities, and it requires incorporating users' perceptions of safety and comfort. Yet existing perception-based bikeability assessment approaches face key limitations in capturing the complexity of road environments and adequately accounting for heterogeneity in subjective user perceptions. This paper proposes a persona-aware Vision-Language Model framework for bikeability assessment with three novel contributions: (i) theory-grounded persona conditioning based on established cyclist typology that generates persona-specific explanations via chain-of-thought reasoning; (ii) multi-granularity supervised fine-tuning that combines scarce expert-annotated reasoning with abundant user ratings for joint prediction and explainable assessment; and (iii) AI-enabled data augmentation that creates controlled paired data to isolate infrastructure variable impacts. To test and validate this framework, we developed a panoramic image-based crowdsourcing system and collected 12,400 persona-conditioned assessments from 427 cyclists. Experiment results show that the proposed framework offers competitive bikeability rating prediction while uniquely enabling explainable factor attribution.

GEO-PHNov 18, 2024
Spatial-variant causal Bayesian inference for rapid seismic ground failures and impacts estimation

Xuechun Li, Susu Xu

Rapid and accurate estimation of post-earthquake ground failures and building damage is critical for effective post-disaster responses. Progression in remote sensing technologies has paved the way for rapid acquisition of detailed, localized data, enabling swift hazard estimation through analysis of correlation deviations between pre- and post-quake satellite imagery. However, discerning seismic hazards and their impacts is challenged by overlapping satellite signals from ground failures, building damage, and environmental noise. Previous advancements introduced a novel causal graph-based Bayesian network that continually refines seismic ground failure and building damage estimates derived from satellite imagery, accounting for the intricate interplay among geospatial elements, seismic activity, ground failures, building structures, damages, and satellite data. However, this model's neglect of spatial heterogeneity across different locations in a seismic region limits its precision in capturing the spatial diversity of seismic effects. In this study, we pioneer an approach that accounts for spatial intricacies by introducing a spatial variable influenced by the bilateral filter to capture relationships from surrounding hazards. The bilateral filter considers both spatial proximity of neighboring hazards and their ground shaking intensity values, ensuring refined modeling of spatial relationships. This integration achieves a balance between site-specific characteristics and spatial tendencies, offering a comprehensive representation of the post-disaster landscape. Our model, tested across multiple earthquake events, demonstrates significant improvements in capturing spatial heterogeneity in seismic hazard estimation. The results highlight enhanced accuracy and efficiency in post-earthquake large-scale multi-impact estimation, effectively informing rapid disaster responses.

CVFeb 25, 2025
Multi-class Seismic Building Damage Assessment from InSAR Imagery using Quadratic Variational Causal Bayesian Inference

Xuechun Li, Susu Xu

Interferometric Synthetic Aperture Radar (InSAR) technology uses satellite radar to detect surface deformation patterns and monitor earthquake impacts on buildings. While vital for emergency response planning, extracting multi-class building damage classifications from InSAR data faces challenges: overlapping damage signatures with environmental noise, computational complexity in multi-class scenarios, and the need for rapid regional-scale processing. Our novel multi-class variational causal Bayesian inference framework with quadratic variational bounds provides rigorous approximations while ensuring efficiency. By integrating InSAR observations with USGS ground failure models and building fragility functions, our approach separates building damage signals while maintaining computational efficiency through strategic pruning. Evaluation across five major earthquakes (Haiti 2021, Puerto Rico 2020, Zagreb 2020, Italy 2016, Ridgecrest 2019) shows improved damage classification accuracy (AUC: 0.94-0.96), achieving up to 35.7% improvement over existing methods. Our approach maintains high accuracy (AUC > 0.93) across all damage categories while reducing computational overhead by over 40% without requiring extensive ground truth data.

CVApr 11, 2024
Post-hurricane building damage assessment using street-view imagery and structured data: A multi-modal deep learning approach

Zhuoqun Xue, Xiaojian Zhang, David O. Prevatt et al.

Accurately assessing building damage is critical for disaster response and recovery. However, many existing models for detecting building damage have poor prediction accuracy due to their limited capabilities of identifying detailed, comprehensive structural and/or non-structural damage from the street-view image. Additionally, these models mainly rely on the imagery data for damage classification, failing to account for other critical information, such as wind speed, building characteristics, evacuation zones, and distance of the building to the hurricane track. To address these limitations, in this study, we propose a novel multi-modal (i.e., imagery and structured data) approach for post-hurricane building damage classification, named the Multi-Modal Swin Transformer (MMST). We empirically train and evaluate the proposed MMST using data collected from the 2022 Hurricane Ian in Florida, USA. Results show that MMST outperforms all selected state-of-the-art benchmark models and can achieve an accuracy of 92.67%, which are 7.71% improvement in accuracy compared to Visual Geometry Group 16 (VGG-16). In addition to the street-view imagery data, building value, building age, and wind speed are the most important predictors for damage level classification. The proposed MMST can be deployed to assist in rapid damage assessment and guide reconnaissance efforts in future hurricanes.

CLDec 4, 2023
Near-real-time Earthquake-induced Fatality Estimation using Crowdsourced Data and Large-Language Models

Chenguang Wang, Davis Engler, Xuechun Li et al.

When a damaging earthquake occurs, immediate information about casualties is critical for time-sensitive decision-making by emergency response and aid agencies in the first hours and days. Systems such as Prompt Assessment of Global Earthquakes for Response (PAGER) by the U.S. Geological Survey (USGS) were developed to provide a forecast within about 30 minutes of any significant earthquake globally. Traditional systems for estimating human loss in disasters often depend on manually collected early casualty reports from global media, a process that's labor-intensive and slow with notable time delays. Recently, some systems have employed keyword matching and topic modeling to extract relevant information from social media. However, these methods struggle with the complex semantics in multilingual texts and the challenge of interpreting ever-changing, often conflicting reports of death and injury numbers from various unverified sources on social media platforms. In this work, we introduce an end-to-end framework to significantly improve the timeliness and accuracy of global earthquake-induced human loss forecasting using multi-lingual, crowdsourced social media. Our framework integrates (1) a hierarchical casualty extraction model built upon large language models, prompt design, and few-shot learning to retrieve quantitative human loss claims from social media, (2) a physical constraint-aware, dynamic-truth discovery model that discovers the truthful human loss from massive noisy and potentially conflicting human loss claims, and (3) a Bayesian updating loss projection model that dynamically updates the final loss estimation using discovered truths. We test the framework in real-time on a series of global earthquake events in 2021 and 2022 and show that our framework streamlines casualty data retrieval, achieving speed and accuracy comparable to manual methods by USGS.

AISep 5, 2025
From Image Generation to Infrastructure Design: a Multi-agent Pipeline for Street Design Generation

Chenguang Wang, Xiang Yan, Yilong Dai et al.

Realistic visual renderings of street-design scenarios are essential for public engagement in active transportation planning. Traditional approaches are labor-intensive, hindering collective deliberation and collaborative decision-making. While AI-assisted generative design shows transformative potential by enabling rapid creation of design scenarios, existing generative approaches typically require large amounts of domain-specific training data and struggle to enable precise spatial variations of design/configuration in complex street-view scenes. We introduce a multi-agent system that edits and redesigns bicycle facilities directly on real-world street-view imagery. The framework integrates lane localization, prompt optimization, design generation, and automated evaluation to synthesize realistic, contextually appropriate designs. Experiments across diverse urban scenarios demonstrate that the system can adapt to varying road geometries and environmental conditions, consistently yielding visually coherent and instruction-compliant results. This work establishes a foundation for applying multi-agent pipelines to transportation infrastructure planning and facility design.

MLApr 5, 2025
Spatially-Heterogeneous Causal Bayesian Networks for Seismic Multi-Hazard Estimation: A Variational Approach with Gaussian Processes and Normalizing Flows

Xuechun Li, Shan Gao, Runyu Gao et al.

Post-earthquake hazard and impact estimation are critical for effective disaster response, yet current approaches face significant limitations. Traditional models employ fixed parameters regardless of geographical context, misrepresenting how seismic effects vary across diverse landscapes, while remote sensing technologies struggle to distinguish between co-located hazards. We address these challenges with a spatially-aware causal Bayesian network that decouples co-located hazards by modeling their causal relationships with location-specific parameters. Our framework integrates sensing observations, latent variables, and spatial heterogeneity through a novel combination of Gaussian Processes with normalizing flows, enabling us to capture how same earthquake produces different effects across varied geological and topographical features. Evaluations across three earthquakes demonstrate Spatial-VCBN achieves Area Under the Curve (AUC) improvements of up to 35.2% over existing methods. These results highlight the critical importance of modeling spatial heterogeneity in causal mechanisms for accurate disaster assessment, with direct implications for improving emergency response resource allocation.

LGOct 15, 2025
Decision-focused Sensing and Forecasting for Adaptive and Rapid Flood Response: An Implicit Learning Approach

Qian Sun, Graham Hults, Susu Xu

Timely and reliable decision-making is vital for flood emergency response, yet it remains severely hindered by limited and imprecise situational awareness due to various budget and data accessibility constraints. Traditional flood management systems often rely on in-situ sensors to calibrate remote sensing-based large-scale flood depth forecasting models, and further take flood depth estimates to optimize flood response decisions. However, these approaches often take fixed, decision task-agnostic strategies to decide where to put in-situ sensors (e.g., maximize overall information gain) and train flood forecasting models (e.g., minimize average forecasting errors), but overlook that systems with the same sensing gain and average forecasting errors may lead to distinct decisions. To address this, we introduce a novel decision-focused framework that strategically selects locations for in-situ sensor placement and optimize spatio-temporal flood forecasting models to optimize downstream flood response decision regrets. Our end-to-end pipeline integrates four components: a contextual scoring network, a differentiable sensor selection module under hard budget constraints, a spatio-temporal flood reconstruction and forecasting model, and a differentiable decision layer tailored to task-specific objectives. Central to our approach is the incorporation of Implicit Maximum Likelihood Estimation (I-MLE) to enable gradient-based learning over discrete sensor configurations, and probabilistic decision heads to enable differentiable approximation to various constrained disaster response tasks.

AIMay 22, 2025
Where You Go is Who You Are: Behavioral Theory-Guided LLMs for Inverse Reinforcement Learning

Yuran Sun, Susu Xu, Chenguang Wang et al.

Big trajectory data hold great promise for human mobility analysis, but their utility is often constrained by the absence of critical traveler attributes, particularly sociodemographic information. While prior studies have explored predicting such attributes from mobility patterns, they often overlooked underlying cognitive mechanisms and exhibited low predictive accuracy. This study introduces SILIC, short for Sociodemographic Inference with LLM-guided Inverse Reinforcement Learning (IRL) and Cognitive Chain Reasoning (CCR), a theoretically grounded framework that leverages LLMs to infer sociodemographic attributes from observed mobility patterns by capturing latent behavioral intentions and reasoning through psychological constructs. Particularly, our approach explicitly follows the Theory of Planned Behavior (TPB), a foundational behavioral framework in transportation research, to model individuals' latent cognitive processes underlying travel decision-making. The LLMs further provide heuristic guidance to improve IRL reward function initialization and update by addressing its ill-posedness and optimization challenges arising from the vast and unstructured reward space. Evaluated in the 2017 Puget Sound Regional Council Household Travel Survey, our method substantially outperforms state-of-the-art baselines and shows great promise for enriching big trajectory data to support more behaviorally grounded applications in transportation planning and beyond.

LGApr 5, 2025
Multi-resolution Score-Based Variational Graphical Diffusion for Causal Disaster System Modeling and Inference

Xuechun Li, Shan Gao, Susu Xu

Complex systems with intricate causal dependencies challenge accurate prediction. Effective modeling requires precise physical process representation, integration of interdependent factors, and incorporation of multi-resolution observational data. These systems manifest in both static scenarios with instantaneous causal chains and temporal scenarios with evolving dynamics, complicating modeling efforts. Current methods struggle to simultaneously handle varying resolutions, capture physical relationships, model causal dependencies, and incorporate temporal dynamics, especially with inconsistently sampled data from diverse sources. We introduce Temporal-SVGDM: Score-based Variational Graphical Diffusion Model for Multi-resolution observations. Our framework constructs individual SDEs for each variable at its native resolution, then couples these SDEs through a causal score mechanism where parent nodes inform child nodes' evolution. This enables unified modeling of both immediate causal effects in static scenarios and evolving dependencies in temporal scenarios. In temporal models, state representations are processed through a sequence prediction model to predict future states based on historical patterns and causal relationships. Experiments on real-world datasets demonstrate improved prediction accuracy and causal understanding compared to existing methods, with robust performance under varying levels of background knowledge. Our model exhibits graceful degradation across different disaster types, successfully handling both static earthquake scenarios and temporal hurricane and wildfire scenarios, while maintaining superior performance even with limited data.

LGNov 1, 2024
Preventing Model Collapse in Deep Canonical Correlation Analysis by Noise Regularization

Junlin He, Jinxiao Du, Susu Xu et al.

Multi-View Representation Learning (MVRL) aims to learn a unified representation of an object from multi-view data. Deep Canonical Correlation Analysis (DCCA) and its variants share simple formulations and demonstrate state-of-the-art performance. However, with extensive experiments, we observe the issue of model collapse, {\em i.e.}, the performance of DCCA-based methods will drop drastically when training proceeds. The model collapse issue could significantly hinder the wide adoption of DCCA-based methods because it is challenging to decide when to early stop. To this end, we develop NR-DCCA, which is equipped with a novel noise regularization approach to prevent model collapse. Theoretical analysis shows that the Correlation Invariant Property is the key to preventing model collapse, and our noise regularization forces the neural network to possess such a property. A framework to construct synthetic data with different common and complementary information is also developed to compare MVRL methods comprehensively. The developed NR-DCCA outperforms baselines stably and consistently in both synthetic and real-world datasets, and the proposed noise regularization approach can also be generalized to other DCCA-based methods such as DGCCA.

AIJul 23, 2021
HierMUD: Hierarchical Multi-task Unsupervised Domain Adaptation between Bridges for Drive-by Damage Diagnosis

Jingxiao Liu, Susu Xu, Mario Bergés et al.

Monitoring bridge health using vibrations of drive-by vehicles has various benefits, such as no need for directly installing and maintaining sensors on the bridge. However, many of the existing drive-by monitoring approaches are based on supervised learning models that require labeled data from every bridge of interest, which is expensive and time-consuming, if not impossible, to obtain. To this end, we introduce a new framework that transfers the model learned from one bridge to diagnose damage in another bridge without any labels from the target bridge. Our framework trains a hierarchical neural network model in an adversarial way to extract task-shared and task-specific features that are informative to multiple diagnostic tasks and invariant across multiple bridges. We evaluate our framework on experimental data collected from 2 bridges and 3 vehicles. We achieve accuracies of 95% for damage detection, 93% for localization, and up to 72% for quantification, which are ~2 times improvements from baseline methods.

LGAug 28, 2019
O-MedAL: Online Active Deep Learning for Medical Image Analysis

Asim Smailagic, Pedro Costa, Alex Gaudio et al.

Active Learning methods create an optimized labeled training set from unlabeled data. We introduce a novel Online Active Deep Learning method for Medical Image Analysis. We extend our MedAL active learning framework to present new results in this paper. Our novel sampling method queries the unlabeled examples that maximize the average distance to all training set examples. Our online method enhances performance of its underlying baseline deep network. These novelties contribute significant performance improvements, including improving the model's underlying deep network accuracy by 6.30%, using only 25% of the labeled dataset to achieve baseline accuracy, reducing backpropagated images during training by as much as 67%, and demonstrating robustness to class imbalance in binary and multi-class tasks.

LGNov 19, 2018
Stackelberg GAN: Towards Provable Minimax Equilibrium via Multi-Generator Architectures

Hongyang Zhang, Susu Xu, Jiantao Jiao et al.

We study the problem of alleviating the instability issue in the GAN training procedure via new architecture design. The discrepancy between the minimax and maximin objective values could serve as a proxy for the difficulties that the alternating gradient descent encounters in the optimization of GANs. In this work, we give new results on the benefits of multi-generator architecture of GANs. We show that the minimax gap shrinks to $ε$ as the number of generators increases with rate $\widetilde{O}(1/ε)$. This improves over the best-known result of $\widetilde{O}(1/ε^2)$. At the core of our techniques is a novel application of Shapley-Folkman lemma to the generic minimax problem, where in the literature the technique was only known to work when the objective function is restricted to the Lagrangian function of a constraint optimization problem. Our proposed Stackelberg GAN performs well experimentally in both synthetic and real-world datasets, improving Fréchet Inception Distance by $14.61\%$ over the previous multi-generator GANs on the benchmark datasets.

CVSep 25, 2018
MedAL: Deep Active Learning Sampling Method for Medical Image Analysis

Asim Smailagic, Hae Young Noh, Pedro Costa et al.

Deep learning models have been successfully used in medical image analysis problems but they require a large amount of labeled images to obtain good performance.Deep learning models have been successfully used in medical image analysis problems but they require a large amount of labeled images to obtain good performance. However, such large labeled datasets are costly to acquire. Active learning techniques can be used to minimize the number of required training labels while maximizing the model's performance.In this work, we propose a novel sampling method that queries the unlabeled examples that maximize the average distance to all training set examples in a learned feature space. We then extend our sampling method to define a better initial training set, without the need for a trained model, by using ORB feature descriptors. We validate MedAL on 3 medical image datasets and show that our method is robust to different dataset properties. MedAL is also efficient, achieving 80% accuracy on the task of Diabetic Retinopathy detection using only 425 labeled images, corresponding to a 32% reduction in the number of required labeled examples compared to the standard uncertainty sampling technique, and a 40% reduction compared to random sampling.