Cooper U. Gamble

Bardia Khosravi, Frank Li, Theo Dapamede et al.

Chest X-rays (CXR) are essential for diagnosing a variety of conditions, but when used on new populations, model generalizability issues limit their efficacy. Generative AI, particularly denoising diffusion probabilistic models (DDPMs), offers a promising approach to generating synthetic images, enhancing dataset diversity. This study investigates the impact of synthetic data supplementation on the performance and generalizability of medical imaging research. The study employed DDPMs to create synthetic CXRs conditioned on demographic and pathological characteristics from the CheXpert dataset. These synthetic images were used to supplement training datasets for pathology classifiers, with the aim of improving their performance. The evaluation involved three datasets (CheXpert, MIMIC-CXR, and Emory Chest X-ray) and various experiments, including supplementing real data with synthetic data, training with purely synthetic data, and mixing synthetic data with external datasets. Performance was assessed using the area under the receiver operating curve (AUROC). Adding synthetic data to real datasets resulted in a notable increase in AUROC values (up to 0.02 in internal and external test sets with 1000% supplementation, p-value less than 0.01 in all instances). When classifiers were trained exclusively on synthetic data, they achieved performance levels comparable to those trained on real data with 200%-300% data supplementation. The combination of real and synthetic data from different sources demonstrated enhanced model generalizability, increasing model AUROC from 0.76 to 0.80 on the internal test set (p-value less than 0.01). In conclusion, synthetic data supplementation significantly improves the performance and generalizability of pathology classifiers in medical imaging.

Pouria Rouzrokh, Shahriar Faghani, Cooper U. Gamble et al.

Retrieval-augmented generation (RAG) frameworks enable large language models (LLMs) to retrieve relevant information from a knowledge base and incorporate it into the context for generating responses. This mitigates hallucinations and allows for the updating of knowledge without retraining the LLM. However, RAG does not guarantee valid responses if retrieval fails to identify the necessary information as the context for response generation. Also, if there is contradictory content, the RAG response will likely reflect only one of the two possible responses. Therefore, quantifying uncertainty in the retrieval process is crucial for ensuring RAG trustworthiness. In this report, we introduce a four-step framework for applying conformal prediction to quantify retrieval uncertainty in RAG frameworks. First, a calibration set of questions answerable from the knowledge base is constructed. Each question's embedding is compared against document embeddings to identify the most relevant document chunks containing the answer and record their similarity scores. Given a user-specified error rate (α), these similarity scores are then analyzed to determine a similarity score cutoff threshold. During inference, all chunks with similarity exceeding this threshold are retrieved to provide context to the LLM, ensuring the true answer is captured in the context with a (1-α) confidence level. We provide a Python package that enables users to implement the entire workflow proposed in our work, only using LLMs and without human intervention.