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Distributionally robust optimization (DRO) studies decision problems under uncertainty where the probability distribution governing the uncertain problem parameters is itself uncertain. A key component of any DRO model is its ambiguity set, that is, a family of probability distributions consistent with any available structural or statistical information. DRO seeks decisions that perform best under the worst distribution in the ambiguity set. This worst case criterion is supported by findings in psychology and neuroscience, which indicate that many decision-makers have a low tolerance for distributional ambiguity. DRO is rooted in statistics, operations research and control theory, and recent research has uncovered its deep connections to regularization techniques and adversarial training in machine learning. This survey presents the key findings of the field in a unified and self-contained manner.

Autoregressive (AR) Transformer-based sequence models are known to have difficulty generalizing to sequences longer than those seen during training. When applied to text-to-speech (TTS), these models tend to drop or repeat words or produce erratic output, especially for longer utterances. In this paper, we introduce enhancements aimed at AR Transformer-based encoder-decoder TTS systems that address these robustness and length generalization issues. Our approach uses an alignment mechanism to provide cross-attention operations with relative location information. The associated alignment position is learned as a latent property of the model via backprop and requires no external alignment information during training. While the approach is tailored to the monotonic nature of TTS input-output alignment, it is still able to benefit from the flexible modeling power of interleaved multi-head self- and cross-attention operations. A system incorporating these improvements, which we call Very Attentive Tacotron, matches the naturalness and expressiveness of a baseline T5-based TTS system, while eliminating problems with repeated or dropped words and enabling generalization to any practical utterance length., Comment: Submitted to NAACL

Speech pathology has impacts on communication abilities and quality of life. While deep learning-based models have shown potential in diagnosing these disorders, the use of sensitive data raises critical privacy concerns. Although differential privacy (DP) has been explored in the medical imaging domain, its application in pathological speech analysis remains largely unexplored despite the equally critical privacy concerns. This study is the first to investigate DP's impact on pathological speech data, focusing on the trade-offs between privacy, diagnostic accuracy, and fairness. Using a large, real-world dataset of 200 hours of recordings from 2,839 German-speaking participants, we observed a maximum accuracy reduction of 3.85% when training with DP with a privacy budget, denoted by {\epsilon}, of 7.51. To generalize our findings, we validated our approach on a smaller dataset of Spanish-speaking Parkinson's disease patients, demonstrating that careful pretraining on large-scale task-specific datasets can maintain or even improve model accuracy under DP constraints. We also conducted a comprehensive fairness analysis, revealing that reasonable privacy levels (2<{\epsilon}<10) do not introduce significant gender bias, though age-related disparities may require further attention. Our results suggest that DP can effectively balance privacy and utility in speech disorder detection, but also highlight the unique challenges in the speech domain, particularly regarding the privacy-fairness trade-off. This provides a foundation for future work to refine DP methodologies and address fairness across diverse patient groups in real-world deployments.

Traffic sampling has become an indispensable tool in network management. While there exists a plethora of sampling systems, they generally assume flow rates are stable and predictable over a sampling period. Consequently, when deployed in networks with dynamic flow rates, some flows may be missed or under-sampled, while others are over-sampled. This paper presents the design and evaluation of dSamp, a network-wide sampling system capable of handling dynamic flow rates in Software-Defined Networks (SDNs). The key idea in dSamp is to consider flow rate fluctuations when deciding on which network switches and at what rate to sample each flow. To this end, we develop a general model for sampling allocation with dynamic flow rates, and then design an efficient approximate integer linear program called APX that can be used to compute sampling allocations even in large-scale networks. To show the efficacy of dSamp for network monitoring, we have implemented APX and several existing solutions in ns-3 and conducted extensive experiments using model-driven as well as trace-driven simulations. Our results indicate that, by considering dynamic flow rates, APX outperforms the existing solutions by up to 10% in sampling more flows at a given sampling rate., Comment: 9 pages, 8 figures

Large language models (LLMs) have advanced the field of artificial intelligence (AI) in medicine. However LLMs often generate outdated or inaccurate information based on static training datasets. Retrieval augmented generation (RAG) mitigates this by integrating outside data sources. While previous RAG systems used pre-assembled, fixed databases with limited flexibility, we have developed Radiology RAG (RadioRAG) as an end-to-end framework that retrieves data from authoritative radiologic online sources in real-time. RadioRAG is evaluated using a dedicated radiologic question-and-answer dataset (RadioQA). We evaluate the diagnostic accuracy of various LLMs when answering radiology-specific questions with and without access to additional online information via RAG. Using 80 questions from RSNA Case Collection across radiologic subspecialties and 24 additional expert-curated questions, for which the correct gold-standard answers were available, LLMs (GPT-3.5-turbo, GPT-4, Mistral-7B, Mixtral-8x7B, and Llama3 [8B and 70B]) were prompted with and without RadioRAG. RadioRAG retrieved context-specific information from www.radiopaedia.org in real-time and incorporated them into its reply. RadioRAG consistently improved diagnostic accuracy across all LLMs, with relative improvements ranging from 2% to 54%. It matched or exceeded question answering without RAG across radiologic subspecialties, particularly in breast imaging and emergency radiology. However, degree of improvement varied among models; GPT-3.5-turbo and Mixtral-8x7B-instruct-v0.1 saw notable gains, while Mistral-7B-instruct-v0.2 showed no improvement, highlighting variability in its effectiveness. LLMs benefit when provided access to domain-specific data beyond their training data. For radiology, RadioRAG establishes a robust framework that substantially improves diagnostic accuracy and factuality in radiological question answering.

We consider learning in an adversarial environment, where an $\varepsilon$-fraction of samples from a distribution $P$ are arbitrarily modified (global corruptions) and the remaining perturbations have average magnitude bounded by $\rho$ (local corruptions). Given access to $n$ such corrupted samples, we seek a computationally efficient estimator $\hat{P}_n$ that minimizes the Wasserstein distance $\mathsf{W}_1(\hat{P}_n,P)$. In fact, we attack the fine-grained task of minimizing $\mathsf{W}_1(\Pi_\# \hat{P}_n, \Pi_\# P)$ for all orthogonal projections $\Pi \in \mathbb{R}^{d \times d}$, with performance scaling with $\mathrm{rank}(\Pi) = k$. This allows us to account simultaneously for mean estimation ($k=1$), distribution estimation ($k=d$), as well as the settings interpolating between these two extremes. We characterize the optimal population-limit risk for this task and then develop an efficient finite-sample algorithm with error bounded by $\sqrt{\varepsilon k} + \rho + \tilde{O}(d\sqrt{k}n^{-1/(k \lor 2)})$ when $P$ has bounded covariance. This guarantee holds uniformly in $k$ and is minimax optimal up to the sub-optimality of the plug-in estimator when $\rho = \varepsilon = 0$. Our efficient procedure relies on a novel trace norm approximation of an ideal yet intractable 2-Wasserstein projection estimator. We apply this algorithm to robust stochastic optimization, and, in the process, uncover a new method for overcoming the curse of dimensionality in Wasserstein distributionally robust optimization., Comment: Accepted for presentation at the Conference on Learning Theory (COLT) 2024

Designing policies for a network of agents is typically done by formulating an optimization problem where each agent has access to state measurements of all the other agents in the network. Such policy designs with centralized information exchange result in optimization problems that are typically hard to solve, require establishing substantial communication links, and do not promote privacy since all information is shared among the agents. Designing policies based on arbitrary communication structures can lead to non-convex optimization problems which are typically NP-hard. In this work, we propose an optimization framework for decentralized policy designs. In contrast to the centralized information exchange, our approach requires only local communication exchange among the neighboring agents matching the physical coupling of the network. Thus, each agent only requires information from its direct neighbors, minimizing the need for excessive communication and promoting privacy amongst the agents. Using robust optimization techniques, we formulate a convex optimization problem with a loosely coupled structure that can be solved efficiently. We numerically demonstrate the efficacy of the proposed approach in energy management and supply chain applications. We show that the proposed approach leads to solutions that closely approximate those obtained by the centralized formulation only at a fraction of the computational effort., Comment: arXiv admin note: text overlap with arXiv:1803.07660

Integration of speech into healthcare has intensified privacy concerns due to its potential as a non-invasive biomarker containing individual biometric information. In response, speaker anonymization aims to conceal personally identifiable information while retaining crucial linguistic content. However, the application of anonymization techniques to pathological speech, a critical area where privacy is especially vital, has not been extensively examined. This study investigates anonymization's impact on pathological speech across over 2,700 speakers from multiple German institutions, focusing on privacy, pathological utility, and demographic fairness. We explore both deep-learning-based and signal processing-based anonymization methods. We document substantial privacy improvements across disorders-evidenced by equal error rate increases up to 1933%, with minimal overall impact on utility. Specific disorders such as Dysarthria, Dysphonia, and Cleft Lip and Palate experience minimal utility changes, while Dysglossia shows slight improvements. Our findings underscore that the impact of anonymization varies substantially across different disorders. This necessitates disorder-specific anonymization strategies to optimally balance privacy with diagnostic utility. Additionally, our fairness analysis reveals consistent anonymization effects across most of the demographics. This study demonstrates the effectiveness of anonymization in pathological speech for enhancing privacy, while also highlighting the importance of customized and disorder-specific approaches to account for inversion attacks., Comment: Published in Communications Medicine

In this report, we introduce the Gemini 1.5 family of models, representing the next generation of highly compute-efficient multimodal models capable of recalling and reasoning over fine-grained information from millions of tokens of context, including multiple long documents and hours of video and audio. The family includes two new models: (1) an updated Gemini 1.5 Pro, which exceeds the February version on the great majority of capabilities and benchmarks; (2) Gemini 1.5 Flash, a more lightweight variant designed for efficiency with minimal regression in quality. Gemini 1.5 models achieve near-perfect recall on long-context retrieval tasks across modalities, improve the state-of-the-art in long-document QA, long-video QA and long-context ASR, and match or surpass Gemini 1.0 Ultra's state-of-the-art performance across a broad set of benchmarks. Studying the limits of Gemini 1.5's long-context ability, we find continued improvement in next-token prediction and near-perfect retrieval (>99%) up to at least 10M tokens, a generational leap over existing models such as Claude 3.0 (200k) and GPT-4 Turbo (128k). Finally, we highlight real-world use cases, such as Gemini 1.5 collaborating with professionals on completing their tasks achieving 26 to 75% time savings across 10 different job categories, as well as surprising new capabilities of large language models at the frontier; when given a grammar manual for Kalamang, a language with fewer than 200 speakers worldwide, the model learns to translate English to Kalamang at a similar level to a person who learned from the same content.

Distributionally robust optimization (DRO) is an effective approach for data-driven decision-making in the presence of uncertainty. Geometric uncertainty due to sampling or localized perturbations of data points is captured by Wasserstein DRO (WDRO), which seeks to learn a model that performs uniformly well over a Wasserstein ball centered around the observed data distribution. However, WDRO fails to account for non-geometric perturbations such as adversarial outliers, which can greatly distort the Wasserstein distance measurement and impede the learned model. We address this gap by proposing a novel outlier-robust WDRO framework for decision-making under both geometric (Wasserstein) perturbations and non-geometric (total variation (TV)) contamination that allows an $\varepsilon$-fraction of data to be arbitrarily corrupted. We design an uncertainty set using a certain robust Wasserstein ball that accounts for both perturbation types and derive minimax optimal excess risk bounds for this procedure that explicitly capture the Wasserstein and TV risks. We prove a strong duality result that enables tractable convex reformulations and efficient computation of our outlier-robust WDRO problem. When the loss function depends only on low-dimensional features of the data, we eliminate certain dimension dependencies from the risk bounds that are unavoidable in the general setting. Finally, we present experiments validating our theory on standard regression and classification tasks., Comment: Appearing at NeurIPS 2023

Dielectric nanostructures have demonstrated optical antenna effects due to Mie resonances. Preliminary investigations on dielectric nanoantennas have been carried out for a trifecta of enhancements, i.e., simultaneous enhancements in absorption, emission directionality and radiative decay rates of quantum emitters. However, these investigations are limited by fragile substrates or low Purcell factor, which is extremely important for exciting quantum emitters electrically. In this paper, we present a Si mix antenna array to achieve the trifecta enhancement of ~1200 fold with a Purcell factor of ~47. The antenna design incorporates ~10 nm gaps within which fluorescent molecules strongly absorb the pump laser energy through a resonant mode. In the emission process, the antenna array increases the radiative decay rates of the fluorescence molecules via Purcell effect and provides directional emission through a separate mode. This work could lead to novel CMOS compatible platforms for enhancing fluorescence for biological and chemical applications., Comment: 20 pages, 4 figures

Developing robust artificial intelligence (AI) models that generalize well to unseen datasets is challenging and usually requires large and variable datasets, preferably from multiple institutions. In federated learning (FL), a model is trained collaboratively at numerous sites that hold local datasets without exchanging them. So far, the impact of training strategy, i.e., local versus collaborative, on the diagnostic on-domain and off-domain performance of AI models interpreting chest radiographs has not been assessed. Consequently, using 610,000 chest radiographs from five institutions across the globe, we assessed diagnostic performance as a function of training strategy (i.e., local vs. collaborative), network architecture (i.e., convolutional vs. transformer-based), generalization performance (i.e., on-domain vs. off-domain), imaging finding (i.e., cardiomegaly, pleural effusion, pneumonia, atelectasis, consolidation, pneumothorax, and no abnormality), dataset size (i.e., from n=18,000 to 213,921 radiographs), and dataset diversity. Large datasets not only showed minimal performance gains with FL but, in some instances, even exhibited decreases. In contrast, smaller datasets revealed marked improvements. Thus, on-domain performance was mainly driven by training data size. However, off-domain performance leaned more on training diversity. When trained collaboratively across diverse external institutions, AI models consistently surpassed models trained locally for off-domain tasks, emphasizing FL's potential in leveraging data diversity. In conclusion, FL can bolster diagnostic privacy, reproducibility, and off-domain reliability of AI models and, potentially, optimize healthcare outcomes., Comment: Published in Nature Scientific Reports

We present a novel human body model formulated by an extensive set of anthropocentric measurements, which is capable of generating a wide range of human body shapes and poses. The proposed model enables direct modeling of specific human identities through a deep generative architecture, which can produce humans in any arbitrary pose. It is the first of its kind to have been trained end-to-end using only synthetically generated data, which not only provides highly accurate human mesh representations but also allows for precise anthropometry of the body. Moreover, using a highly diverse animation library, we articulated our synthetic humans' body and hands to maximize the diversity of the learnable priors for model training. Our model was trained on a dataset of $100k$ procedurally-generated posed human meshes and their corresponding anthropometric measurements. Our synthetic data generator can be used to generate millions of unique human identities and poses for non-commercial academic research purposes., Comment: AnthroNet's Unity data generator source code is available at: https://unity-technologies.github.io/AnthroNet/

A knowledge gap persists between machine learning (ML) developers (e.g., data scientists) and practitioners (e.g., clinicians), hampering the full utilization of ML for clinical data analysis. We investigated the potential of the ChatGPT Advanced Data Analysis (ADA), an extension of GPT-4, to bridge this gap and perform ML analyses efficiently. Real-world clinical datasets and study details from large trials across various medical specialties were presented to ChatGPT ADA without specific guidance. ChatGPT ADA autonomously developed state-of-the-art ML models based on the original study's training data to predict clinical outcomes such as cancer development, cancer progression, disease complications, or biomarkers such as pathogenic gene sequences. Following the re-implementation and optimization of the published models, the head-to-head comparison of the ChatGPT ADA-crafted ML models and their respective manually crafted counterparts revealed no significant differences in traditional performance metrics (P>0.071). Strikingly, the ChatGPT ADA-crafted ML models often outperformed their counterparts. In conclusion, ChatGPT ADA offers a promising avenue to democratize ML in medicine by simplifying complex data analyses, yet should enhance, not replace, specialized training and resources, to promote broader applications in medical research and practice., Comment: Published in Nature Communications

Pre-training datasets, like ImageNet, have become the gold standard in medical image analysis. However, the emergence of self-supervised learning (SSL), which leverages unlabeled data to learn robust features, presents an opportunity to bypass the intensive labeling process. In this study, we explored if SSL for pre-training on non-medical images can be applied to chest radiographs and how it compares to supervised pre-training on non-medical images and on medical images. We utilized a vision transformer and initialized its weights based on (i) SSL pre-training on natural images (DINOv2), (ii) SL pre-training on natural images (ImageNet dataset), and (iii) SL pre-training on chest radiographs from the MIMIC-CXR database. We tested our approach on over 800,000 chest radiographs from six large global datasets, diagnosing more than 20 different imaging findings. Our SSL pre-training on curated images not only outperformed ImageNet-based pre-training (P<0.001 for all datasets) but, in certain cases, also exceeded SL on the MIMIC-CXR dataset. Our findings suggest that selecting the right pre-training strategy, especially with SSL, can be pivotal for improving artificial intelligence (AI)'s diagnostic accuracy in medical imaging. By demonstrating the promise of SSL in chest radiograph analysis, we underline a transformative shift towards more efficient and accurate AI models in medical imaging., Comment: Published in European Radiology Experimental

Metal halide perovskite quantum dots (PQDs) have emerged as promising materials due to their exceptional photoluminescence (PL) properties. A wide range of applications could benefit from adjustable luminescence properties, while preserving the physical and chemical properties of the PQDs. Therefore, post-synthesis engineering has gained attention recently, involving the use of ion-exchange or external stimuli, such as extreme pressure, magnetic and electric fields. Nevertheless, these methods typically suffer from spectrum broadening, intensity quenching or yield multiple bands. Alternatively, photonic antennas can modify the radiative decay channel of perovskites via the Purcell effect, with the largest wavelength shift being 8 nm to date, at an expense of 5-fold intensity loss. Here, we present an optical nanoantenna array with polarization-controlled quasi-bound-states-in-the-continuum (q-BIC) resonances, which can engineer and shift the photoluminescence wavelength over a ~39 nm range and confers a 21-fold emission enhancement of FAPbI3 perovskite QDs. The spectrum is engineered in a non-invasive manner via lithographically defined antennas and the pump laser polarization at ambient conditions. Our research provides a path towards advanced optoelectronic devices, such as spectrally tailored quantum emitters and lasers., Comment: 39 pages, 4 figures in the main text and 10 figures in the supporting information

Developing robust and effective artificial intelligence (AI) models in medicine requires access to large amounts of patient data. The use of AI models solely trained on large multi-institutional datasets can help with this, yet the imperative to ensure data privacy remains, particularly as membership inference risks breaching patient confidentiality. As a proposed remedy, we advocate for the integration of differential privacy (DP). We specifically investigate the performance of models trained with DP as compared to models trained without DP on data from institutions that the model had not seen during its training (i.e., external validation) - the situation that is reflective of the clinical use of AI models. By leveraging more than 590,000 chest radiographs from five institutions, we evaluated the efficacy of DP-enhanced domain transfer (DP-DT) in diagnosing cardiomegaly, pleural effusion, pneumonia, atelectasis, and in identifying healthy subjects. We juxtaposed DP-DT with non-DP-DT and examined diagnostic accuracy and demographic fairness using the area under the receiver operating characteristic curve (AUC) as the main metric, as well as accuracy, sensitivity, and specificity. Our results show that DP-DT, even with exceptionally high privacy levels (epsilon around 1), performs comparably to non-DP-DT (P>0.119 across all domains). Furthermore, DP-DT led to marginal AUC differences - less than 1% - for nearly all subgroups, relative to non-DP-DT. Despite consistent evidence suggesting that DP models induce significant performance degradation for on-domain applications, we show that off-domain performance is almost not affected. Therefore, we ardently advocate for the adoption of DP in training diagnostic medical AI models, given its minimal impact on performance., Comment: Published in Radiology: Artificial Intelligence. RSNA

We present Spectron, a novel approach to adapting pre-trained large language models (LLMs) to perform spoken question answering (QA) and speech continuation. By endowing the LLM with a pre-trained speech encoder, our model becomes able to take speech inputs and generate speech outputs. The entire system is trained end-to-end and operates directly on spectrograms, simplifying our architecture. Key to our approach is a training objective that jointly supervises speech recognition, text continuation, and speech synthesis using only paired speech-text pairs, enabling a `cross-modal' chain-of-thought within a single decoding pass. Our method surpasses existing spoken language models in speaker preservation and semantic coherence. Furthermore, the proposed model improves upon direct initialization in retaining the knowledge of the original LLM as demonstrated through spoken QA datasets. We release our audio samples (https://michelleramanovich.github.io/spectron/spectron) and spoken QA dataset (https://github.com/google-research-datasets/LLAMA1-Test-Set)., Comment: ICLR 2024 camera-ready

Parkinson's disease (PD) is a neurological disorder impacting a person's speech. Among automatic PD assessment methods, deep learning models have gained particular interest. Recently, the community has explored cross-pathology and cross-language models which can improve diagnostic accuracy even further. However, strict patient data privacy regulations largely prevent institutions from sharing patient speech data with each other. In this paper, we employ federated learning (FL) for PD detection using speech signals from 3 real-world language corpora of German, Spanish, and Czech, each from a separate institution. Our results indicate that the FL model outperforms all the local models in terms of diagnostic accuracy, while not performing very differently from the model based on centrally combined training sets, with the advantage of not requiring any data sharing among collaborators. This will simplify inter-institutional collaborations, resulting in enhancement of patient outcomes., Comment: INTERSPEECH 2023, pp. 5003--5007, Dublin, Ireland

Accurate and automatic segmentation of fibroglandular tissue in breast MRI screening is essential for the quantification of breast density and background parenchymal enhancement. In this retrospective study, we developed and evaluated a transformer-based neural network for breast segmentation (TraBS) in multi-institutional MRI data, and compared its performance to the well established convolutional neural network nnUNet. TraBS and nnUNet were trained and tested on 200 internal and 40 external breast MRI examinations using manual segmentations generated by experienced human readers. Segmentation performance was assessed in terms of the Dice score and the average symmetric surface distance. The Dice score for nnUNet was lower than for TraBS on the internal testset (0.909$\pm$0.069 versus 0.916$\pm$0.067, P<0.001) and on the external testset (0.824$\pm$0.144 versus 0.864$\pm$0.081, P=0.004). Moreover, the average symmetric surface distance was higher (=worse) for nnUNet than for TraBS on the internal (0.657$\pm$2.856 versus 0.548$\pm$2.195, P=0.001) and on the external testset (0.727$\pm$0.620 versus 0.584$\pm$0.413, P=0.03). Our study demonstrates that transformer-based networks improve the quality of fibroglandular tissue segmentation in breast MRI compared to convolutional-based models like nnUNet. These findings might help to enhance the accuracy of breast density and parenchymal enhancement quantification in breast MRI screening.

Optimization problems involving minimization of a rank-one convex function over constraints modeling restrictions on the support of the decision variables emerge in various machine learning applications. These problems are often modeled with indicator variables for identifying the support of the continuous variables. In this paper we investigate compact extended formulations for such problems through perspective reformulation techniques. In contrast to the majority of previous work that relies on support function arguments and disjunctive programming techniques to provide convex hull results, we propose a constructive approach that exploits a hidden conic structure induced by perspective functions. To this end, we first establish a convex hull result for a general conic mixed-binary set in which each conic constraint involves a linear function of independent continuous variables and a set of binary variables. We then demonstrate that extended representations of sets associated with epigraphs of rank-one convex functions over constraints modeling indicator relations naturally admit such a conic representation. This enables us to systematically give perspective formulations for the convex hull descriptions of these sets with nonlinear separable or non-separable objective functions, sign constraints on continuous variables, and combinatorial constraints on indicator variables. We illustrate the efficacy of our results on sparse nonnegative logistic regression problems.

We study optimal transport-based distributionally robust optimization problems where a fictitious adversary, often envisioned as nature, can choose the distribution of the uncertain problem parameters by reshaping a prescribed reference distribution at a finite transportation cost. In this framework, we show that robustification is intimately related to various forms of variation and Lipschitz regularization even if the transportation cost function fails to be (some power of) a metric. We also derive conditions for the existence and the computability of a Nash equilibrium between the decision-maker and nature, and we demonstrate numerically that nature's Nash strategy can be viewed as a distribution that is supported on remarkably deceptive adversarial samples. Finally, we identify practically relevant classes of optimal transport-based distributionally robust optimization problems that can be addressed with efficient gradient descent algorithms even if the loss function or the transportation cost function are nonconvex (but not both at the same time).

Artificial intelligence (AI) models are increasingly used in the medical domain. However, as medical data is highly sensitive, special precautions to ensure its protection are required. The gold standard for privacy preservation is the introduction of differential privacy (DP) to model training. Prior work indicates that DP has negative implications on model accuracy and fairness, which are unacceptable in medicine and represent a main barrier to the widespread use of privacy-preserving techniques. In this work, we evaluated the effect of privacy-preserving training of AI models regarding accuracy and fairness compared to non-private training. For this, we used two datasets: (1) A large dataset (N=193,311) of high quality clinical chest radiographs, and (2) a dataset (N=1,625) of 3D abdominal computed tomography (CT) images, with the task of classifying the presence of pancreatic ductal adenocarcinoma (PDAC). Both were retrospectively collected and manually labeled by experienced radiologists. We then compared non-private deep convolutional neural networks (CNNs) and privacy-preserving (DP) models with respect to privacy-utility trade-offs measured as area under the receiver-operator-characteristic curve (AUROC), and privacy-fairness trade-offs, measured as Pearson's r or Statistical Parity Difference. We found that, while the privacy-preserving trainings yielded lower accuracy, they did largely not amplify discrimination against age, sex or co-morbidity. Our study shows that -- under the challenging realistic circumstances of a real-life clinical dataset -- the privacy-preserving training of diagnostic deep learning models is possible with excellent diagnostic accuracy and fairness., Comment: Published in Communications Medicine. Nature Portfolio

Multimodal deep learning has been used to predict clinical endpoints and diagnoses from clinical routine data. However, these models suffer from scaling issues: they have to learn pairwise interactions between each piece of information in each data type, thereby escalating model complexity beyond manageable scales. This has so far precluded a widespread use of multimodal deep learning. Here, we present a new technical approach of "learnable synergies", in which the model only selects relevant interactions between data modalities and keeps an "internal memory" of relevant data. Our approach is easily scalable and naturally adapts to multimodal data inputs from clinical routine. We demonstrate this approach on three large multimodal datasets from radiology and ophthalmology and show that it outperforms state-of-the-art models in clinically relevant diagnosis tasks. Our new approach is transferable and will allow the application of multimodal deep learning to a broad set of clinically relevant problems.

The success of Deep Learning applications critically depends on the quality and scale of the underlying training data. Generative adversarial networks (GANs) can generate arbitrary large datasets, but diversity and fidelity are limited, which has recently been addressed by denoising diffusion probabilistic models (DDPMs) whose superiority has been demonstrated on natural images. In this study, we propose Medfusion, a conditional latent DDPM for medical images. We compare our DDPM-based model against GAN-based models, which constitute the current state-of-the-art in the medical domain. Medfusion was trained and compared with (i) StyleGan-3 on n=101,442 images from the AIROGS challenge dataset to generate fundoscopies with and without glaucoma, (ii) ProGAN on n=191,027 from the CheXpert dataset to generate radiographs with and without cardiomegaly and (iii) wGAN on n=19,557 images from the CRCMS dataset to generate histopathological images with and without microsatellite stability. In the AIROGS, CRMCS, and CheXpert datasets, Medfusion achieved lower (=better) FID than the GANs (11.63 versus 20.43, 30.03 versus 49.26, and 17.28 versus 84.31). Also, fidelity (precision) and diversity (recall) were higher (=better) for Medfusion in all three datasets. Our study shows that DDPM are a superior alternative to GANs for image synthesis in the medical domain.