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Hauptverfasser: Xu, Qinmei, Li, Yiheng, Zhan, Xianghao, Er, Ahmet Gorkem, Dashevsky, Brittany, Xu, Chuanjun, Alawad, Mohammed, Yang, Mengya, Ya, Liu, Zhou, Changsheng, Li, Xiao, Itakura, Haruka, Gevaert, Olivier
Format: Preprint
Veröffentlicht: 2025
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Online-Zugang:https://arxiv.org/abs/2505.16027
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author Xu, Qinmei
Li, Yiheng
Zhan, Xianghao
Er, Ahmet Gorkem
Dashevsky, Brittany
Xu, Chuanjun
Alawad, Mohammed
Yang, Mengya
Ya, Liu
Zhou, Changsheng
Li, Xiao
Itakura, Haruka
Gevaert, Olivier
author_facet Xu, Qinmei
Li, Yiheng
Zhan, Xianghao
Er, Ahmet Gorkem
Dashevsky, Brittany
Xu, Chuanjun
Alawad, Mohammed
Yang, Mengya
Ya, Liu
Zhou, Changsheng
Li, Xiao
Itakura, Haruka
Gevaert, Olivier
contents Foundation models leveraging vision-language pretraining have shown promise in chest X-ray (CXR) interpretation, yet their real-world performance across diverse populations and diagnostic tasks remains insufficiently evaluated. This study benchmarks the diagnostic performance and generalizability of foundation models versus traditional convolutional neural networks (CNNs) on multinational CXR datasets. We evaluated eight CXR diagnostic models - five vision-language foundation models and three CNN-based architectures - across 37 standardized classification tasks using six public datasets from the USA, Spain, India, and Vietnam, and three private datasets from hospitals in China. Performance was assessed using AUROC, AUPRC, and other metrics across both shared and dataset-specific tasks. Foundation models outperformed CNNs in both accuracy and task coverage. MAVL, a model incorporating knowledge-enhanced prompts and structured supervision, achieved the highest performance on public (mean AUROC: 0.82; AUPRC: 0.32) and private (mean AUROC: 0.95; AUPRC: 0.89) datasets, ranking first in 14 of 37 public and 3 of 4 private tasks. All models showed reduced performance on pediatric cases, with average AUROC dropping from 0.88 +/- 0.18 in adults to 0.57 +/- 0.29 in children (p = 0.0202). These findings highlight the value of structured supervision and prompt design in radiologic AI and suggest future directions including geographic expansion and ensemble modeling for clinical deployment. Code for all evaluated models is available at https://drive.google.com/drive/folders/1B99yMQm7bB4h1sVMIBja0RfUu8gLktCE
format Preprint
id arxiv_https___arxiv_org_abs_2505_16027
institution arXiv
publishDate 2025
record_format arxiv
spellingShingle Benchmarking Chest X-ray Diagnosis Models Across Multinational Datasets
Xu, Qinmei
Li, Yiheng
Zhan, Xianghao
Er, Ahmet Gorkem
Dashevsky, Brittany
Xu, Chuanjun
Alawad, Mohammed
Yang, Mengya
Ya, Liu
Zhou, Changsheng
Li, Xiao
Itakura, Haruka
Gevaert, Olivier
Image and Video Processing
Artificial Intelligence
Computer Vision and Pattern Recognition
I.2
I.2
Foundation models leveraging vision-language pretraining have shown promise in chest X-ray (CXR) interpretation, yet their real-world performance across diverse populations and diagnostic tasks remains insufficiently evaluated. This study benchmarks the diagnostic performance and generalizability of foundation models versus traditional convolutional neural networks (CNNs) on multinational CXR datasets. We evaluated eight CXR diagnostic models - five vision-language foundation models and three CNN-based architectures - across 37 standardized classification tasks using six public datasets from the USA, Spain, India, and Vietnam, and three private datasets from hospitals in China. Performance was assessed using AUROC, AUPRC, and other metrics across both shared and dataset-specific tasks. Foundation models outperformed CNNs in both accuracy and task coverage. MAVL, a model incorporating knowledge-enhanced prompts and structured supervision, achieved the highest performance on public (mean AUROC: 0.82; AUPRC: 0.32) and private (mean AUROC: 0.95; AUPRC: 0.89) datasets, ranking first in 14 of 37 public and 3 of 4 private tasks. All models showed reduced performance on pediatric cases, with average AUROC dropping from 0.88 +/- 0.18 in adults to 0.57 +/- 0.29 in children (p = 0.0202). These findings highlight the value of structured supervision and prompt design in radiologic AI and suggest future directions including geographic expansion and ensemble modeling for clinical deployment. Code for all evaluated models is available at https://drive.google.com/drive/folders/1B99yMQm7bB4h1sVMIBja0RfUu8gLktCE
title Benchmarking Chest X-ray Diagnosis Models Across Multinational Datasets
topic Image and Video Processing
Artificial Intelligence
Computer Vision and Pattern Recognition
I.2
I.2
url https://arxiv.org/abs/2505.16027