Why Do Probabilistic Clinical Models Fail To Transport Between Sites?
Not on the map. Why?
Abstract (arXiv)
The rising popularity of artificial intelligence in healthcare is highlighting the problem that a computational model achieving super-human clinical performance at its training sites may perform substantially worse at new sites. In this perspective, we present common sources for this failure to transport, which we divide into sources under the control of the experimenter and sources inherent to the clinical data-generating process. Of the inherent sources we look a little deeper into site-specific clinical practices that can affect the data distribution, and propose a potential solution intended to isolate the imprint of those practices on the data from the patterns of disease cause and effect that are the usual target of probabilistic clinical models.
Key facts. Cited by 9 papers in the map (data through 7 Oct 2026). Builds on 35 of its 113 references that are in the map. First posted on arXiv 8 Nov 2023.
Builds on
35 of 113 references.
References · 35
- 2020Shortcut Learning in Deep Neural Networkscited by 1,928
- 2019Invariant Risk Minimizationcited by 1,832
- 2016Concrete Problems in AI Safetycited by 1,582
- 2020WILDS: A Benchmark of in-the-Wild Distribution Shiftscited by 1,366
- 2018Reconciling modern machine learning practice and the bias-variance trade-offcited by 919
- 2021Generalizing to Unseen Domains: A Survey on Domain Generalizationcited by 762
- 2021Domain Generalization: A Surveycited by 760
- 2020Underspecification Presents Challenges for Credibility in Modern Machine Learningcited by 488
- 2017CheXNet: Radiologist-Level Pneumonia Detection on Chest X-Rays with Deep Learningcited by 459
- 2021Towards Out-Of-Distribution Generalization: A Surveycited by 431
- 2018Confounding variables can degrade generalization performance of radiological deep learning modelscited by 374
- 2017High-dimensional dynamics of generalization error in neural networkscited by 238
23 more
- 2019Hidden Stratification Causes Clinically Meaningful Failures in Machine Learning for Medical Imagingcited by 215
- 2022Neural Networks and the Chomsky Hierarchycited by 214
- 2019Quantifying the effects of data augmentation and stain color normalization in convolutional neural networks for computational pathologycited by 172
- 2021Fit without fear: remarkable mathematical phenomena of deep learning through the prism of interpolationcited by 130
- 2017Domain Adaptation by Using Causal Inference to Predict Invariant Conditional Distributionscited by 125
- 2013Stabilitycited by 119
- 2018The Blessings of Multiple Causescited by 103
- 2020A causal view of compositional zero-shot recognitioncited by 78
- 2019Veridical Data Sciencecited by 65
- 2020Triple descent and the two kinds of overfitting: Where & why do they appear?cited by 64
- 2018Deep Learning Predicts Hip Fracture using Confounding Patient and Healthcare Variablescited by 50
- 2019Feature Robustness in Non-stationary Health Records: Caveats to Deployable Model Performance in Common Clinical Machine Learning Taskscited by 39
- 2022Identifying Patient-Specific Root Causes with the Heteroscedastic Noise Modelcited by 38
- 2021A Review of Generalizability and Transportabilitycited by 36
- 2017Fast Causal Inference with Non-Random Missingness by Test-Wise Deletioncited by 22
- 2019A Unifying Causal Framework for Analyzing Dataset Shift-stable Learning Algorithmscited by 17
- 2020Accounting for Unobserved Confounding in Domain Generalizationcited by 14
- 2022Identifying Patient-Specific Root Causes of Diseasecited by 8
- 2022Overcoming Shortcut Learning in a Target Domain by Generalizing Basic Visual Factors from a Source Domaincited by 7
- 2020Counterexamples to "The Blessings of Multiple Causes" by Wang and Bleicited by 6
- 2022Sample-Specific Root Causal Inference with Latent Variablescited by 6
- 2020I-SPEC: An End-to-End Framework for Learning Transportable, Shift-Stable Modelscited by 3
- 2023Dynamic Updating of Clinical Survival Prediction Models in a Rapidly Changing Environmentcited by 1
Built on by
Citing papers per year: 2024: 1; 2025: 4; 2026: 4.
9 papers.
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- 2026MedCL-Bench: Benchmarking stability-efficiency trade-offs and scaling in biomedical continual learningcited by 2
- 2026Keeping an Eye on AI: A Framework for Effective Human Oversight of AI Systemscited by 2
- 2025Cohort-Aware Agents for Individualized Lung Cancer Risk Prediction Using a Retrieval-Augmented Model Selection Frameworkcited by 1
- 2025Bridging the Generalisation Gap: Synthetic Data Generation for Multi-Site Clinical Model Validationcited by 0
- 2025Cryptogenic stroke and migraine: using probabilistic independence and machine learning to uncover latent sources of disease from the electronic health recordcited by 0
- 2025A tutorial on discovering and quantifying the effect of latent causal sources of multimodal EHR datacited by 0
- 2026Domain-Adaptive Arrhythmia Classification Using a Hybrid Transformer on Wearable Heart Signalscited by 0
- 2026Unveiling Invariant and Transferable Latent Factors Across Heterogeneous Environments via ATLAScited by 0
- 2026Unveiling Invariant and Transferable Latent Factors Across Heterogeneous Environments via ATLAS20 Jul 2026
- 2026Domain-Adaptive Arrhythmia Classification Using a Hybrid Transformer on Wearable Heart Signals5 May 2026
- 2026Keeping an Eye on AI: A Framework for Effective Human Oversight of AI Systems9 Apr 2026
- 2026MedCL-Bench: Benchmarking stability-efficiency trade-offs and scaling in biomedical continual learning17 Mar 2026
- 2025A tutorial on discovering and quantifying the effect of latent causal sources of multimodal EHR data15 Oct 2025
- 2025Cohort-Aware Agents for Individualized Lung Cancer Risk Prediction Using a Retrieval-Augmented Model Selection Framework20 Aug 2025
- 2025Bridging the Generalisation Gap: Synthetic Data Generation for Multi-Site Clinical Model Validation29 Apr 2025
- 2025Cryptogenic stroke and migraine: using probabilistic independence and machine learning to uncover latent sources of disease from the electronic health record22 Apr 2025
- 2024MetaWearS: A Shortcut in Wearable Systems Lifecycle with Only a Few Shots4 Aug 2024