# Closing the AI generalization gap by adjusting for dermatology condition distribution differences across clinical settings

arXiv: https://arxiv.org/abs/2402.15566 · HTML: https://mlsanity.com/paper/2402.15566/

## Key facts

- Cited by 1 papers in the map (data through 14 Oct 2026).
- Builds on 15 of its 35 references that are in the map.
- First posted on arXiv 23 Feb 2024.

## Builds on (most cited first, 15 of 15)

- [Deep Residual Learning for Image Recognition](https://mlsanity.com/paper/1512.03385/) (2015)
- [A Simple Framework for Contrastive Learning of Visual Representations](https://mlsanity.com/paper/2002.05709/) (2020)
- [On Calibration of Modern Neural Networks](https://mlsanity.com/paper/1706.04599/) (2017)
- [UMAP: Uniform Manifold Approximation and Projection for Dimension Reduction](https://mlsanity.com/paper/1802.03426/) (2018)
- [FiLM: Visual Reasoning with a General Conditioning Layer](https://mlsanity.com/paper/1709.07871/) (2017)
- [Revisiting Unreasonable Effectiveness of Data in Deep Learning Era](https://mlsanity.com/paper/1707.02968/) (2017)
- [Big Transfer (BiT): General Visual Representation Learning](https://mlsanity.com/paper/1912.11370/) (2019)
- [Generalizing to Unseen Domains: A Survey on Domain Generalization](https://mlsanity.com/paper/2103.03097/) (2021)
- [Contrastive Learning of Medical Visual Representations from Paired Images and Text](https://mlsanity.com/paper/2010.00747/) (2020)
- [Conformal Risk Control](https://mlsanity.com/paper/2208.02814/) (2022)
- [Disparities in Dermatology AI: Assessments Using Diverse Clinical Images](https://mlsanity.com/paper/2111.08006/) (2021)
- [A deep learning system for differential diagnosis of skin diseases](https://mlsanity.com/paper/1909.05382/) (2019)
- [FiLM-Ensemble: Probabilistic Deep Learning via Feature-wise Linear Modulation](https://mlsanity.com/paper/2206.00050/) (2022)
- [TrueImage: A Machine Learning Algorithm to Improve the Quality of Telehealth Photos](https://mlsanity.com/paper/2010.02086/) (2020)
- [Closing the Gap between Single-User and Multi-User VoiceFilter-Lite](https://mlsanity.com/paper/2202.12169/) (2022)

## Built on by (most cited first, 1 of 1)

- [Health AI Developer Foundations](https://mlsanity.com/paper/2411.15128/) (2024)

## Abstract (arXiv)

Recently, there has been great progress in the ability of artificial intelligence (AI) algorithms to classify dermatological conditions from clinical photographs. However, little is known about the robustness of these algorithms in real-world settings where several factors can lead to a loss of generalizability. Understanding and overcoming these limitations will permit the development of generalizable AI that can aid in the diagnosis of skin conditions across a variety of clinical settings. In this retrospective study, we demonstrate that differences in skin condition distribution, rather than in demographics or image capture mode are the main source of errors when an AI algorithm is evaluated on data from a previously unseen source. We demonstrate a series of steps to close this generalization gap, requiring progressively more information about the new source, ranging from the condition distribution to training data enriched for data less frequently seen during training. Our results also suggest comparable performance from end-to-end fine tuning versus fine tuning solely the classification layer on top of a frozen embedding model. Our approach can inform the adaptation of AI algorithms to new settings, based on the information and resources available.