# Are We Ready for Out-of-Distribution Detection in Digital Pathology?

arXiv: https://arxiv.org/abs/2407.13708 · HTML: https://mlsanity.com/paper/2407.13708/

## Key facts

- Cited by 8 papers in the map (data through 7 Oct 2026).
- Builds on 29 of its 37 references that are in the map.
- First posted on arXiv 18 Jul 2024.

## Builds on (most cited first, 29 of 29)

- [Learning Transferable Visual Models From Natural Language Supervision](https://mlsanity.com/paper/2103.00020/) (2021)
- [An Image is Worth 16x16 Words: Transformers for Image Recognition at Scale](https://mlsanity.com/paper/2010.11929/) (2020)
- [Swin Transformer: Hierarchical Vision Transformer using Shifted Windows](https://mlsanity.com/paper/2103.14030/) (2021)
- [Simple and Scalable Predictive Uncertainty Estimation using Deep Ensembles](https://mlsanity.com/paper/1612.01474/) (2016)
- [A ConvNet for the 2020s](https://mlsanity.com/paper/2201.03545/) (2022)
- [Unsupervised Learning of Visual Features by Contrasting Cluster Assignments](https://mlsanity.com/paper/2006.09882/) (2020)
- [A Baseline for Detecting Misclassified and Out-of-Distribution Examples in Neural Networks](https://mlsanity.com/paper/1610.02136/) (2016)
- [Improved Baselines with Momentum Contrastive Learning](https://mlsanity.com/paper/2003.04297/) (2020)
- [Barlow Twins: Self-Supervised Learning via Redundancy Reduction](https://mlsanity.com/paper/2103.03230/) (2021)
- [A Simple Unified Framework for Detecting Out-of-Distribution Samples and Adversarial Attacks](https://mlsanity.com/paper/1807.03888/) (2018)
- [Out-of-Distribution Detection with Deep Nearest Neighbors](https://mlsanity.com/paper/2204.06507/) (2022)
- [ReAct: Out-of-distribution Detection With Rectified Activations](https://mlsanity.com/paper/2111.12797/) (2021)
- [Scaling Out-of-Distribution Detection for Real-World Settings](https://mlsanity.com/paper/1911.11132/) (2019)
- [ViM: Out-Of-Distribution with Virtual-logit Matching](https://mlsanity.com/paper/2203.10807/) (2022)
- [Using Pre-Training Can Improve Model Robustness and Uncertainty](https://mlsanity.com/paper/1901.09960/) (2019)
- [On the Importance of Gradients for Detecting Distributional Shifts in the Wild](https://mlsanity.com/paper/2110.00218/) (2021)
- [Quilt-1M: One Million Image-Text Pairs for Histopathology](https://mlsanity.com/paper/2306.11207/) (2023)
- [Are Transformers More Robust Than CNNs?](https://mlsanity.com/paper/2111.05464/) (2021)
- [OpenOOD v1.5: Enhanced Benchmark for Out-of-Distribution Detection](https://mlsanity.com/paper/2306.09301/) (2023)
- [Ensemble Distribution Distillation](https://mlsanity.com/paper/1905.00076/) (2019)
- [Benchmarking Self-Supervised Learning on Diverse Pathology Datasets](https://mlsanity.com/paper/2212.04690/) (2022)
- [Quantifying Aleatoric and Epistemic Uncertainty in Machine Learning: Are Conditional Entropy and Mutual Information Appropriate Measures?](https://mlsanity.com/paper/2209.03302/) (2022)
- [A Call to Reflect on Evaluation Practices for Failure Detection in Image Classification](https://mlsanity.com/paper/2211.15259/) (2022)
- [A Benchmark of Medical Out of Distribution Detection](https://mlsanity.com/paper/2007.04250/) (2020)
- [An Impartial Take to the CNN vs Transformer Robustness Contest](https://mlsanity.com/paper/2207.11347/) (2022)
- [Know Your Limits: Uncertainty Estimation with ReLU Classifiers Fails at Reliable OOD Detection](https://mlsanity.com/paper/2012.05329/) (2020)
- [Benchmarking the Robustness of Deep Neural Networks to Common Corruptions in Digital Pathology](https://mlsanity.com/paper/2206.14973/) (2022)
- [Out-Of-Distribution Detection Is Not All You Need](https://mlsanity.com/paper/2211.16158/) (2022)
- [Are Bayesian neural networks intrinsically good at out-of-distribution detection?](https://mlsanity.com/paper/2107.12248/) (2021)

## Built on by (most cited first, 8 of 8)

- [Out-of-Distribution Detection: A Task-Oriented Survey of Recent Advances](https://mlsanity.com/paper/2409.11884/) (2024)
- [Hierarchical Vision-Language Learning for Medical Out-of-Distribution Detection](https://mlsanity.com/paper/2508.17667/) (2025)
- [Finer Disentanglement of Aleatoric Uncertainty Can Accelerate Chemical Histopathology Imaging](https://mlsanity.com/paper/2502.20532/) (2025)
- [Hallucination Detection in Virtually-Stained Histology: A Latent Space Baseline](https://mlsanity.com/paper/2411.15060/) (2024)
- [Benchmarking Post-Hoc Unknown-Category Detection in Food Recognition](https://mlsanity.com/paper/2503.18548/) (2025)
- [Anatomy of a failure: When, how, and why deep vision fails in scientific domains](https://mlsanity.com/paper/2605.04231/) (2026)
- [Training-Free Out-of-Distribution Detection for Pathology Whole-Slide Images](https://mlsanity.com/paper/2608.01407/) (2026)
- [CHILD: Human-in-the-Loop OOD Detection for Safe Clinical Deployment](https://mlsanity.com/paper/2609.07188/) (2026)

## Abstract (arXiv)

The detection of semantic and covariate out-of-distribution (OOD) examples is a critical yet overlooked challenge in digital pathology (DP). Recently, substantial insight and methods on OOD detection were presented by the ML community, but how do they fare in DP applications? To this end, we establish a benchmark study, our highlights being: 1) the adoption of proper evaluation protocols, 2) the comparison of diverse detectors in both a single and multi-model setting, and 3) the exploration into advanced ML settings like transfer learning (ImageNet vs. DP pre-training) and choice of architecture (CNNs vs. transformers). Through our comprehensive experiments, we contribute new insights and guidelines, paving the way for future research and discussion.