# Discovering Hierarchy-Grounded Domains with Adaptive Granularity for Clinical Domain Generalization

arXiv: https://arxiv.org/abs/2506.06977 · HTML: https://mlsanity.com/paper/2506.06977/

## Key facts

- Cited by 3 papers in the map (data through 14 Oct 2026).
- Builds on 34 of its 76 references that are in the map.
- First posted on arXiv 8 Jun 2025.

## Builds on (most cited first, 30 of 34)

- [Attention Is All You Need](https://mlsanity.com/paper/1706.03762/) (2017)
- [Model-Agnostic Meta-Learning for Fast Adaptation of Deep Networks](https://mlsanity.com/paper/1703.03400/) (2017)
- [Image-to-Image Translation with Conditional Adversarial Networks](https://mlsanity.com/paper/1611.07004/) (2016)
- [Domain-Adversarial Training of Neural Networks](https://mlsanity.com/paper/1505.07818/) (2015)
- [UMAP: Uniform Manifold Approximation and Projection for Dimension Reduction](https://mlsanity.com/paper/1802.03426/) (2018)
- [Invariant Risk Minimization](https://mlsanity.com/paper/1907.02893/) (2019)
- [WILDS: A Benchmark of in-the-Wild Distribution Shifts](https://mlsanity.com/paper/2012.07421/) (2020)
- [Domain Generalization: A Survey](https://mlsanity.com/paper/2103.02503/) (2021)
- [Learning to Generalize: Meta-Learning for Domain Generalization](https://mlsanity.com/paper/1710.03463/) (2017)
- [Domain Generalization via Invariant Feature Representation](https://mlsanity.com/paper/1301.2115/) (2013)
- [ClinicalBERT: Modeling Clinical Notes and Predicting Hospital Readmission](https://mlsanity.com/paper/1904.05342/) (2019)
- [SWAD: Domain Generalization by Seeking Flat Minima](https://mlsanity.com/paper/2102.08604/) (2021)
- [Domain Generalization via Model-Agnostic Learning of Semantic Features](https://mlsanity.com/paper/1910.13580/) (2019)
- [Domain Separation Networks](https://mlsanity.com/paper/1608.06019/) (2016)
- [Doctor AI: Predicting Clinical Events via Recurrent Neural Networks](https://mlsanity.com/paper/1511.05942/) (2015)
- [SelfReg: Self-supervised Contrastive Regularization for Domain Generalization](https://mlsanity.com/paper/2104.09841/) (2021)
- [Adaptive Risk Minimization: Learning to Adapt to Domain Shift](https://mlsanity.com/paper/2007.02931/) (2020)
- [Domain Generalization Using a Mixture of Multiple Latent Domains](https://mlsanity.com/paper/1911.07661/) (2019)
- [Reviving Iterative Training with Mask Guidance for Interactive Segmentation](https://mlsanity.com/paper/2102.06583/) (2021)
- [Pre-training of Graph Augmented Transformers for Medication Recommendation](https://mlsanity.com/paper/1906.00346/) (2019)
- [Domain Generalization for Medical Imaging Classification with Linear-Dependency Regularization](https://mlsanity.com/paper/2009.12829/) (2020)
- [Unsupervised domain adaptation for medical imaging segmentation with self-ensembling](https://mlsanity.com/paper/1811.06042/) (2018)
- [Towards Principled Disentanglement for Domain Generalization](https://mlsanity.com/paper/2111.13839/) (2021)
- [GAMENet: Graph Augmented MEmory Networks for Recommending Medication Combination](https://mlsanity.com/paper/1809.01852/) (2018)
- [Connect, Not Collapse: Explaining Contrastive Learning for Unsupervised Domain Adaptation](https://mlsanity.com/paper/2204.00570/) (2022)
- [GraphCare: Enhancing Healthcare Predictions with Personalized Knowledge Graphs](https://mlsanity.com/paper/2305.12788/) (2023)
- [Feature Stylization and Domain-aware Contrastive Learning for Domain Generalization](https://mlsanity.com/paper/2108.08596/) (2021)
- [An Empirical Framework for Domain Generalization in Clinical Settings](https://mlsanity.com/paper/2103.11163/) (2021)
- [Collaborative Graph Learning with Auxiliary Text for Temporal Event Prediction in Healthcare](https://mlsanity.com/paper/2105.07542/) (2021)
- [Domain Generalization by Learning and Removing Domain-specific Features](https://mlsanity.com/paper/2212.07101/) (2022)

## Built on by (most cited first, 3 of 3)

- [Implicit Hypergraph Neural Networks: A Stable Framework for Higher-Order Relational Learning with Provable Guarantees](https://mlsanity.com/paper/2508.09427/) (2025)
- [Exploring Accurate and Transparent Domain Adaptation in Predictive Healthcare via Concept-Grounded Orthogonal Inference](https://mlsanity.com/paper/2602.12542/) (2026)
- [HydroDCM: Hydrological Domain-Conditioned Modulation for Cross-Reservoir Inflow Prediction](https://mlsanity.com/paper/2512.03300/) (2025)

## Abstract (arXiv)

Domain generalization has become a critical challenge in predictive healthcare, where different patient groups exhibit shifting data distributions that degrade model performance. Still, regular domain generalization approaches often struggle in clinical settings due to (1) the absence of domain labels and (2) the lack of clinical insight integration. To address these challenges in healthcare, we aim to explore how medical ontologies can be used to discover dynamic yet hierarchy-grounded patient domains, a partitioning strategy that remains under-explored in prior work. Hence, we introduce UdonCare, a hierarchy-pruning method that iteratively divides patients into latent domains and retrieves domain-invariant (label) information from patient data. On public datasets (MIMIC-III, MIMIC-IV, and eICU), UdonCare shows superiority over eight generalization baselines across four representative clinical prediction tasks with substantial domain gaps, highlighting the potential of medical knowledge for enhancing model generalization.