# Fixed-Budget Parameter-Efficient Training with Frozen Encoders Improves Multimodal Chest X-Ray Classification

arXiv: https://arxiv.org/abs/2512.21508 · HTML: https://mlsanity.com/paper/2512.21508/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 16 of its 21 references that are in the map.
- First posted on arXiv 25 Dec 2025.

## Builds on (most cited first, 16 of 16)

- [Deep Residual Learning for Image Recognition](https://mlsanity.com/paper/1512.03385/) (2015)
- [An Image is Worth 16x16 Words: Transformers for Image Recognition at Scale](https://mlsanity.com/paper/2010.11929/) (2020)
- [LoRA: Low-Rank Adaptation of Large Language Models](https://mlsanity.com/paper/2106.09685/) (2021)
- [RoBERTa: A Robustly Optimized BERT Pretraining Approach](https://mlsanity.com/paper/1907.11692/) (2019)
- [Visual Instruction Tuning](https://mlsanity.com/paper/2304.08485/) (2023)
- [EfficientNet: Rethinking Model Scaling for Convolutional Neural Networks](https://mlsanity.com/paper/1905.11946/) (2019)
- [BLIP: Bootstrapping Language-Image Pre-training for Unified Vision-Language Understanding and Generation](https://mlsanity.com/paper/2201.12086/) (2022)
- [DistilBERT, a distilled version of BERT: smaller, faster, cheaper and lighter](https://mlsanity.com/paper/1910.01108/) (2019)
- [Parameter-Efficient Transfer Learning for NLP](https://mlsanity.com/paper/1902.00751/) (2019)
- [MobileNets: Efficient Convolutional Neural Networks for Mobile Vision Applications](https://mlsanity.com/paper/1704.04861/) (2017)
- [BioBERT: a pre-trained biomedical language representation model for biomedical text mining](https://mlsanity.com/paper/1901.08746/) (2019)
- [CheXpert: A Large Chest Radiograph Dataset with Uncertainty Labels and Expert Comparison](https://mlsanity.com/paper/1901.07031/) (2019)
- [BitFit: Simple Parameter-efficient Fine-tuning for Transformer-based Masked Language-models](https://mlsanity.com/paper/2106.10199/) (2021)
- [ClinicalBERT: Modeling Clinical Notes and Predicting Hospital Readmission](https://mlsanity.com/paper/1904.05342/) (2019)
- [CheXNet: Radiologist-Level Pneumonia Detection on Chest X-Rays with Deep Learning](https://mlsanity.com/paper/1711.05225/) (2017)
- [Comparative Analysis of Resource-Efficient CNN Architectures for Brain Tumor Classification](https://mlsanity.com/paper/2411.15596/) (2024)

## Abstract (arXiv)

Multimodal chest X-Ray analysis often fine-tunes large vision-language models, which is computationally costly. We study parameter-efficient training (PET) strategies, including frozen encoders, BitFit, LoRA, and adapters for multi-label classification on the Indiana University Chest X-Ray dataset (3,851 image-report pairs; 579 test samples). To mitigate data leakage, we redact pathology terms from reports used as text inputs while retaining clinical context. Under a fixed parameter budget (2.37M parameters, 2.51% of total), all PET variants achieve AUROC between 0.892 and 0.908, outperforming full fine-tuning (0.770 AUROC), which uses 94.3M trainable parameters, a 40x reduction. External validation on CheXpert (224,316 images, 58x larger) confirms scalability: all PET methods achieve >0.69 AUROC with <9% trainable parameters, with Adapter achieving best performance (0.7214 AUROC). Budget-matched comparisons reveal that vision-only models (0.653 AUROC, 1.06M parameters) outperform budget-matched multimodal models (0.641 AUROC, 1.06M parameters), indicating improvements arise primarily from parameter allocation rather than cross-modal synergy. While PET methods show degraded calibration (ECE: 0.29-0.34) compared to simpler models (ECE: 0.049), this represents a tractable limitation addressable through post-hoc calibration methods. These findings demonstrate that frozen encoder strategies provide superior discrimination at substantially reduced computational cost, though calibration correction is essential for clinical deployment.