arXiv subjects

Lucy Q. Shen

Publications and source records attributed to Lucy Q. Shen.

5 recordsLinked to original sources

arXiv2026

Representation-guided in-context learning for medical image interpretation with multimodal large language models

Medical image interpretation is central to diagnosis and care, yet adapting general-purpose multimodal large language models (MLLMs) often requires resource-intensive domain-specific fine-tuning. Here we introduce representation-guided in-context learning (RG-ICL), a training-free inference framework that retrieves query-aligned demonstrations using frozen encoders, without task-specific parameter updates. Across eight datasets spanning histopathology, radiology and retinal fundoscopy, RG-ICL improved classification (mean gain 20 percentage points) and visual question answering (VQA) (mean gain 13 percentage points) over no-context and conventional ICL, approaching or exceeding training-based comparators. Which cases were retrieved mattered more than how many: 6 query-aligned cases outperformed up to 32 randomly selected ones, whereas fixed or random cases often reduced accuracy below baseline. For VQA, aligning reference cases with both image content and question intent produced further gains. These findings indicate that for medical image interpretation, curating which reference cases an MLLM sees is a practical alternative to retraining it.

cs.AI↗

arXiv2026

MultiFair: Multimodal Balanced Fairness-Aware Medical Classification with Dual-Level Gradient Modulation

Medical decision systems increasingly rely on data from multiple sources to ensure reliable and unbiased diagnosis. However, existing multimodal learning models fail to achieve this goal because they often overlook two critical challenges. First, various data modalities may learn unevenly, thereby converging to a model biased towards certain modalities. Second, the model may emphasize learning on certain demographic groups causing unfair performances. The two aspects can influence each other, as different data modalities may favor respective groups during optimization, leading to both imbalanced and unfair multimodal learning. This paper proposes a novel approach called MultiFair for multimodal medical classification, which addresses these challenges with a dual-level gradient modulation process. MultiFair dynamically modulates training gradients regarding the optimization direction and magnitude at both data modality and group levels. We evaluate MultiFair on three real-world medical classification datasets with diverse demographic attributes,including multiclass classification and missing-modality settings. Experimental results demonstrate its effectiveness.

cs.LG↗

arXiv2025

Evaluation of In Vivo Subject-Specific Mechanical Modeling of the Optic Nerve Head for Robust Assessment of Ocular Mechanics

To establish the tissue regions necessary to accurately represent the mechanics of the optic nerve head (ONH), imaging data of the ONH from 2 healthy subjects were used to create in vivo subject-specific eye mechanical models considering distinct properties for all major ocular tissues. Tests were performed to evaluate the effect of the material properties and the inclusion of these tissues on the mechanics of the lamina cribrosa (LC), retina, and optic nerve. Then, the LC mechanical response due to variations in intraocular and intracranial pressures was evaluated to validate the modeling approach. The sclera stiffness has the largest impact on the mechanics of the LC, retina, and optic nerve, while Bruchs membrane has a negligible effect on these tissues response. The validation tests showed increased LC strain with increased pressure and highest strains in the inferior and temporal subregion, as seen in literature studies. Consequently, accurate ONH mechanical representation can be obtained by only including those tissue regions identified as necessary.

physics.med-ph↗

arXiv2024

Harvard Glaucoma Fairness: A Retinal Nerve Disease Dataset for Fairness Learning and Fair Identity Normalization

Fairness (also known as equity interchangeably) in machine learning is important for societal well-being, but limited public datasets hinder its progress. Currently, no dedicated public medical datasets with imaging data for fairness learning are available, though minority groups suffer from more health issues. To address this gap, we introduce Harvard Glaucoma Fairness (Harvard-GF), a retinal nerve disease dataset with both 2D and 3D imaging data and balanced racial groups for glaucoma detection. Glaucoma is the leading cause of irreversible blindness globally with Blacks having doubled glaucoma prevalence than other races. We also propose a fair identity normalization (FIN) approach to equalize the feature importance between different identity groups. Our FIN approach is compared with various the-state-of-the-art fairness learning methods with superior performance in the racial, gender, and ethnicity fairness tasks with 2D and 3D imaging data, which demonstrate the utilities of our dataset Harvard-GF for fairness learning. To facilitate fairness comparisons between different models, we propose an equity-scaled performance measure, which can be flexibly used to compare all kinds of performance metrics in the context of fairness. The dataset and code are publicly accessible via \url{https://ophai.hms.harvard.edu/datasets/harvard-glaucoma-fairness-3300-samples/}.

cs.CV↗

arXiv2022

Artifact-Tolerant Clustering-Guided Contrastive Embedding Learning for Ophthalmic Images

Ophthalmic images and derivatives such as the retinal nerve fiber layer (RNFL) thickness map are crucial for detecting and monitoring ophthalmic diseases (e.g., glaucoma). For computer-aided diagnosis of eye diseases, the key technique is to automatically extract meaningful features from ophthalmic images that can reveal the biomarkers (e.g., RNFL thinning patterns) linked to functional vision loss. However, representation learning from ophthalmic images that links structural retinal damage with human vision loss is non-trivial mostly due to large anatomical variations between patients. The task becomes even more challenging in the presence of image artifacts, which are common due to issues with image acquisition and automated segmentation. In this paper, we propose an artifact-tolerant unsupervised learning framework termed EyeLearn for learning representations of ophthalmic images. EyeLearn has an artifact correction module to learn representations that can best predict artifact-free ophthalmic images. In addition, EyeLearn adopts a clustering-guided contrastive learning strategy to explicitly capture the intra- and inter-image affinities. During training, images are dynamically organized in clusters to form contrastive samples in which images in the same or different clusters are encouraged to learn similar or dissimilar representations, respectively. To evaluate EyeLearn, we use the learned representations for visual field prediction and glaucoma detection using a real-world ophthalmic image dataset of glaucoma patients. Extensive experiments and comparisons with state-of-the-art methods verified the effectiveness of EyeLearn for learning optimal feature representations from ophthalmic images.

cs.CV↗