Anita Kriz

Prompt4Trust: A Reinforcement Learning Prompt Augmentation Framework for Clinically-Aligned Confidence Calibration in Multimodal Large Language Models

Multimodal large language models (MLLMs) hold considerable promise for applications in healthcare. However, their deployment in safety-criti… (see more)cal settings is hindered by two key limitations: (i) sensitivity to prompt design, and (ii) a tendency to generate incorrect responses with high confidence. As clinicians may rely on a model's stated confidence to gauge the reliability of its predictions, it is especially important that when a model expresses high confidence, it is also highly accurate. We introduce Prompt4Trust, the first reinforcement learning (RL) framework for prompt augmentation targeting confidence calibration in MLLMs. A lightweight LLM is trained to produce context-aware auxiliary prompts that guide a downstream task MLLM to generate responses in which the expressed confidence more accurately reflects predictive accuracy. Unlike conventional calibration techniques, Prompt4Trust specifically prioritizes aspects of calibration most critical for safe and trustworthy clinical decision-making. Beyond improvements driven by this clinically motivated calibration objective, our proposed method also improves task accuracy, achieving state-of-the-art medical visual question answering (VQA) performance on the PMC-VQA benchmark, which is composed of multiple-choice questions spanning diverse medical imaging modalities. Moreover, our framework trained with a small downstream task MLLM showed promising zero-shot generalization to larger MLLMs in our experiments, suggesting the potential for scalable calibration without the associated computational costs. This work demonstrates the potential of automated yet human-aligned prompt engineering for improving the the trustworthiness of MLLMs in safety critical settings. Our codebase can be found at https://github.com/xingbpshen/prompt4trust.

2025-07-12

ArXiv (preprint)

doi.org

arxiv.org

Leveraging Vision-Language Foundation Models to Reveal Hidden Image-Attribute Relationships in Medical Imaging

Amar Kumar

Anita Kriz

B. Pertzov

Tal Arbel

2025-03-30

ArXiv (preprint)

arxiv.org

Leveraging Vision-Language Foundation Models to Reveal Hidden Image-Attribute Relationships in Medical Imaging

Amar Kumar

Anita Kriz

B. Pertzov

Tal Arbel

Vision-language foundation models (VLMs) have shown impressive performance in guiding image generation through text, with emerging applicati… (see more)ons in medical imaging. In this work, we are the first to investigate the question: 'Can fine-tuned foundation models help identify critical, and possibly unknown, data properties?' By evaluating our proposed method on a chest x-ray dataset, we show that these models can generate high-resolution, precisely edited images compared to methods that rely on Structural Causal Models (SCMs) according to numerous metrics. For the first time, we demonstrate that fine-tuned VLMs can reveal hidden data relationships that were previously obscured due to available metadata granularity and model capacity limitations. Our experiments demonstrate both the potential of these models to reveal underlying dataset properties while also exposing the limitations of fine-tuned VLMs for accurate image editing and susceptibility to biases and spurious correlations.

2025-03-30

ArXiv (preprint)

doi.org

arxiv.org

PRISM: High-Resolution&Precise Counterfactual Medical Image Generation using Language-guided Stable Diffusion

Developing reliable and generalizable deep learning systems for medical imaging faces significant obstacles due to spurious correlations, da… (see more)ta imbalances, and limited text annotations in datasets. Addressing these challenges requires architectures robust to the unique complexities posed by medical imaging data. The rapid advancements in vision-language foundation models within the natural image domain prompt the question of how they can be adapted for medical imaging tasks. In this work, we present PRISM, a framework that leverages foundation models to generate high-resolution, language-guided medical image counterfactuals using Stable Diffusion. Our approach demonstrates unprecedented precision in selectively modifying spurious correlations (the medical devices) and disease features, enabling the removal and addition of specific attributes while preserving other image characteristics. Through extensive evaluation, we show how PRISM advances counterfactual generation and enables the development of more robust downstream classifiers for clinically deployable solutions. To facilitate broader adoption and research, we make our code publicly available at https://github.com/Amarkr1/PRISM.

2025-03-27

MIDL.io/2025/Conference (oral)

doi.org

openreview.net

PRISM: High-Resolution & Precise Counterfactual Medical Image Generation using Language-guided Stable Diffusion

Developing reliable and generalizable deep learning systems for medical imaging faces significant obstacles due to spurious correlations, da… (see more)ta imbalances, and limited text annotations in datasets. Addressing these challenges requires architectures robust to the unique complexities posed by medical imaging data. The rapid advancements in vision-language foundation models within the natural image domain prompt the question of how they can be adapted for medical imaging tasks. In this work, we present PRISM, a framework that leverages foundation models to generate high-resolution, language-guided medical image counterfactuals using Stable Diffusion. Our approach demonstrates unprecedented precision in selectively modifying spurious correlations (the medical devices) and disease features, enabling the removal and addition of specific attributes while preserving other image characteristics. Through extensive evaluation, we show how PRISM advances counterfactual generation and enables the development of more robust downstream classifiers for clinically deployable solutions. To facilitate broader adoption and research, we make our code publicly available at https://github.com/Amarkr1/PRISM.

2025-03-01

arXiv (published)

doi.org

PRISM: High-Resolution&Precise Counterfactual Medical Image Generation using Language-guided Stable Diffusion

Developing reliable and generalizable deep learning systems for medical imaging faces significant obstacles due to spurious correlations, da… (see more)ta imbalances, and limited text annotations in datasets. Addressing these challenges requires architectures robust to the unique complexities posed by medical imaging data. The rapid advancements in vision-language foundation models within the natural image domain prompt the question of how they can be adapted for medical imaging tasks. In this work, we present PRISM, a framework that leverages foundation models to generate high-resolution, language-guided medical image counterfactuals using Stable Diffusion. Our approach demonstrates unprecedented precision in selectively modifying spurious correlations (the medical devices) and disease features, enabling the removal and addition of specific attributes while preserving other image characteristics. Through extensive evaluation, we show how PRISM advances counterfactual generation and enables the development of more robust downstream classifiers for clinically deployable solutions. To facilitate broader adoption and research, we make our code publicly available at https://github.com/Amarkr1/PRISM.

2025-02-28

ArXiv (preprint)

arxiv.org