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.
We study hierarchical domain generalization as a problem of extrapolation from finite observed regions to an entire instance space, replacing i.i.d. sampling with arbitrary domain hierarchies. We show that the central obstruction is not only the complexity of the hypothesis class, but the train/test domain partition through which evidence is revealed. In particular, no matter how small the class or how large the training size, some partition makes generalization fail for some target. These results suggest that modern generalization theory must treat domain structure as a first-class object.
Pathology foundation models (PFMs) have advanced rapidly in recent years and support training classifiers for a range of histopathology tasks. However, their robustness across hospitals remains limited: performance often degrades when training a classifier on data from one hospital and evaluating it on another target hospital. We address this challenge by fine-tuning PFMs with a local maximum mean discrepancy (LMMD) objective that applies to two settings: domain adaptation, where unlabeled target-hospital data is available, and domain generalization, where target-hospital data is unavailable at all. Experiments at both the patch- and slide-level show consistent improvements across multiple PFMs and tasks.
In NLP classification tasks where little labeled data exists, domain fine-tuning of transformer models on unlabeled data is an established approach. In this paper we have two aims. (1) We describe our observations from fine-tuning the Finnish BERT model on Finnish medical text data. (2) We report on our attempts to predict the benefit of domain-specific pre-training of Finnish BERT from observing the geometry of embedding changes due to domain fine-tuning. Our driving motivation is the common\situation in healthcare AI where we might experience long delays in acquiring datasets, especially with respect to labels.