Abnormality detection is a crucial yet challenging task in medical image analysis. Distinguishing abnormalities from normal data by learning to reconstruct normal-only data alleviates the reliance on labeled datasets. However, many studies, even if unsupervised, rely on a labeled validation set to select the best model for inference from multiple training iterations. For many diseases labeled data are unavailable and substantially time consuming to obtain. To address this, AUCp - a novel metric that supports abnormality detection for unsupervised and self-supervised methods is proposed. Instead of evaluating the realism of reconstructed images to select the best of model for inference, it focuses on actual detection performance and without requiring an annotated test set. Assuming the pseudo ground truth of all unannotated samples in the test set as abnormal/positive and using traditional AUC calculation, AUCp scores are derived. Given a large and representative training set of normal samples, we show mathematical and empirical evidence that model selection using AUCp scores improves disease detection in terms of unsupervised and self-supervised methods over conventional metrics. Using two unsupervised methods for neurologic disease detection and self-supervised methods on diverse datasets, our results demonstrate that the AUCp score effectively identifies the optimal model for inference, significantly enhancing abnormality and disease detection. The corresponding implementations are available in https://github.com/mahfuzmohammad/AUCp.
Anomaly detection systems are often trained using normal data alone, while model selection and evaluation typically require labeled anomalies. We study whether anomaly detection performance can be predicted without access to anomalous data. For kNN-based detectors, we derive a lower bound on the area under the ROC curve (AUC) that relates detection performance to the separation between inlier and outlier scores and to their respective variances. Under a local scaling model, we use this bound to characterize how density variation, intrinsic-dimensional heterogeneity, and cross-domain mismatch contribute to score variability. We then investigate anomaly-free model selection and show that inlier score variance alone does not reliably predict performance across different representations. To address this limitation, we introduce simple pseudo-anomaly probes that provide a reference for estimating relative score separation. Experiments on the DCASE 2022-2025 benchmarks, spanning four embedding models and 208 candidate systems, show that pseudo-anomaly-based estimators substantially improve anomaly-free model selection. In particular, diverse pseudo-anomalies enable anomaly-free model selection to outperform conventional development-set selection under domain shift. These results show that embedding-space geometry contains predictive information about anomaly detection performance while also highlighting the representation-dependent nature of inlier-only performance estimates.
Reliable automated analysis of Optical Coherence Tomography (OCT) imaging is crucial for diagnosing retinal disorders but faces a critical barrier: the need for expensive, labor-intensive expert annotations. Supervised deep learning models struggle to generalize across diverse pathologies, imaging devices, and patient populations due to their restricted vocabulary of annotated abnormalities. We propose an unsupervised anomaly detection framework that learns the normative distribution of healthy retinal anatomy without lesion annotations, directly addressing annotation efficiency challenges in clinical deployment. Our approach leverages a discrete latent model trained on normal B-scans to capture OCT-specific structural patterns. To enhance clinical robustness, we incorporate retinal layer-aware supervision and structured triplet learning to separate healthy from pathological representations, improving model reliability across varied imaging conditions. During inference, anomalies are detected and localized via reconstruction discrepancies, enabling both image and pixel-level identification without requiring disease-specific labels. On the Kermany dataset (AUROC: 0.799), our method substantially outperforms VAE, VQVAE, VQGAN, and f-AnoGAN baselines. Critically, cross-dataset evaluation on Srinivasan achieves AUROC 0.884 with superior generalization, demonstrating robust domain adaptation. On the external RETOUCH benchmark, unsupervised anomaly segmentation achieves competitive Dice (0.200) and mIoU (0.117) scores, validating reproducibility across institutions.
Unsupervised outlier detection is attractive because it eliminates the need for labeled data. Moreover, forming multi-model ensembles can improve detection robustness. However, composing an ensemble without labeled data is challenging. Naively composed ensembles can suffer from ensemble saturation, where redundant or unreliable detection models degrade performance and incur unnecessary computation. We propose MetaEns, an automatic unsupervised framework for selecting ensembles of outlier detection models. Using labeled meta-datasets, MetaEns learns a model that predicts marginal ensemble gains, estimating the expected improvement from adding a candidate model to a partially constructed ensemble. At test time, this learned signal is combined with a submodular-inspired proxy objective that enforces diminishing returns through diversity-aware discounting and family-level risk regularization, thereby enabling greedy sequential selection with adaptive early stopping. As a result, MetaEns constructs compact, high-quality ensembles without access to ground-truth labels. Experiments on 39 real-world datasets show that MetaEns consistently outperforms state-of-the-art unsupervised selectors and ensemble baselines, achieving higher average precision while using fewer models.