Organizations: NepAl Applied Mathematics and Informatics Institute for research, Nepal · Kathmandu University, Nepal · NHS Grampian, UK · West Virginia University, USA · University College London, UK · University of Aberdeen, UK
Abstract
Deep neural networks have achieved remarkable performance across medical imaging tasks, yet their tendency to overgeneralize under distributional shifts poses a major obstacle to safe clinical deployment. Out-of-Distribution (OOD) detection methods aim to mitigate this risk, but most existing approaches rely on opaque internal signals with poorly understood semantic meaning, limiting trust in safety-critical settings. In this work, we propose an interpretable OOD detection framework that probes the stability of model predictions under class-conditioned semantic perturbations. Leveraging sparse autoencoders (SAEs), we learn class-specific concept vectors from in-distribution data that disentangle dense intermediate representations into sparse, semantically meaningful components. At inference, we perturb deeper-layer representations using the concept vectors associated with the model's predicted class and measure the class logits stability. We hypothesize that in-distribution samples exhibit low sensitivity to such perturbations, as their representations align with class-specific semantic directions, whereas OOD samples show amplified deviations due to representational misalignment. By framing OOD detection as a concept conditioned stability analysis, our approach provides both a discriminative OOD signal and an interpretable lens into the internal mechanisms driving model uncertainty, making it particularly suitable for high stakes medical applications.
Reliable detection of out-of-distribution (OOD) samples is crucial for the safe deployment of machine learning models. Neural networks often produce overconfident predictions for inputs that deviate from their training data, leading to significant degradation in performance. While many OOD detection methods focus on the final output layer, they neglect the rich hierarchical information present in intermediate network layers. This paper introduces a novel approach that leverages sparse autoencoders (SAEs) to learn interpretable features from these intermediate activations. We find that in-distribution (ID) and OOD data activate distinct sets of these sparse features. We propose a new OOD score derived from the cosine similarity between the sparse feature activations of a test sample and the mean activations of ID classes. Our post-hoc detection method not only achieves state-of-the-art performance on standard OOD detection benchmarks, but yields interpretable insights into how distribution shift affects learned representations.
Ayush Karmacharya, Luke Luschwitz, Lucia Romero +2
Out-of-distribution (OOD) detection is critical for safe deployment of medical AI systems. Recently, test-time adaptation (TTA) has emerged as a new paradigm for OOD detection, automatically adjusting detector behavior during deployment. However, such automatic adaptation mechanisms may raise safety concerns in safety-critical clinical environments. While physician oversight can mitigate these risks, it is resource-intensive and must be judiciously allocated. To reconcile safety with efficiency, we propose CHILD, a training-free framework designed to enhance streaming OOD detection via sparse human feedback. Operating under strict budget constraints, CHILD employs an adaptive risk-aware sample selection mechanism to pinpoint only the most decision-uncertain samples for review. Crucially, it maximizes the utility of this sparse feedback through a retrieval-based score calibration module, which refines model predictions using a compact feature cache without any parameter updates. Extensive experiments on four medical benchmarks demonstrate that CHILD turns limited supervision into significant reliability gains: with a sparse feedback budget of only 5%, it reduces the average FPR95 from 72.63% to 60.26% and improves AUROC from 75.53% to 81.85%, consistently outperforming state-of-the-art baselines. Our code is publicly available at https://github.com/figec/CHILD.
Out-of-distribution (OOD) detection is crucial for ensuring the reliability of deep learning models. Existing methods mostly focus on regular entangled representations to discriminate in-distribution (ID) and OOD data, neglecting the rich contextual information within images. This issue is particularly challenging for detecting near-OOD, as models with simplicity bias struggle to learn discriminative features in disentangled representations. The human visual system can use the co-occurrence of objects in the natural environment to facilitate scene understanding. Inspired by this, we propose an Object-Centric OOD detection framework that learns to capture Object CO-occurrence (OCO) patterns within images. The proposed method introduces a new OOD detection paradigm that understands object co-occurrence within an image by predicting disentangled representations for the test sample, then adaptively divides patterns into three scenarios based on object co-occurrence patterns observed in ID training data, and finally performs OOD detection in a divide-and-conquer manner. By doing so, OCO can distinguish near-OOD by considering the semantic contextual relationships present in their images, avoiding the tendency to focus solely on simple, easily learnable regions. We evaluate OCO through experiments across challenging and full-spectrum OOD settings, demonstrating competitive results and confirming its ability to address both semantic and covariate shifts. Code is released at https://github.com/Michael-McQueen/OCO.