Distribution Shift

Recent text-to-image (T2I) diffusion models produce visually stunning images and demonstrate excellent prompt following. But do they perform well as synthetic vision data generators? In this work, we revisit the promise of synthetic data as a scalable substitute for real training sets and uncover a surprising performance regression. We generate large-scale synthetic datasets using state-of-the-art T2I models released between 2022 and 2025, train standard classifiers solely on this synthetic data, and evaluate them on real test data. Despite observable advances in visual fidelity and prompt adherence, classification accuracy on real test data consistently declines with newer T2I models as training data generators. Our analysis reveals a hidden trend: These models collapse to a narrow, aesthetic-centric distribution that undermines diversity and real data distribution coverage. Overall, our findings challenge a growing assumption in vision research, namely that progress in generative realism implies progress in data realism. We thus highlight an urgent need to rethink the capabilities of modern T2I models as reliable training data generators.

Factorizable joint shift (FJS) represents a type of distribution shift (or dataset shift) that comprises both covariate and label shift. Recently, it has been observed that FJS actually arises from consecutive label and covariate (or vice versa) shifts. Research into FJS so far has been confined mostly to the case of categorical labels. We propose a framework for analysing distribution shift in the case of a general label space, thus covering both classification and regression models. Based on the framework, we generalise existing results on FJS to general label spaces and present and analyse a related extension to label distribution estimation of the expectation maximisation (EM) algorithm for class prior probabilities. We also take a fresh look at generalized label shift (GLS) in the case of a general label space.

Public datasets of Chest X-Rays (CXRs) have long been a popular benchmark for developing machine learning (ML) computer vision models in healthcare. However, the reported strong average-case performance of these models do not necessarily reflect their actual utility when used in heterogeneous clinical settings, potentially masking weaker performance in medically significant scenarios. In this work we use clinical context to provide a more holistic evaluation of models for CXR diagnosis. In particular, we use discharge summaries, recorded prior to each CXR, to derive a ``pre-CXR'' probability of each CXR label, as a proxy for existing contextual knowledge available to clinicians when interpreting CXRs. We use this measure to probe model performance along two dimensions: First, using a stratified analysis, we show that models tend to have lower performance (as measured by AUROC and other metrics) among individuals with higher pre-CXR probability. Second, by controlling for pre-CXR probability via matching and re-weighting, we demonstrate that performance degrades when the correlation is broken between prior context and the current CXR label, suggesting that model performance is highly sensitive to the underlying distribution of clinical context. Specifically, cases with high pre-test probabilities present a fundamentally more difficult visual classification task, highlighting a gap in clinical utility when models are applied to high-risk cohorts.