MoBE is proposed: a fully optimization-free framework that performs dynamic expert selection and adaptation at test time that combines entropy-guided dynamic routing in MoE settings with expert-wise Bayesian adaptation, enabling experts to update their confidence and adapt online without gradient updates.
Abstract
Medical vision-language models (MVLMs) promise broad zero-shot generalization, yet their reliability collapses when confronted with unseen modalities and domains, precisely where clinical robustness matters most. To address this gap, we revisit test-time modality generalization from the perspective of Mixture-of-Experts (MoE) and ask: can experts route-and-adapt without any optimization during inference? We identify a fundamental specialization-generalization dilemma at test time, where blindly aggregating modality experts dilutes modality-specific knowledge, while selecting one highly confident expert risks mismatch under shift. To address this, we propose MoBE: a fully optimization-free framework that performs dynamic expert selection and adaptation at test time. MoBE combines entropy-guided dynamic routing in MoE settings with expert-wise Bayesian adaptation, enabling experts to update their confidence and adapt online without gradient updates. Without parametric updates, MoBE augments a static MVLM with test-time routing and online statistics, achieving average accuracy gains of +4.72, +7.17, and +4.3 over state-of-the-art TTA methods across seen, unseen, and heterogeneous medical benchmarks, highlighting the effectiveness of training-free expert adaptation for robust modality generalization.
This doctoral research addresses fragility in multimodal deep learning by shifting the paradigm from generative imputation to uncertainty-guided abstention and introducing QA-MoE (Quality-Aware MoE), which explicitly decouples reliability estimation from the routing process.
Lin-Peng Sun· Proceedings of the Thirty-Fi...· 0 citations
Evaluations on clinical benchmarks demonstrate that QA-MoE outperforms strong multimodal baselines, improving reliability while cutting down unnecessary computation, indicating that QA-MoE offers a robust solution for multimodal decision support, especially in clinical settings prone to noise and missing data.
Lin-Peng Sun, Victor S. Sheng· Proceedings of the Thirty-Fi...· 0 citations
Medical image segmenters often get worse when sites, scanner vendors, or protocols change. Continual test-time adaptation (CTTA) addresses this problem without target labels, but it can be impossible to update a model on a non-stationary stream and can lead to a lot of errors. We examine a more reasonable and meaningfu...
Large pretrained clinical models provide a practical way to reuse learned prior knowledge across hospitals by adapting models to them. In practice, a target hospital may only have a small labeled patient cohort, a setting commonly referred to as few-shot adaptation. This requires making multiple decisions, such as whic...
Song Wang, Jie Peng, Davis Hobley et al.· 0 citations
The underlying causes of miscalibration in VLMs and Medical-VLMs are investigated and a simple train-time calibration method, Multi-Class Margin (MCM) regularization, is proposed, which achieves lowest ECE on 10 out of 12 settings in in-domain and remains competitive under domain shifts.
Recent advances in large language models (LLMs) and vision transformers have enabled multimodal systems that integrate clinical text with medical imaging for diagnostic decision-making. While these systems show promising results on benchmark datasets in well-resourced research settings, their applicability in low-resou...
Kahakashan Ashraf, Md.Hamid Hosen, N. Farah et al.· Frontiers in Digital Health· 0 citations
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