{"id":"https://openalex.org/W4396894318","doi":"https://doi.org/10.1038/s41746-024-01118-4","title":"Shortcut learning in medical AI hinders generalization: method for estimating AI model generalization without external data","display_name":"Shortcut learning in medical AI hinders generalization: method for estimating AI model generalization without external data","publication_year":2024,"publication_date":"2024-05-14","ids":{"openalex":"https://openalex.org/W4396894318","doi":"https://doi.org/10.1038/s41746-024-01118-4","pmid":"https://pubmed.ncbi.nlm.nih.gov/38744921"},"language":"en","primary_location":{"id":"doi:10.1038/s41746-024-01118-4","is_oa":true,"landing_page_url":"https://doi.org/10.1038/s41746-024-01118-4","pdf_url":"https://www.nature.com/articles/s41746-024-01118-4.pdf","source":{"id":"https://openalex.org/S4210195431","display_name":"npj Digital Medicine","issn_l":"2398-6352","issn":["2398-6352"],"is_oa":true,"is_in_doaj":true,"is_core":true,"host_organization":"https://openalex.org/P4310319908","host_organization_name":"Nature Portfolio","host_organization_lineage":["https://openalex.org/P4310319908","https://openalex.org/P4310319965"],"host_organization_lineage_names":["Nature Portfolio","Springer Nature"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"npj Digital Medicine","raw_type":"journal-article"},"type":"article","indexed_in":["crossref","doaj","pubmed"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://www.nature.com/articles/s41746-024-01118-4.pdf","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5030981495","display_name":"Cathy Ong Ly","orcid":"https://orcid.org/0000-0002-4328-1581"},"institutions":[{"id":"https://openalex.org/I1325899441","display_name":"University Health Network","ror":"https://ror.org/042xt5161","country_code":"CA","type":"healthcare","lineage":["https://openalex.org/I1325899441"]},{"id":"https://openalex.org/I2801845744","display_name":"Toronto General Hospital","ror":"https://ror.org/026pg9j08","country_code":"CA","type":"healthcare","lineage":["https://openalex.org/I1325899441","https://openalex.org/I2801845744"]},{"id":"https://openalex.org/I4210091032","display_name":"Ted Rogers Centre for Heart Research","ror":"https://ror.org/00cgnj660","country_code":"CA","type":"healthcare","lineage":["https://openalex.org/I1325899441","https://openalex.org/I185261750","https://openalex.org/I4210091032","https://openalex.org/I4210141030"]},{"id":"https://openalex.org/I185261750","display_name":"University of Toronto","ror":"https://ror.org/03dbr7087","country_code":"CA","type":"education","lineage":["https://openalex.org/I185261750"]}],"countries":["CA"],"is_corresponding":true,"raw_author_name":"Cathy Ong Ly","raw_affiliation_strings":["Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada","Peter Munk Cardiac Centre and Ted Rogers Centre for Heart Research, University Health Network, Toronto, ON, Canada","Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada"],"affiliations":[{"raw_affiliation_string":"Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada","institution_ids":["https://openalex.org/I185261750"]},{"raw_affiliation_string":"Peter Munk Cardiac Centre and Ted Rogers Centre for Heart Research, University Health Network, Toronto, ON, Canada","institution_ids":["https://openalex.org/I4210091032","https://openalex.org/I1325899441"]},{"raw_affiliation_string":"Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada","institution_ids":["https://openalex.org/I1325899441","https://openalex.org/I2801845744"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5021785527","display_name":"Balagopal Unnikrishnan","orcid":null},"institutions":[{"id":"https://openalex.org/I4210127509","display_name":"Vector Institute","ror":"https://ror.org/03kqdja62","country_code":"CA","type":"facility","lineage":["https://openalex.org/I4210127509"]},{"id":"https://openalex.org/I1325899441","display_name":"University Health Network","ror":"https://ror.org/042xt5161","country_code":"CA","type":"healthcare","lineage":["https://openalex.org/I1325899441"]},{"id":"https://openalex.org/I2801845744","display_name":"Toronto General Hospital","ror":"https://ror.org/026pg9j08","country_code":"CA","type":"healthcare","lineage":["https://openalex.org/I1325899441","https://openalex.org/I2801845744"]},{"id":"https://openalex.org/I185261750","display_name":"University of Toronto","ror":"https://ror.org/03dbr7087","country_code":"CA","type":"education","lineage":["https://openalex.org/I185261750"]}],"countries":["CA"],"is_corresponding":false,"raw_author_name":"Balagopal Unnikrishnan","raw_affiliation_strings":["Department of Computer Science, University of Toronto, Toronto, ON, Canada","Joint Department of Medical Imaging, University Health Network, Toronto, ON, Canada","Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada","Vector Institute, Toronto, ON, Canada"],"affiliations":[{"raw_affiliation_string":"Department of Computer Science, University of Toronto, Toronto, ON, Canada","institution_ids":["https://openalex.org/I185261750"]},{"raw_affiliation_string":"Joint Department of Medical Imaging, University Health Network, Toronto, ON, Canada","institution_ids":["https://openalex.org/I1325899441"]},{"raw_affiliation_string":"Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada","institution_ids":["https://openalex.org/I1325899441","https://openalex.org/I2801845744"]},{"raw_affiliation_string":"Vector Institute, Toronto, ON, Canada","institution_ids":["https://openalex.org/I4210127509"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5081114674","display_name":"Tony Tadic","orcid":"https://orcid.org/0000-0001-7797-2893"},"institutions":[{"id":"https://openalex.org/I185261750","display_name":"University of Toronto","ror":"https://ror.org/03dbr7087","country_code":"CA","type":"education","lineage":["https://openalex.org/I185261750"]},{"id":"https://openalex.org/I1325899441","display_name":"University Health Network","ror":"https://ror.org/042xt5161","country_code":"CA","type":"healthcare","lineage":["https://openalex.org/I1325899441"]},{"id":"https://openalex.org/I2802654988","display_name":"Princess Margaret Cancer Centre","ror":"https://ror.org/03zayce58","country_code":"CA","type":"healthcare","lineage":["https://openalex.org/I1325899441","https://openalex.org/I2802654988"]}],"countries":["CA"],"is_corresponding":false,"raw_author_name":"Tony Tadic","raw_affiliation_strings":["Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada","Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada"],"affiliations":[{"raw_affiliation_string":"Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada","institution_ids":["https://openalex.org/I185261750"]},{"raw_affiliation_string":"Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada","institution_ids":["https://openalex.org/I2802654988","https://openalex.org/I1325899441"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5043371954","display_name":"Tirth Patel","orcid":"https://orcid.org/0000-0002-3628-2367"},"institutions":[{"id":"https://openalex.org/I2802654988","display_name":"Princess Margaret Cancer Centre","ror":"https://ror.org/03zayce58","country_code":"CA","type":"healthcare","lineage":["https://openalex.org/I1325899441","https://openalex.org/I2802654988"]},{"id":"https://openalex.org/I1325899441","display_name":"University Health Network","ror":"https://ror.org/042xt5161","country_code":"CA","type":"healthcare","lineage":["https://openalex.org/I1325899441"]}],"countries":["CA"],"is_corresponding":false,"raw_author_name":"Tirth Patel","raw_affiliation_strings":["Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada"],"affiliations":[{"raw_affiliation_string":"Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada","institution_ids":["https://openalex.org/I2802654988","https://openalex.org/I1325899441"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5050739286","display_name":"Joe Duhamel","orcid":"https://orcid.org/0000-0002-3457-2715"},"institutions":[{"id":"https://openalex.org/I1325899441","display_name":"University Health Network","ror":"https://ror.org/042xt5161","country_code":"CA","type":"healthcare","lineage":["https://openalex.org/I1325899441"]},{"id":"https://openalex.org/I4210091032","display_name":"Ted Rogers Centre for Heart Research","ror":"https://ror.org/00cgnj660","country_code":"CA","type":"healthcare","lineage":["https://openalex.org/I1325899441","https://openalex.org/I185261750","https://openalex.org/I4210091032","https://openalex.org/I4210141030"]}],"countries":["CA"],"is_corresponding":false,"raw_author_name":"Joe Duhamel","raw_affiliation_strings":["Peter Munk Cardiac Centre and Ted Rogers Centre for Heart Research, University Health Network, Toronto, ON, Canada"],"affiliations":[{"raw_affiliation_string":"Peter Munk Cardiac Centre and Ted Rogers Centre for Heart Research, University Health Network, Toronto, ON, Canada","institution_ids":["https://openalex.org/I4210091032","https://openalex.org/I1325899441"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5076824164","display_name":"Sonja Kandel","orcid":"https://orcid.org/0000-0002-5085-3373"},"institutions":[{"id":"https://openalex.org/I1325899441","display_name":"University Health Network","ror":"https://ror.org/042xt5161","country_code":"CA","type":"healthcare","lineage":["https://openalex.org/I1325899441"]}],"countries":["CA"],"is_corresponding":false,"raw_author_name":"Sonja Kandel","raw_affiliation_strings":["Joint Department of Medical Imaging, University Health Network, Toronto, ON, Canada"],"affiliations":[{"raw_affiliation_string":"Joint Department of Medical Imaging, University Health Network, Toronto, ON, Canada","institution_ids":["https://openalex.org/I1325899441"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5036427523","display_name":"Yasbanoo Moayedi","orcid":"https://orcid.org/0000-0002-3288-7393"},"institutions":[{"id":"https://openalex.org/I4210091032","display_name":"Ted Rogers Centre for Heart Research","ror":"https://ror.org/00cgnj660","country_code":"CA","type":"healthcare","lineage":["https://openalex.org/I1325899441","https://openalex.org/I185261750","https://openalex.org/I4210091032","https://openalex.org/I4210141030"]},{"id":"https://openalex.org/I1325899441","display_name":"University Health Network","ror":"https://ror.org/042xt5161","country_code":"CA","type":"healthcare","lineage":["https://openalex.org/I1325899441"]}],"countries":["CA"],"is_corresponding":false,"raw_author_name":"Yasbanoo Moayedi","raw_affiliation_strings":["Peter Munk Cardiac Centre and Ted Rogers Centre for Heart Research, University Health Network, Toronto, ON, Canada"],"affiliations":[{"raw_affiliation_string":"Peter Munk Cardiac Centre and Ted Rogers Centre for Heart Research, University Health Network, Toronto, ON, Canada","institution_ids":["https://openalex.org/I4210091032","https://openalex.org/I1325899441"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5012113499","display_name":"Michael Brudno","orcid":"https://orcid.org/0000-0001-7947-2243"},"institutions":[{"id":"https://openalex.org/I1325899441","display_name":"University Health Network","ror":"https://ror.org/042xt5161","country_code":"CA","type":"healthcare","lineage":["https://openalex.org/I1325899441"]},{"id":"https://openalex.org/I4210127509","display_name":"Vector Institute","ror":"https://ror.org/03kqdja62","country_code":"CA","type":"facility","lineage":["https://openalex.org/I4210127509"]},{"id":"https://openalex.org/I185261750","display_name":"University of Toronto","ror":"https://ror.org/03dbr7087","country_code":"CA","type":"education","lineage":["https://openalex.org/I185261750"]},{"id":"https://openalex.org/I2802654988","display_name":"Princess Margaret Cancer Centre","ror":"https://ror.org/03zayce58","country_code":"CA","type":"healthcare","lineage":["https://openalex.org/I1325899441","https://openalex.org/I2802654988"]}],"countries":["CA"],"is_corresponding":false,"raw_author_name":"Michael Brudno","raw_affiliation_strings":["Department of Computer Science, University of Toronto, Toronto, ON, Canada","Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada","Vector Institute, Toronto, ON, Canada"],"affiliations":[{"raw_affiliation_string":"Department of Computer Science, University of Toronto, Toronto, ON, Canada","institution_ids":["https://openalex.org/I185261750"]},{"raw_affiliation_string":"Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada","institution_ids":["https://openalex.org/I2802654988","https://openalex.org/I1325899441"]},{"raw_affiliation_string":"Vector Institute, Toronto, ON, Canada","institution_ids":["https://openalex.org/I4210127509"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5010067099","display_name":"Andrew Hope","orcid":"https://orcid.org/0000-0001-6793-2863"},"institutions":[{"id":"https://openalex.org/I185261750","display_name":"University of Toronto","ror":"https://ror.org/03dbr7087","country_code":"CA","type":"education","lineage":["https://openalex.org/I185261750"]},{"id":"https://openalex.org/I2802654988","display_name":"Princess Margaret Cancer Centre","ror":"https://ror.org/03zayce58","country_code":"CA","type":"healthcare","lineage":["https://openalex.org/I1325899441","https://openalex.org/I2802654988"]},{"id":"https://openalex.org/I1325899441","display_name":"University Health Network","ror":"https://ror.org/042xt5161","country_code":"CA","type":"healthcare","lineage":["https://openalex.org/I1325899441"]}],"countries":["CA"],"is_corresponding":false,"raw_author_name":"Andrew Hope","raw_affiliation_strings":["Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada","Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada"],"affiliations":[{"raw_affiliation_string":"Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada","institution_ids":["https://openalex.org/I185261750"]},{"raw_affiliation_string":"Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada","institution_ids":["https://openalex.org/I2802654988","https://openalex.org/I1325899441"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5021437066","display_name":"Heather J. Ross","orcid":"https://orcid.org/0000-0003-4384-3027"},"institutions":[{"id":"https://openalex.org/I4210091032","display_name":"Ted Rogers Centre for Heart Research","ror":"https://ror.org/00cgnj660","country_code":"CA","type":"healthcare","lineage":["https://openalex.org/I1325899441","https://openalex.org/I185261750","https://openalex.org/I4210091032","https://openalex.org/I4210141030"]},{"id":"https://openalex.org/I1325899441","display_name":"University Health Network","ror":"https://ror.org/042xt5161","country_code":"CA","type":"healthcare","lineage":["https://openalex.org/I1325899441"]}],"countries":["CA"],"is_corresponding":false,"raw_author_name":"Heather Ross","raw_affiliation_strings":["Peter Munk Cardiac Centre and Ted Rogers Centre for Heart Research, University Health Network, Toronto, ON, Canada"],"affiliations":[{"raw_affiliation_string":"Peter Munk Cardiac Centre and Ted Rogers Centre for Heart Research, University Health Network, Toronto, ON, Canada","institution_ids":["https://openalex.org/I4210091032","https://openalex.org/I1325899441"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5044425152","display_name":"Chris McIntosh","orcid":"https://orcid.org/0000-0003-1371-1250"},"institutions":[{"id":"https://openalex.org/I2801845744","display_name":"Toronto General Hospital","ror":"https://ror.org/026pg9j08","country_code":"CA","type":"healthcare","lineage":["https://openalex.org/I1325899441","https://openalex.org/I2801845744"]},{"id":"https://openalex.org/I1325899441","display_name":"University Health Network","ror":"https://ror.org/042xt5161","country_code":"CA","type":"healthcare","lineage":["https://openalex.org/I1325899441"]}],"countries":["CA"],"is_corresponding":false,"raw_author_name":"Chris McIntosh","raw_affiliation_strings":["Department of Computer Science, University of Toronto, Toronto, ON, Canada. chris.mcintosh@uhn.ca","Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada. chris.mcintosh@uhn.ca","Department of Medical Imaging, University of Toronto, Toronto, ON, Canada. chris.mcintosh@uhn.ca","Joint Department of Medical Imaging, University Health Network, Toronto, ON, Canada. chris.mcintosh@uhn.ca","Peter Munk Cardiac Centre and Ted Rogers Centre for Heart Research, University Health Network, Toronto, ON, Canada. chris.mcintosh@uhn.ca","Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada. chris.mcintosh@uhn.ca","Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada. chris.mcintosh@uhn.ca","Vector Institute, Toronto, ON, Canada. chris.mcintosh@uhn.ca","Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada"],"affiliations":[{"raw_affiliation_string":"Department of Computer Science, University of Toronto, Toronto, ON, Canada. chris.mcintosh@uhn.ca","institution_ids":[]},{"raw_affiliation_string":"Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada. chris.mcintosh@uhn.ca","institution_ids":[]},{"raw_affiliation_string":"Department of Medical Imaging, University of Toronto, Toronto, ON, Canada. chris.mcintosh@uhn.ca","institution_ids":[]},{"raw_affiliation_string":"Joint Department of Medical Imaging, University Health Network, Toronto, ON, Canada. chris.mcintosh@uhn.ca","institution_ids":[]},{"raw_affiliation_string":"Peter Munk Cardiac Centre and Ted Rogers Centre for Heart Research, University Health Network, Toronto, ON, Canada. chris.mcintosh@uhn.ca","institution_ids":[]},{"raw_affiliation_string":"Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada. chris.mcintosh@uhn.ca","institution_ids":[]},{"raw_affiliation_string":"Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada. chris.mcintosh@uhn.ca","institution_ids":[]},{"raw_affiliation_string":"Vector Institute, Toronto, ON, Canada. chris.mcintosh@uhn.ca","institution_ids":[]},{"raw_affiliation_string":"Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada","institution_ids":["https://openalex.org/I1325899441","https://openalex.org/I2801845744"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":11,"corresponding_author_ids":["https://openalex.org/A5030981495"],"corresponding_institution_ids":["https://openalex.org/I1325899441","https://openalex.org/I185261750","https://openalex.org/I2801845744","https://openalex.org/I4210091032"],"apc_list":{"value":3060,"currency":"USD","value_usd":3060},"apc_paid":{"value":3060,"currency":"USD","value_usd":3060},"fwci":16.1544,"has_fulltext":true,"cited_by_count":46,"citation_normalized_percentile":{"value":0.99295604,"is_in_top_1_percent":true,"is_in_top_10_percent":true},"cited_by_percentile_year":{"min":99,"max":100},"biblio":{"volume":"7","issue":"1","first_page":"124","last_page":"124"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T13702","display_name":"Machine Learning in Healthcare","score":0.9991000294685364,"subfield":{"id":"https://openalex.org/subfields/1702","display_name":"Artificial Intelligence"},"field":{"id":"https://openalex.org/fields/17","display_name":"Computer Science"},"domain":{"id":"https://openalex.org/domains/3","display_name":"Physical Sciences"}},"topics":[{"id":"https://openalex.org/T13702","display_name":"Machine Learning in Healthcare","score":0.9991000294685364,"subfield":{"id":"https://openalex.org/subfields/1702","display_name":"Artificial Intelligence"},"field":{"id":"https://openalex.org/fields/17","display_name":"Computer Science"},"domain":{"id":"https://openalex.org/domains/3","display_name":"Physical Sciences"}},{"id":"https://openalex.org/T11396","display_name":"Artificial Intelligence in Healthcare","score":0.9811999797821045,"subfield":{"id":"https://openalex.org/subfields/3605","display_name":"Health Information Management"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10862","display_name":"AI in cancer detection","score":0.9807999730110168,"subfield":{"id":"https://openalex.org/subfields/1702","display_name":"Artificial Intelligence"},"field":{"id":"https://openalex.org/fields/17","display_name":"Computer Science"},"domain":{"id":"https://openalex.org/domains/3","display_name":"Physical Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/generalization","display_name":"Generalization","score":0.8992305994033813},{"id":"https://openalex.org/keywords/computer-science","display_name":"Computer science","score":0.6186866164207458},{"id":"https://openalex.org/keywords/artificial-intelligence","display_name":"Artificial intelligence","score":0.617603600025177},{"id":"https://openalex.org/keywords/machine-learning","display_name":"Machine learning","score":0.5333858132362366},{"id":"https://openalex.org/keywords/mathematics","display_name":"Mathematics","score":0.1741514503955841}],"concepts":[{"id":"https://openalex.org/C177148314","wikidata":"https://www.wikidata.org/wiki/Q170084","display_name":"Generalization","level":2,"score":0.8992305994033813},{"id":"https://openalex.org/C41008148","wikidata":"https://www.wikidata.org/wiki/Q21198","display_name":"Computer science","level":0,"score":0.6186866164207458},{"id":"https://openalex.org/C154945302","wikidata":"https://www.wikidata.org/wiki/Q11660","display_name":"Artificial intelligence","level":1,"score":0.617603600025177},{"id":"https://openalex.org/C119857082","wikidata":"https://www.wikidata.org/wiki/Q2539","display_name":"Machine learning","level":1,"score":0.5333858132362366},{"id":"https://openalex.org/C33923547","wikidata":"https://www.wikidata.org/wiki/Q395","display_name":"Mathematics","level":0,"score":0.1741514503955841},{"id":"https://openalex.org/C134306372","wikidata":"https://www.wikidata.org/wiki/Q7754","display_name":"Mathematical analysis","level":1,"score":0.0}],"mesh":[],"locations_count":4,"locations":[{"id":"doi:10.1038/s41746-024-01118-4","is_oa":true,"landing_page_url":"https://doi.org/10.1038/s41746-024-01118-4","pdf_url":"https://www.nature.com/articles/s41746-024-01118-4.pdf","source":{"id":"https://openalex.org/S4210195431","display_name":"npj Digital Medicine","issn_l":"2398-6352","issn":["2398-6352"],"is_oa":true,"is_in_doaj":true,"is_core":true,"host_organization":"https://openalex.org/P4310319908","host_organization_name":"Nature Portfolio","host_organization_lineage":["https://openalex.org/P4310319908","https://openalex.org/P4310319965"],"host_organization_lineage_names":["Nature Portfolio","Springer Nature"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"npj Digital Medicine","raw_type":"journal-article"},{"id":"pmid:38744921","is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/38744921","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"NPJ digital medicine","raw_type":null},{"id":"pmh:oai:pubmedcentral.nih.gov:11094145","is_oa":true,"landing_page_url":"https://www.ncbi.nlm.nih.gov/pmc/articles/11094145","pdf_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC11094145/pdf/41746_2024_Article_1118.pdf","source":{"id":"https://openalex.org/S2764455111","display_name":"PubMed Central","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"NPJ Digit Med","raw_type":"Text"},{"id":"pmh:oai:doaj.org/article:185bf36da61c42b38703f56516e21d80","is_oa":true,"landing_page_url":"https://doaj.org/article/185bf36da61c42b38703f56516e21d80","pdf_url":null,"source":{"id":"https://openalex.org/S112646816","display_name":"SHILAP Revista de lepidopterolog\u00eda","issn_l":"0300-5267","issn":["0300-5267","2340-4078"],"is_oa":true,"is_in_doaj":true,"is_core":false,"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"npj Digital Medicine, Vol 7, Iss 1, Pp 1-10 (2024)","raw_type":"article"}],"best_oa_location":{"id":"doi:10.1038/s41746-024-01118-4","is_oa":true,"landing_page_url":"https://doi.org/10.1038/s41746-024-01118-4","pdf_url":"https://www.nature.com/articles/s41746-024-01118-4.pdf","source":{"id":"https://openalex.org/S4210195431","display_name":"npj Digital Medicine","issn_l":"2398-6352","issn":["2398-6352"],"is_oa":true,"is_in_doaj":true,"is_core":true,"host_organization":"https://openalex.org/P4310319908","host_organization_name":"Nature Portfolio","host_organization_lineage":["https://openalex.org/P4310319908","https://openalex.org/P4310319965"],"host_organization_lineage_names":["Nature Portfolio","Springer Nature"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"npj Digital Medicine","raw_type":"journal-article"},"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/4","score":0.49000000953674316,"display_name":"Quality Education"}],"awards":[{"id":"https://openalex.org/G1597412403","display_name":null,"funder_award_id":"RGPIN-","funder_id":"https://openalex.org/F4320334593","funder_display_name":"Natural Sciences and Engineering Research Council of Canada"},{"id":"https://openalex.org/G3033334534","display_name":null,"funder_award_id":"AI Chair","funder_id":"https://openalex.org/F4320309949","funder_display_name":"Canadian Institute for Advanced Research"},{"id":"https://openalex.org/G5536939483","display_name":null,"funder_award_id":"DGECR-","funder_id":"https://openalex.org/F4320334593","funder_display_name":"Natural Sciences and Engineering Research Council of Canada"},{"id":"https://openalex.org/G5784215521","display_name":null,"funder_award_id":"Chair","funder_id":"https://openalex.org/F4320334593","funder_display_name":"Natural Sciences and Engineering Research Council of Canada"},{"id":"https://openalex.org/G6221715925","display_name":null,"funder_award_id":"RGPIN","funder_id":"https://openalex.org/F4320334593","funder_display_name":"Natural Sciences and Engineering Research Council of Canada"},{"id":"https://openalex.org/G8105784103","display_name":null,"funder_award_id":"RGPIN-202","funder_id":"https://openalex.org/F4320334593","funder_display_name":"Natural Sciences and Engineering Research Council of Canada"},{"id":"https://openalex.org/G8309216404","display_name":null,"funder_award_id":"RGPIN-2022-05117","funder_id":"https://openalex.org/F4320334593","funder_display_name":"Natural Sciences and Engineering Research Council of Canada"}],"funders":[{"id":"https://openalex.org/F4320309949","display_name":"Canadian Institute for Advanced Research","ror":"https://ror.org/01sdtdd95"},{"id":"https://openalex.org/F4320311433","display_name":"University Health Network","ror":"https://ror.org/042xt5161"},{"id":"https://openalex.org/F4320322015","display_name":"University of Toronto","ror":"https://ror.org/03dbr7087"},{"id":"https://openalex.org/F4320334593","display_name":"Natural Sciences and Engineering Research Council of Canada","ror":"https://ror.org/01h531d29"}],"has_content":{"grobid_xml":false,"pdf":true},"content_urls":{"pdf":"https://content.openalex.org/works/W4396894318.pdf"},"referenced_works_count":28,"referenced_works":["https://openalex.org/W2052785055","https://openalex.org/W2096192437","https://openalex.org/W2107665951","https://openalex.org/W2169353806","https://openalex.org/W2396881363","https://openalex.org/W2883544453","https://openalex.org/W2912223386","https://openalex.org/W2950684648","https://openalex.org/W2963446712","https://openalex.org/W2963466845","https://openalex.org/W3016970897","https://openalex.org/W3027572331","https://openalex.org/W3091994574","https://openalex.org/W3103934428","https://openalex.org/W3119527628","https://openalex.org/W3126702715","https://openalex.org/W3128681511","https://openalex.org/W3135057764","https://openalex.org/W3136933888","https://openalex.org/W3150684546","https://openalex.org/W3170948795","https://openalex.org/W3171849353","https://openalex.org/W3174786846","https://openalex.org/W3186679119","https://openalex.org/W4200191097","https://openalex.org/W4229036772","https://openalex.org/W4379769651","https://openalex.org/W4384663506"],"related_works":["https://openalex.org/W2961085424","https://openalex.org/W4306674287","https://openalex.org/W3046775127","https://openalex.org/W3107602296","https://openalex.org/W4394896187","https://openalex.org/W3170094116","https://openalex.org/W4386462264","https://openalex.org/W4364306694","https://openalex.org/W4312192474","https://openalex.org/W4283697347"],"abstract_inverted_index":{"Healthcare":[0],"datasets":[1,67],"are":[2,30],"becoming":[3],"larger":[4],"and":[5,13,26,40,75,160],"more":[6],"complex,":[7],"necessitating":[8],"the":[9,46,126,135],"development":[10],"of":[11,48,98],"accurate":[12],"generalizable":[14],"AI":[15,113],"models":[16,50],"for":[17,162],"medical":[18,23],"applications.":[19],"Unstructured":[20],"datasets,":[21],"including":[22,68],"imaging,":[24],"electrocardiograms,":[25],"natural":[27],"language":[28,42],"data,":[29,78],"gaining":[31],"attention":[32],"with":[33],"advancements":[34],"in":[35,110,125],"deep":[36],"convolutional":[37],"neural":[38],"networks":[39],"large":[41],"models.":[43],"However,":[44],"estimating":[45],"generalizability":[47],"these":[49],"to":[51,90,95,107,116,130,134,153],"new":[52],"healthcare":[53],"settings":[54],"without":[55],"extensive":[56],"validation":[57],"on":[58,92,121,156],"external":[59,144,151],"data":[60,100,127],"remains":[61],"challenging.":[62],"In":[63],"experiments":[64],"across":[65],"13":[66],"X-rays,":[69],"CTs,":[70],"ECGs,":[71],"clinical":[72],"discharge":[73],"summaries,":[74],"lung":[76],"auscultation":[77],"our":[79],"results":[80],"demonstrate":[81],"that":[82,148],"model":[83,114],"performance":[84],"is":[85],"frequently":[86],"overestimated":[87],"by":[88,158],"up":[89],"20%":[91],"average":[93,157],"due":[94],"shortcut":[96,164],"learning":[97,105],"hidden":[99],"acquisition":[101],"biases":[102],"(DAB).":[103],"Shortcut":[104],"refers":[106],"a":[108,118],"phenomenon":[109],"which":[111],"an":[112,140],"learns":[115],"solve":[117],"task":[119,136],"based":[120],"spurious":[122],"correlations":[123],"present":[124],"as":[128],"opposed":[129],"features":[131],"directly":[132],"related":[133],"itself.":[137],"We":[138],"propose":[139],"open":[141],"source,":[142],"bias-corrected":[143],"accuracy":[145,152],"estimate,":[146],"P<sub>Est</sub>,":[147],"better":[149],"estimates":[150],"within":[154],"4%":[155],"measuring":[159],"calibrating":[161],"DAB-induced":[163],"learning.":[165]},"counts_by_year":[{"year":2026,"cited_by_count":11},{"year":2025,"cited_by_count":27},{"year":2024,"cited_by_count":8}],"updated_date":"2026-03-25T14:56:36.534964","created_date":"2025-10-10T00:00:00"}