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Explanation Stability of Test-Time Adaptation in Computational Pathology: A Large-Scale Benchmark

Research Medical/Healthcare AI

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TL;DR - A large-scale benchmark (2,958 adaptation runs) measuring how much test-time adaptation shifts model explanations in computational pathology, arguing explanation stability is a reliability axis distinct from accuracy. It matters because clinically deployed models adapting to staining/scanner/cohort shifts can silently lose attribution fidelity while accuracy metrics look fine.

  • Scope: two histopathology benchmarks (Camelyon17, NCT CRC-HE), five architectures (CNNs through vision transformers and a pathology foundation model), seventeen TTA methods, and four attribution families.
  • Frozen-backbone TTA methods leave attributions nearly unchanged; continual methods like CoTTA and RoTTA cause the largest explanation drift.
  • Sensitivity is architecture-dependent — CNNs drift substantially more than transformer and foundation-model backbones — and drift grows with adaptation strength but is largely insensitive to batch size.
  • Explanation stability correlates only weakly with adaptation quality: some methods preserve attributions while degrading calibration or accuracy, yielding "silent failures" missed by accuracy-only or explanation-only evaluation. Metric, protocol, and full benchmark released as code.

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Explanation Stability of Test-Time Adaptation in Computational Pathology: A Large-Scale Benchmark

arXiv cs.CV R. G. Bahumanya, Harshith V. M., Shreyank N. Gowda, Anala M. R 2026-08-07 arXiv:2608.07062
Public signals Semantic Scholar citations 0 · Semantic Scholar influential citations 0
Providers: Hugging Face · N/A OpenAlex · N/A Publisher · N/A Semantic Scholar · Citations 0 · Influential citations 0 X · N/A Fetched 2026-08-18 02:16:59.518049 UTC

TL;DR - A large-scale benchmark (2,958 adaptation runs) measuring how much test-time adaptation shifts model explanations in computational pathology, arguing explanation stability is a reliability axis distinct from accuracy. It matters because clinically deployed models adapting to staining/scanner/cohort shifts can silently lose attribution fidelity while accuracy metrics look fine.

  • Scope: two histopathology benchmarks (Camelyon17, NCT CRC-HE), five architectures (CNNs through vision transformers and a pathology foundation model), seventeen TTA methods, and four attribution families.
  • Frozen-backbone TTA methods leave attributions nearly unchanged; continual methods like CoTTA and RoTTA cause the largest explanation drift.
  • Sensitivity is architecture-dependent — CNNs drift substantially more than transformer and foundation-model backbones — and drift grows with adaptation strength but is largely insensitive to batch size.
  • Explanation stability correlates only weakly with adaptation quality: some methods preserve attributions while degrading calibration or accuracy, yielding "silent failures" missed by accuracy-only or explanation-only evaluation. Metric, protocol, and full benchmark released as code.
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