Much of federated learning (FL) focuses on settings where local dataset statistics remain the same between training and testing. However, this assumption often does not hold in practice due to distribution shifts, motivating the development of domain generalization (DG) approaches that leverage source domain data to train models capable of generalizing to unseen target domains. In this paper, we are motivated by two major gaps in existing work on FL and DG: (1) the lack of formal mathematical analysis of DG objectives; and (2) DG research in FL being limited to the star-topology architecture. We develop Decentralized Federated Domain Generalization with Style Sharing ($\textit{StyleDDG}$), a decentralized DG algorithm which allows devices in a peer-to-peer network to achieve DG based on sharing style information inferred from their datasets. Additionally, we provide the first systematic approach to analyzing style-based DG training in decentralized networks. We cast existing centralized DG algorithms within our framework, and employ their formalisms to model $\textit{StyleDDG}$. We then obtain analytical conditions under which convergence of $\textit{StyleDDG}$ can be guaranteed. Through experiments on popular DG datasets, we demonstrate that $\textit{StyleDDG}$ can obtain significant improvements in accuracy across target domains with minimal communication overhead compared to baseline decentralized gradient methods.

Performance degradation due to distribution discrepancy is a longstanding challenge in intelligent imaging, particularly for chest X-rays (CXRs). Recent studies have demonstrated that CNNs are biased toward styles (e.g., uninformative textures) rather than content (e.g., shape), in stark contrast to the human vision system. Radiologists tend to learn visual cues from CXRs and thus perform well across multiple domains. Motivated by this, we employ the novel on-the-fly style randomization modules at both image (SRM-IL) and feature (SRM-FL) levels to create rich style perturbed features while keeping the content intact for robust cross-domain performance. Previous methods simulate unseen domains by constructing new styles via interpolation or swapping styles from existing data, limiting them to available source domains during training. However, SRM-IL samples the style statistics from the possible value range of a CXR image instead of the training data to achieve more diversified augmentations. Moreover, we utilize pixel-wise learnable parameters in the SRM-FL compared to pre-defined channel-wise mean and standard deviations as style embeddings for capturing more representative style features. Additionally, we leverage consistency regularizations on global semantic features and predictive distributions from with and without style-perturbed versions of the same CXR to tweak the model's sensitivity toward content markers for accurate predictions. Our proposed method, trained on CheXpert and MIMIC-CXR datasets, achieves 77.32$\pm$0.35, 88.38$\pm$0.19, 82.63$\pm$0.13 AUCs(%) on the unseen domain test datasets, i.e., BRAX, VinDr-CXR, and NIH chest X-ray14, respectively, compared to 75.56$\pm$0.80, 87.57$\pm$0.46, 82.07$\pm$0.19 from state-of-the-art models on five-fold cross-validation with statistically significant results in thoracic disease classification.

In domain generalization (DG), the target domain is unknown when the model is being trained, and the trained model should successfully work on an arbitrary (and possibly unseen) target domain during inference. This is a difficult problem, and despite active studies in recent years, it remains a great challenge. In this paper, we take a simple yet effective approach to tackle this issue. We propose test-time style shifting, which shifts the style of the test sample (that has a large style gap with the source domains) to the nearest source domain that the model is already familiar with, before making the prediction. This strategy enables the model to handle any target domains with arbitrary style statistics, without additional model update at test-time. Additionally, we propose style balancing, which provides a great platform for maximizing the advantage of test-time style shifting by handling the DG-specific imbalance issues. The proposed ideas are easy to implement and successfully work in conjunction with various other DG schemes. Experimental results on different datasets show the effectiveness of our methods.