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However, medical foundation models are often tested on limited tasks, leaving their generalisability and biases unexplored. Here we introduce RayDINO, a large-scale self-supervised visual encoder for chest X-rays trained on 840,000 images and evaluated on 82,000 images sourced from 12 publicly available datasets. We compare RayDINO to previous state-of-the-art models across nine radiology tasks, from classification and dense segmentation to text generation, and provide an in-depth analysis of population, age and sex biases of our model. Our findings suggest that self-supervision enables patient-centric analysis useful in clinical workflows, allowing for a more holistic interpretation of X-rays. With RayDINO and small task-specific adapters, we reach state-of-the-art results and improve generalization to unseen populations while mitigating bias, illustrating the versatility and robustness of foundation models.<\/jats:p>","DOI":"10.1038\/s41467-026-76076-4","type":"journal-article","created":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T09:47:09Z","timestamp":1787219229000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Advancing human-centric AI for robust X-ray analysis through holistic self-supervised learning"],"prefix":"10.1038","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-2681-5169","authenticated-orcid":false,"given":"Th\u00e9o","family":"Moutakanni","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piotr","family":"Bojanowski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guillaume","family":"Chassagnon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C\u00e9line","family":"Hudelot","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Armand","family":"Joulin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yann","family":"LeCun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Muckley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maxime","family":"Oquab","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8213-7817","authenticated-orcid":false,"given":"Marie-Pierre","family":"Revel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Vakalopoulou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,20]]},"reference":[{"key":"76076_CR1","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1186\/s41235-022-00449-8","volume":"7","author":"M Bilali\u0107","year":"2022","unstructured":"Bilali\u0107, M., Grottenthaler, T., N\u00e4gele, T. & Lindig, T. 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