Multiple instance learning (MIL) is often used in medical imaging to classify high-resolution 2D images by processing patches or classify 3D volumes by processing slices. However, conventional MIL approaches treat instances separately, ignoring contextual relationships such as the appearance of nearby patches or slices that can be essential in real applications. We design a synthetic classification task where accounting for adjacent instance features is crucial for accurate prediction. We demonstrate the limitations of off-the-shelf MIL approaches by quantifying their performance compared to the optimal Bayes estimator for this task, which is available in closed-form. We empirically show that newer correlated MIL methods still struggle to generalize as well as possible when trained from scratch on tens of thousands of instances.

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