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Main Authors: Stutz, David, Cemgil, Ali Taylan, Roy, Abhijit Guha, Matejovicova, Tatiana, Barsbey, Melih, Strachan, Patricia, Schaekermann, Mike, Freyberg, Jan, Rikhye, Rajeev, Freeman, Beverly, Matos, Javier Perez, Telang, Umesh, Webster, Dale R., Liu, Yuan, Corrado, Greg S., Matias, Yossi, Kohli, Pushmeet, Liu, Yun, Doucet, Arnaud, Karthikesalingam, Alan
Format: Preprint
Published: 2023
Subjects:
Online Access:https://arxiv.org/abs/2307.02191
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author Stutz, David
Cemgil, Ali Taylan
Roy, Abhijit Guha
Matejovicova, Tatiana
Barsbey, Melih
Strachan, Patricia
Schaekermann, Mike
Freyberg, Jan
Rikhye, Rajeev
Freeman, Beverly
Matos, Javier Perez
Telang, Umesh
Webster, Dale R.
Liu, Yuan
Corrado, Greg S.
Matias, Yossi
Kohli, Pushmeet
Liu, Yun
Doucet, Arnaud
Karthikesalingam, Alan
author_facet Stutz, David
Cemgil, Ali Taylan
Roy, Abhijit Guha
Matejovicova, Tatiana
Barsbey, Melih
Strachan, Patricia
Schaekermann, Mike
Freyberg, Jan
Rikhye, Rajeev
Freeman, Beverly
Matos, Javier Perez
Telang, Umesh
Webster, Dale R.
Liu, Yuan
Corrado, Greg S.
Matias, Yossi
Kohli, Pushmeet
Liu, Yun
Doucet, Arnaud
Karthikesalingam, Alan
contents For safety, medical AI systems undergo thorough evaluations before deployment, validating their predictions against a ground truth which is assumed to be fixed and certain. However, this ground truth is often curated in the form of differential diagnoses. While a single differential diagnosis reflects the uncertainty in one expert assessment, multiple experts introduce another layer of uncertainty through disagreement. Both forms of uncertainty are ignored in standard evaluation which aggregates these differential diagnoses to a single label. In this paper, we show that ignoring uncertainty leads to overly optimistic estimates of model performance, therefore underestimating risk associated with particular diagnostic decisions. To this end, we propose a statistical aggregation approach, where we infer a distribution on probabilities of underlying medical condition candidates themselves, based on observed annotations. This formulation naturally accounts for the potential disagreements between different experts, as well as uncertainty stemming from individual differential diagnoses, capturing the entire ground truth uncertainty. Our approach boils down to generating multiple samples of medical condition probabilities, then evaluating and averaging performance metrics based on these sampled probabilities. In skin condition classification, we find that a large portion of the dataset exhibits significant ground truth uncertainty and standard evaluation severely over-estimates performance without providing uncertainty estimates. In contrast, our framework provides uncertainty estimates on common metrics of interest such as top-k accuracy and average overlap, showing that performance can change multiple percentage points. We conclude that, while assuming a crisp ground truth can be acceptable for many AI applications, a more nuanced evaluation protocol should be utilized in medical diagnosis.
format Preprint
id arxiv_https___arxiv_org_abs_2307_02191
institution arXiv
publishDate 2023
record_format arxiv
spellingShingle Evaluating AI systems under uncertain ground truth: a case study in dermatology
Stutz, David
Cemgil, Ali Taylan
Roy, Abhijit Guha
Matejovicova, Tatiana
Barsbey, Melih
Strachan, Patricia
Schaekermann, Mike
Freyberg, Jan
Rikhye, Rajeev
Freeman, Beverly
Matos, Javier Perez
Telang, Umesh
Webster, Dale R.
Liu, Yuan
Corrado, Greg S.
Matias, Yossi
Kohli, Pushmeet
Liu, Yun
Doucet, Arnaud
Karthikesalingam, Alan
Machine Learning
Computer Vision and Pattern Recognition
Methodology
For safety, medical AI systems undergo thorough evaluations before deployment, validating their predictions against a ground truth which is assumed to be fixed and certain. However, this ground truth is often curated in the form of differential diagnoses. While a single differential diagnosis reflects the uncertainty in one expert assessment, multiple experts introduce another layer of uncertainty through disagreement. Both forms of uncertainty are ignored in standard evaluation which aggregates these differential diagnoses to a single label. In this paper, we show that ignoring uncertainty leads to overly optimistic estimates of model performance, therefore underestimating risk associated with particular diagnostic decisions. To this end, we propose a statistical aggregation approach, where we infer a distribution on probabilities of underlying medical condition candidates themselves, based on observed annotations. This formulation naturally accounts for the potential disagreements between different experts, as well as uncertainty stemming from individual differential diagnoses, capturing the entire ground truth uncertainty. Our approach boils down to generating multiple samples of medical condition probabilities, then evaluating and averaging performance metrics based on these sampled probabilities. In skin condition classification, we find that a large portion of the dataset exhibits significant ground truth uncertainty and standard evaluation severely over-estimates performance without providing uncertainty estimates. In contrast, our framework provides uncertainty estimates on common metrics of interest such as top-k accuracy and average overlap, showing that performance can change multiple percentage points. We conclude that, while assuming a crisp ground truth can be acceptable for many AI applications, a more nuanced evaluation protocol should be utilized in medical diagnosis.
title Evaluating AI systems under uncertain ground truth: a case study in dermatology
topic Machine Learning
Computer Vision and Pattern Recognition
Methodology
url https://arxiv.org/abs/2307.02191