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Does Your Dermatology Classifier Know What It Doesn't Know? Detecting the Long-Tail of Unseen Conditions (2104.03829v1)

Published 8 Apr 2021 in cs.CV and cs.LG

Abstract: We develop and rigorously evaluate a deep learning based system that can accurately classify skin conditions while detecting rare conditions for which there is not enough data available for training a confident classifier. We frame this task as an out-of-distribution (OOD) detection problem. Our novel approach, hierarchical outlier detection (HOD) assigns multiple abstention classes for each training outlier class and jointly performs a coarse classification of inliers vs. outliers, along with fine-grained classification of the individual classes. We demonstrate the effectiveness of the HOD loss in conjunction with modern representation learning approaches (BiT, SimCLR, MICLe) and explore different ensembling strategies for further improving the results. We perform an extensive subgroup analysis over conditions of varying risk levels and different skin types to investigate how the OOD detection performance changes over each subgroup and demonstrate the gains of our framework in comparison to baselines. Finally, we introduce a cost metric to approximate downstream clinical impact. We use this cost metric to compare the proposed method against a baseline system, thereby making a stronger case for the overall system effectiveness in a real-world deployment scenario.

Citations (95)

Summary

  • The paper introduces a hierarchical loss (HOD) to better distinguish rare, unseen dermatological conditions from typical inliers.
  • It leverages multi-level classification and ensembling of diverse representation learning methods to significantly reduce false positives.
  • The approach outperforms traditional softmax-based methods, improving reliability in clinical diagnostic scenarios.

Insightful Overview of "Does Your Dermatology Classifier Know What It Doesn't Know? Detecting the Long-Tail of Unseen Conditions"

The paper presents a thorough investigation into the challenges and opportunities associated with the detection of out-of-distribution (OOD) samples in dermatology classification tasks. Despite significant advancements in deep learning for medical imaging, accurately recognizing unseen conditions, which often occur in the long-tail of medical data distributions, remains a pressing concern. The authors frame this as an OOD detection problem, introducing a novel hierarchical outlier detection (HOD) approach that leverages a multi-level loss function to enhance model robustness and reliability across clinical scenarios.

Methodological Innovations

The paper's central contribution is the development of a hierarchical loss structure, termed Hierarchical Outlier Detection (HOD) loss, aimed at resolving the challenge posed by individually rare dermatological conditions. The HOD loss incorporates two significant aspects: a fine-grained classification that manages multiple abstention classes and a coarse classification that ensures robust management of inliers versus outliers. This hierarchical configuration enhances the separation between inlier and outlier predictions, allowing the model to better handle unseen dermatological conditions.

Furthermore, the authors demonstrate that the inclusion of HOD significantly outperforms traditional methods utilizing single abstention classes or relying on maximum softmax probabilities (MSP) for OOD detection. The approach showcases substantial performance improvements against baselines, with notable reductions in false positive rates at high true positive rates, showcasing the fine-grained loss's advantages in decreasing outlier heterogeneity.

Representation Learning and Ensembling Strategies

The paper deeply explores the integration of advanced representation learning techniques to reinforce model capabilities. By comparing models pre-trained on natural image datasets like ImageNet and BiT-L, with contrastive learning based approaches such as SimCLR and MICLe, the authors identify significant gains in OOD detection when dermatology-specific representations are employed. Importantly, the paper highlights the cross-disciplinary potential of self-supervised learning paradigms in elevating clinical task performance.

Additionally, the research underscores the merit of ensembling strategies, particularly those that integrate diverse representational learning and objective functions. The deployment of a greedy search algorithm for selecting ensemble models that maximize OOD performance further emphasizes the nuances of utilizing complementary model features to their fullest extent. This ensemble diversity not only supports enhanced OOD detection but also reveals potential in optimizing inlier accuracy, a crucial aspect for clinical adoption.

Implications and Future Directions

This research carries profound implications for AI applications in clinical environments, where ensuring safety and reliability are paramount. The demonstrated advantages of HOD in scenarios with diverse dermatological conditions underscore the potential for reducing misdiagnoses and improving patient outcomes. By facilitating the reliable recognition of unseen conditions, this work sets the stage for more widespread and dependable deployment of AI systems in healthcare settings.

Looking forward, extensions of this approach could explore adaptive hierarchical configurations that tune loss components based on domain-specific insights. Additionally, the pursuit of optimized cost-matrices for clinical impact analysis points to fertile ground for future research, involving direct optimization strategies tailored to nuanced medical decision-making needs.

In summary, this paper provides a significant advancement in the domain of medical imaging by addressing the crucial concern of out-of-distribution detection in dermatology through innovative loss mechanisms and representation learning. The proposed methodologies not only enhance the capacity of classifiers to recognize unseen conditions, but they underscore the broader implications and continued potential for AI in transforming healthcare practices.

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