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AI in the Loop -- Functionalizing Fold Performance Disagreement to Monitor Automated Medical Image Segmentation Pipelines

2023/05/15 by Harrison C. Gottlich, Gottlich, Harrison C., Panagiotis Korfiatis +5
Computer Science · Medicine · #Artificial Intelligence in Healthcare and Education #Computer Vision and Pattern Recognition (cs.CV) #Explainable Artificial Intelligence (XAI) #FOS: Computer and information sciences #FOS: Electrical engineering #Image and Video Processing (eess.IV) #Machine Learning (cs.LG) #Radiomics and Machine Learning in Medical Imaging #electronic engineering #information engineering

paper · pdf · doi:10.48550/arxiv.2305.09031

openalex publication_date 2023/05/15 · openalex created_date 2023/05/18 · openalex updated_date 2026/08/01

Abstract

Methods for automatically flag poor performing-predictions are essential for safely implementing machine learning workflows into clinical practice and for identifying difficult cases during model training. We present a readily adoptable method using sub-models trained on different dataset folds, where their disagreement serves as a surrogate for model confidence. Thresholds informed by human interobserver values were used to determine whether a final ensemble model prediction would require manual review. In two different datasets (abdominal CT and MR predicting kidney tumors), our framework effectively identified low performing automated segmentations. Flagging images with a minimum Interfold test Dice score below human interobserver variability maximized the number of flagged images while ensuring maximum ensemble test Dice. When our internally trained model was applied to an external publicly available dataset (KiTS21), flagged images included smaller tumors than those observed in our internally trained dataset, demonstrating the methods robustness to flagging poor performing out-of-distribution input data. Comparing interfold sub-model disagreement against human interobserver values is an efficient way to approximate a model's epistemic uncertainty - its lack of knowledge due to insufficient relevant training data - a key functionality for adopting these applications in clinical practice.

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