为疾病严重程度分类设计新损失函数，提升模型判别力与临床可解释性。

Assessing disease severity with ordinal classes, where each class reflects increasing severity levels, benefits from loss functions designed for this ordinal structure. Traditional categorical loss functions, like Cross-Entropy (CE), often perform suboptimally in these scenarios. To address this, we propose a novel loss function, Class Distance Weighted Cross-Entropy (CDW-CE), which penalizes misclassifications more severely when the predicted and actual classes are farther apart. We evaluated CDW-CE using various deep architectures, comparing its performance against several categorical and ordinal loss functions. To assess the quality of latent representations, we used t-distributed stochastic neighbor embedding (t-SNE) and uniform manifold approximation and projection (UMAP) visualizations, quantified the clustering quality using the Silhouette Score, and compared Class Activation Maps (CAM) generated by models trained with CDW-CE and CE loss. Feedback from domain experts was incorporated to evaluate how well model attention aligns with expert opinion. Our results show that CDW-CE consistently improves performance in ordinal image classification tasks. It achieves higher Silhouette Scores, indicating better class discrimination capability, and its CAM visualizations show a stronger focus on clinically significant regions, as validated by domain experts. Receiver operator characteristics (ROC) curves and the area under the curve (AUC) scores highlight that CDW-CE outperforms other loss functions, including prominent ordinal loss functions from the literature.