提出一种考虑疾病进展顺序的糖尿病视网膜病变分级模型,提升跨数据集泛化能力。
Uncertainty-Aware Ordinal Deep Learning for cross-Dataset Diabetic Retinopathy Grading
- 显式建模疾病分级的有序性,结合证据狄利克雷损失优化预测
- 在多数据集测试中达到高加权肯德尔系数(Kappa)与准确率
- 输出可信度估计,适合临床辅助诊断场景
糖尿病是一种慢性代谢疾病,由胰岛素分泌不足或利用障碍导致持续高血糖。其最严重并发症之一是糖尿病视网膜病变(DR),由微血管损伤引发,表现为出血、渗出,可能导致失明。早期可靠检测对预防不可逆视力丧失至关重要。本文提出一种不确定性感知的深度学习框架,用于自动分级糖尿病视网膜病变,显式建模疾病进展的有序性。方法结合卷积主干网络、病灶查询注意力池化与基于证据狄利克雷的有序回归头,实现精准分级与可解释的预测不确定性估计。通过引入退火正则化的有序证据损失进行训练,提升域偏移下的置信度校准能力。在融合APTOS、Messidor-2及部分EyePACS眼底图像数据集的多域训练设置下评估,实验结果表明该方法具有优异的跨数据集泛化性能,在独立测试集上达成竞争性分类准确率和高二次加权肯德尔系数(quadratic weighted kappa),同时为低置信度案例提供有意义的不确定性估计。结果表明,有序证据学习是构建鲁棒且临床可用的糖尿病视网膜病变分级系统的重要方向。
原文摘要 · Abstract (English)
Diabetes mellitus is a chronic metabolic disorder characterized by persistent hyperglycemia due to insufficient insulin production or impaired insulin utilization. One of its most severe complications is diabetic retinopathy (DR), a progressive retinal disease caused by microvascular damage, leading to hemorrhages, exudates, and potential vision loss. Early and reliable detection of DR is therefore critical for preventing irreversible blindness. In this work, we propose an uncertainty-aware deep learning framework for automated DR severity grading that explicitly models the ordinal nature of disease progression. Our approach combines a convolutional backbone with lesion-query attention pooling and an evidential Dirichlet-based ordinal regression head, enabling both accurate severity prediction and principled estimation of predictive uncertainty. The model is trained using an ordinal evidential loss with annealed regularization to encourage calibrated confidence under domain shift. We evaluate the proposed method on a multi-domain training setup combining APTOS, Messidor-2, and a subset of EyePACS fundus datasets. Experimental results demonstrate strong cross-dataset generalization, achieving competitive classification accuracy and high quadratic weighted kappa on held-out test sets, while providing meaningful uncertainty estimates for low-confidence cases. These results suggest that ordinal evidential learning is a promising direction for robust and clinically reliable diabetic retinopathy grading.
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