arXiv:2608.16198cs.CVcs.AI2026-08

从多张皮肤照片中选最可靠的给模型,提升远程诊疗准确率。

Picking the Right Image to Classify: Reliable-Input Selection in Teledermatology

  • 基于模型输出的置信度、嵌入范数等信息,不依赖额外训练数据选图
  • 用理想选择器可使F1值平均提升20个百分点,但实际方法差距大
  • 当前方法仍难逼近理想效果,适合临床部署中提升诊断可靠性

皮肤病模型在远程诊疗中面临分布偏移问题,提交的图像在光照、角度、距离、对焦和构图上与训练数据不同。当同一病例有多张照片时,选择模型最可能正确分类的那张图像可显著提升准确性,这称为可靠输入选择。一个知晓标签的最优选择器在六个皮肤科数据集和九个冻结主干网络上平均使加权F1提升约20个百分点。然而,实际选择器需在无预训练数据情况下仅依据推理时暴露的信息(如嵌入、嵌入范数、置信度)进行判断。我们评测了四种无需训练数据的选择器:嵌入范数、同病例图像邻域一致性、预测稳定性及模型置信度。无一能显著缩小与理想选择器的差距;其中模型置信度表现最好,但在临床数据集上仅恢复一小部分增益。少量标注参考集也无明显帮助;最佳融合方法(置信度+马氏距离)仍无法弥合主要差距。这是首个系统引入并基准化可靠输入选择的研究,该任务具有重要临床意义但尚未解决。

原文摘要 · Abstract (English)

Dermatology models face distribution shifts in teledermatology settings, where submitted images differ from the training data in lighting, angle, distance, focus, and framing. These test-time images are ordinary clinical photographs, but some fall outside the model's training conditions, leading the model to often misclassify them due to shifts in acquisition between training and deployment. When multiple images of the same case exist (several photos of one patient or lesion), a natural way to improve accuracy is therefore to select the image the model is most likely to classify correctly. We call this task reliable-input selection. An oracle that, for each case, selects a correctly classified image when one exists raises weighted F1 by about 20 percentage points on average across six dermatology datasets and nine frozen backbones. This oracle is an upper bound that sees the labels, whereas a selector must choose blindly. Capturing this gain in practice is hard. A selector that needs no pretraining data applies to any frozen model, including those whose data is not public. It must judge reliability from quantities the model exposes at inference: its embeddings, their norms, and its confidence. We benchmark four such training-data-free selectors: the embedding norm, the neighborhood consensus among a case's images, the stability of the prediction under small perturbations, and the model's own confidence. No training-data-free selector substantially narrows this oracle gap. The best of them is the model's own confidence, but it recovers only a small part of the gap on the clinical datasets. A small labeled reference set does not help either: the best selector overall, a fusion of confidence and Mahalanobis distance, still leaves most of the gap. To our knowledge, this is the first study to introduce and benchmark reliable input selection, a clinically important, unsolved task.

远程医疗皮肤识别模型鲁棒性输入选择

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