Deep neural networks (DNNs) have started to find their role in the modern healthcare system. DNNs are being developed for diagnosis, prognosis, treatment planning, and outcome prediction for various diseases. With the increasing number of applications of DNNs in modern healthcare, their trustworthiness and reliability are becoming increasingly important. An essential aspect of trustworthiness is detecting the performance degradation and failure of deployed DNNs in medical settings. The softmax output values produced by DNNs are not a calibrated measure of model confidence. Softmax probability numbers are generally higher than the actual model confidence. The model confidence-accuracy gap further increases for wrong predictions and noisy inputs. We employ recently proposed Bayesian deep neural networks (BDNNs) to learn uncertainty in the model parameters. These models simultaneously output the predictions and a measure of confidence in the predictions. By testing these models under various noisy conditions, we show that the (learned) predictive confidence is well calibrated. We use these reliable confidence values for monitoring performance degradation and failure detection in DNNs. We propose two different failure detection methods. In the first method, we define a fixed threshold value based on the behavior of the predictive confidence with changing signal-to-noise ratio (SNR) of the test dataset. The second method learns the threshold value with a neural network. The proposed failure detection mechanisms seamlessly abstain from making decisions when the confidence of the BDNN is below the defined threshold and hold the decision for manual review. Resultantly, the accuracy of the models improves on the unseen test samples. We tested our proposed approach on three medical imaging datasets: PathMNIST, DermaMNIST, and OrganAMNIST, under different levels and types of noise. An increase in the noise of the test images increases the number of abstained samples. BDNNs are inherently robust and show more than 10% accuracy improvement with the proposed failure detection methods. The increased number of abstained samples or an abrupt increase in the predictive variance indicates model performance degradation or possible failure. Our work has the potential to improve the trustworthiness of DNNs and enhance user confidence in the model predictions.
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Uncertainty-aware deep learning in healthcare: A scoping review
Mistrust is a major barrier to implementing deep learning in healthcare settings. Entrustment could be earned by conveying model certainty, or the probability that a given model output is accurate, but the use of uncertainty estimation for deep learning entrustment is largely unexplored, and there is no consensus regarding optimal methods for quantifying uncertainty. Our purpose is to critically evaluate methods for quantifying uncertainty in deep learning for healthcare applications and propose a conceptual framework for specifying certainty of deep learning predictions. We searched Embase, MEDLINE, and PubMed databases for articles relevant to study objectives, complying with PRISMA guidelines, rated study quality using validated tools, and extracted data according to modified CHARMS criteria. Among 30 included studies, 24 described medical imaging applications. All imaging model architectures used convolutional neural networks or a variation thereof. The predominant method for quantifying uncertainty was Monte Carlo dropout, producing predictions from multiple networks for which different neurons have dropped out and measuring variance across the distribution of resulting predictions. Conformal prediction offered similar strong performance in estimating uncertainty, along with ease of interpretation and application not only to deep learning but also to other machine learning approaches. Among the six articles describing non-imaging applications, model architectures and uncertainty estimation methods were heterogeneous, but predictive performance was generally strong, and uncertainty estimation was effective in comparing modeling methods. Overall, the use of model learning curves to quantify epistemic uncertainty (attributable to model parameters) was sparse. Heterogeneity in reporting methods precluded the performance of a meta-analysis. Uncertainty estimation methods have the potential to identify rare but important misclassifications made by deep learning models and compare modeling methods, which could build patient and clinician trust in deep learning applications in healthcare. Efficient maturation of this field will require standardized guidelines for reporting performance and uncertainty metrics.
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- Award ID(s):
- 1750192
- NSF-PAR ID:
- 10401755
- Editor(s):
- Lai, Yuan
- Date Published:
- Journal Name:
- PLOS Digital Health
- Volume:
- 1
- Issue:
- 8
- ISSN:
- 2767-3170
- Page Range / eLocation ID:
- e0000085
- Format(s):
- Medium: X
- Sponsoring Org:
- National Science Foundation
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- Free Publicly Accessible Full Text
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Accepted Manuscript1.0
- Journal Article:
- https://doi.org/10.1371/journal.pdig.0000085
