# Class Distance Weighted Cross-Entropy Loss for Ulcerative Colitis Severity Estimation

arXiv: https://arxiv.org/abs/2202.05167 · HTML: https://mlsanity.com/paper/2202.05167/

## Key facts

- Cited by 17 papers in the map (data through 14 Oct 2026).
- Builds on 14 of its 46 references that are in the map.
- First posted on arXiv 9 Feb 2022.

## Builds on (most cited first, 14 of 14)

- [Deep Residual Learning for Image Recognition](https://mlsanity.com/paper/1512.03385/) (2015)
- [PyTorch: An Imperative Style, High-Performance Deep Learning Library](https://mlsanity.com/paper/1912.01703/) (2019)
- [ImageNet Large Scale Visual Recognition Challenge](https://mlsanity.com/paper/1409.0575/) (2014)
- [Grad-CAM: Visual Explanations from Deep Networks via Gradient-based Localization](https://mlsanity.com/paper/1610.02391/) (2016)
- [Densely Connected Convolutional Networks](https://mlsanity.com/paper/1608.06993/) (2016)
- [Rethinking the Inception Architecture for Computer Vision](https://mlsanity.com/paper/1512.00567/) (2015)
- [Going Deeper with Convolutions](https://mlsanity.com/paper/1409.4842/) (2014)
- [Learning Deep Features for Discriminative Localization](https://mlsanity.com/paper/1512.04150/) (2015)
- [Searching for MobileNetV3](https://mlsanity.com/paper/1905.02244/) (2019)
- [Rank consistent ordinal regression for neural networks with application to age estimation](https://mlsanity.com/paper/1901.07884/) (2019)
- [Deep Neural Networks for Rank-Consistent Ordinal Regression Based On Conditional Probabilities](https://mlsanity.com/paper/2111.08851/) (2021)
- [Unimodal probability distributions for deep ordinal classification](https://mlsanity.com/paper/1705.05278/) (2017)
- [Automatic Estimation of Ulcerative Colitis Severity from Endoscopy Videos using Ordinal Multi-Instance Learning](https://mlsanity.com/paper/2109.14685/) (2021)
- [A simple squared-error reformulation for ordinal classification](https://mlsanity.com/paper/1612.00775/) (2016)

## Built on by (most cited first, 17 of 17)

- [Improving Deep Regression with Ordinal Entropy](https://mlsanity.com/paper/2301.08915/) (2023)
- [Using Sequences of Life-events to Predict Human Lives](https://mlsanity.com/paper/2306.03009/) (2023)
- [Learning-to-Rank Meets Language: Boosting Language-Driven Ordering Alignment for Ordinal Classification](https://mlsanity.com/paper/2306.13856/) (2023)
- [Unimodal Distributions for Ordinal Regression](https://mlsanity.com/paper/2303.04547/) (2023)
- [Ordinal Multiple-instance Learning for Ulcerative Colitis Severity Estimation with Selective Aggregated Transformer](https://mlsanity.com/paper/2411.14750/) (2024)
- [Class Distance Weighted Cross Entropy Loss for Classification of Disease Severity](https://mlsanity.com/paper/2412.01246/) (2024)
- [Ulcerative Colitis Mayo Endoscopic Scoring Classification with Active Learning and Generative Data Augmentation](https://mlsanity.com/paper/2311.06057/) (2023)
- [Deep Bayesian Active Learning-to-Rank with Relative Annotation for Estimation of Ulcerative Colitis Severity](https://mlsanity.com/paper/2409.04952/) (2024)
- [Ordinal-Aware Calibration for Ordinal Classification](https://mlsanity.com/paper/2410.15658/) (2024)
- [Weakly-Supervised Domain Adaptation with Proportion-Constrained Pseudo-Labeling](https://mlsanity.com/paper/2506.22301/) (2025)
- [Developing vocal system impaired patient-aimed voice quality assessment approach using ASR representation-included multiple features](https://mlsanity.com/paper/2408.12279/) (2024)
- [Arges: Spatio-Temporal Transformer for Ulcerative Colitis Severity Assessment in Endoscopy Videos](https://mlsanity.com/paper/2410.00536/) (2024)
- [L-MAE: Masked Autoencoders are Semantic Segmentation Datasets Augmenter](https://mlsanity.com/paper/2211.11242/) (2022)
- [CLoE: Curriculum Learning on Endoscopic Images for Robust MES Classification](https://mlsanity.com/paper/2508.13280/) (2025)
- [MEGAN: Mixture of Experts for Robust Uncertainty Estimation in Endoscopy Videos](https://mlsanity.com/paper/2509.12772/) (2025)
- [Domain Adaptation for Ulcerative Colitis Severity Estimation Using Patient-Level Diagnoses](https://mlsanity.com/paper/2509.14573/) (2025)
- [AGGRNet: Selective Feature Extraction and Aggregation for Enhanced Medical Image Classification](https://mlsanity.com/paper/2511.12382/) (2025)

## Abstract (arXiv)

In scoring systems used to measure the endoscopic activity of ulcerative colitis, such as Mayo endoscopic score or Ulcerative Colitis Endoscopic Index Severity, levels increase with severity of the disease activity. Such relative ranking among the scores makes it an ordinal regression problem. On the other hand, most studies use categorical cross-entropy loss function to train deep learning models, which is not optimal for the ordinal regression problem. In this study, we propose a novel loss function, class distance weighted cross-entropy (CDW-CE), that respects the order of the classes and takes the distance of the classes into account in calculation of the cost. Experimental evaluations show that models trained with CDW-CE outperform the models trained with conventional categorical cross-entropy and other commonly used loss functions which are designed for the ordinal regression problems. In addition, the class activation maps of models trained with CDW-CE loss are more class-discriminative and they are found to be more reasonable by the domain experts.