# Opinions Vary? Diagnosis First!

arXiv: https://arxiv.org/abs/2202.06505 · HTML: https://mlsanity.com/paper/2202.06505/

## Key facts

- Cited by 3 papers in the map (data through 14 Oct 2026).
- Builds on 40 of its 77 references that are in the map.
- First posted on arXiv 14 Feb 2022.

## Builds on (most cited first, 30 of 40)

- [Attention Is All You Need](https://mlsanity.com/paper/1706.03762/) (2017)
- [Deep Residual Learning for Image Recognition](https://mlsanity.com/paper/1512.03385/) (2015)
- [Adam: A Method for Stochastic Optimization](https://mlsanity.com/paper/1412.6980/) (2014)
- [Very Deep Convolutional Networks for Large-Scale Image Recognition](https://mlsanity.com/paper/1409.1556/) (2014)
- [Swin Transformer: Hierarchical Vision Transformer using Shifted Windows](https://mlsanity.com/paper/2103.14030/) (2021)
- [End-to-End Object Detection with Transformers](https://mlsanity.com/paper/2005.12872/) (2020)
- [Explaining and Harnessing Adversarial Examples](https://mlsanity.com/paper/1412.6572/) (2014)
- [EfficientNet: Rethinking Model Scaling for Convolutional Neural Networks](https://mlsanity.com/paper/1905.11946/) (2019)
- [Towards Deep Learning Models Resistant to Adversarial Attacks](https://mlsanity.com/paper/1706.06083/) (2017)
- [Intriguing properties of neural networks](https://mlsanity.com/paper/1312.6199/) (2013)
- [Fully Convolutional Networks for Semantic Segmentation](https://mlsanity.com/paper/1411.4038/) (2014)
- [Going Deeper with Convolutions](https://mlsanity.com/paper/1409.4842/) (2014)
- [Gaussian Error Linear Units (GELUs)](https://mlsanity.com/paper/1606.08415/) (2016)
- [Encoder-Decoder with Atrous Separable Convolution for Semantic Image Segmentation](https://mlsanity.com/paper/1802.02611/) (2018)
- [V-Net: Fully Convolutional Neural Networks for Volumetric Medical Image Segmentation](https://mlsanity.com/paper/1606.04797/) (2016)
- [Visualizing and Understanding Convolutional Networks](https://mlsanity.com/paper/1311.2901/) (2013)
- [Rich feature hierarchies for accurate object detection and semantic segmentation](https://mlsanity.com/paper/1311.2524/) (2013)
- [Adversarial Examples Are Not Bugs, They Are Features](https://mlsanity.com/paper/1905.02175/) (2019)
- [Adversarial Examples: Attacks and Defenses for Deep Learning](https://mlsanity.com/paper/1712.07107/) (2017)
- [Road Extraction by Deep Residual U-Net](https://mlsanity.com/paper/1711.10684/) (2017)
- [REFUGE Challenge: A Unified Framework for Evaluating Automated Methods for Glaucoma Assessment from Fundus Photographs](https://mlsanity.com/paper/1910.03667/) (2019)
- [CE-Net: Context Encoder Network for 2D Medical Image Segmentation](https://mlsanity.com/paper/1903.02740/) (2019)
- [PHiSeg: Capturing Uncertainty in Medical Image Segmentation](https://mlsanity.com/paper/1906.04045/) (2019)
- [Learning From Noisy Labels By Regularized Estimation Of Annotator Confusion](https://mlsanity.com/paper/1902.03680/) (2019)
- [MS-Net: Multi-Site Network for Improving Prostate Segmentation with Heterogeneous MRI Data](https://mlsanity.com/paper/2002.03366/) (2020)
- [Who Said What: Modeling Individual Labelers Improves Classification](https://mlsanity.com/paper/1703.08774/) (2017)
- [Attention Based Glaucoma Detection: A Large-scale Database and CNN Model](https://mlsanity.com/paper/1903.10831/) (2019)
- [Robust Multimodal Brain Tumor Segmentation via Feature Disentanglement and Gated Fusion](https://mlsanity.com/paper/2002.09708/) (2020)
- [On the Effect of Inter-observer Variability for a Reliable Estimation of Uncertainty of Medical Image Segmentation](https://mlsanity.com/paper/1806.02562/) (2018)
- [Boundary and Entropy-driven Adversarial Learning for Fundus Image Segmentation](https://mlsanity.com/paper/1906.11143/) (2019)

## Built on by (most cited first, 3 of 3)

- [Learning self-calibrated optic disc and cup segmentation from multi-rater annotations](https://mlsanity.com/paper/2206.05092/) (2022)
- [Calibrate the inter-observer segmentation uncertainty via diagnosis-first principle](https://mlsanity.com/paper/2208.03016/) (2022)
- [Multi-rater Prism: Learning self-calibrated medical image segmentation from multiple raters](https://mlsanity.com/paper/2212.00601/) (2022)

## Abstract (arXiv)

With the advancement of deep learning techniques, an increasing number of methods have been proposed for optic disc and cup (OD/OC) segmentation from the fundus images. Clinically, OD/OC segmentation is often annotated by multiple clinical experts to mitigate the personal bias. However, it is hard to train the automated deep learning models on multiple labels. A common practice to tackle the issue is majority vote, e.g., taking the average of multiple labels. However such a strategy ignores the different expertness of medical experts. Motivated by the observation that OD/OC segmentation is often used for the glaucoma diagnosis clinically, in this paper, we propose a novel strategy to fuse the multi-rater OD/OC segmentation labels via the glaucoma diagnosis performance. Specifically, we assess the expertness of each rater through an attentive glaucoma diagnosis network. For each rater, its contribution for the diagnosis will be reflected as an expertness map. To ensure the expertness maps are general for different glaucoma diagnosis models, we further propose an Expertness Generator (ExpG) to eliminate the high-frequency components in the optimization process. Based on the obtained expertness maps, the multi-rater labels can be fused as a single ground-truth which we dubbed as Diagnosis First Ground-truth (DiagFirstGT). Experimental results show that by using DiagFirstGT as ground-truth, OD/OC segmentation networks will predict the masks with superior glaucoma diagnosis performance.