# Confidence-Driven Deep Learning Framework for Early Detection of Knee Osteoarthritis

arXiv: https://arxiv.org/abs/2303.13203 · HTML: https://mlsanity.com/paper/2303.13203/

## Key facts

- Cited by 2 papers in the map (data through 14 Oct 2026).
- Builds on 12 of its 38 references that are in the map.
- First posted on arXiv 23 Mar 2023.

## Builds on (most cited first, 12 of 12)

- [Adam: A Method for Stochastic Optimization](https://mlsanity.com/paper/1412.6980/) (2014)
- [An Image is Worth 16x16 Words: Transformers for Image Recognition at Scale](https://mlsanity.com/paper/2010.11929/) (2020)
- [PyTorch: An Imperative Style, High-Performance Deep Learning Library](https://mlsanity.com/paper/1912.01703/) (2019)
- [Very Deep Convolutional Networks for Large-Scale Image Recognition](https://mlsanity.com/paper/1409.1556/) (2014)
- [Grad-CAM: Visual Explanations from Deep Networks via Gradient-based Localization](https://mlsanity.com/paper/1610.02391/) (2016)
- [On Calibration of Modern Neural Networks](https://mlsanity.com/paper/1706.04599/) (2017)
- [Delving Deep into Rectifiers: Surpassing Human-Level Performance on ImageNet Classification](https://mlsanity.com/paper/1502.01852/) (2015)
- [Learning Deep Features for Discriminative Localization](https://mlsanity.com/paper/1512.04150/) (2015)
- [When Does Label Smoothing Help?](https://mlsanity.com/paper/1906.02629/) (2019)
- [Automatic Knee Osteoarthritis Diagnosis from Plain Radiographs: A Deep Learning-Based Approach](https://mlsanity.com/paper/1710.10589/) (2017)
- [Quantifying Radiographic Knee Osteoarthritis Severity using Deep Convolutional Neural Networks](https://mlsanity.com/paper/1609.02469/) (2016)
- [Automatic Detection of Knee Joints and Quantification of Knee Osteoarthritis Severity using Convolutional Neural Networks](https://mlsanity.com/paper/1703.09856/) (2017)

## Built on by (most cited first, 2 of 2)

- [Transformer with Selective Shuffled Position Embedding and Key-Patch Exchange Strategy for Early Detection of Knee Osteoarthritis](https://mlsanity.com/paper/2304.08364/) (2023)
- [Deciphering knee osteoarthritis diagnostic features with explainable artificial intelligence: A systematic review](https://mlsanity.com/paper/2308.09380/) (2023)

## Abstract (arXiv)

Knee Osteoarthritis (KOA) is a prevalent musculoskeletal disorder that severely impacts mobility and quality of life, particularly among older adults. Its diagnosis often relies on subjective assessments using the Kellgren-Lawrence (KL) grading system, leading to variability in clinical evaluations. To address these challenges, we propose a confidence-driven deep learning framework for early KOA detection, focusing on distinguishing KL-0 and KL-2 stages. The Siamese-based framework integrates a novel multi-level feature extraction architecture with a hybrid loss strategy. Specifically, multi-level Global Average Pooling (GAP) layers are employed to extract features from varying network depths, ensuring comprehensive feature representation, while the hybrid loss strategy partitions training samples into high-, medium-, and low-confidence subsets. Tailored loss functions are applied to improve model robustness and effectively handle uncertainty in annotations. Experimental results on the Osteoarthritis Initiative (OAI) dataset demonstrate that the proposed framework achieves competitive accuracy, sensitivity, and specificity, comparable to those of expert radiologists. Cohen's kappa values (k > 0.85)) confirm substantial agreement, while McNemar's test (p > 0.05) indicates no statistically significant differences between the model and radiologists. Additionally, Confidence distribution analysis reveals that the model emulates radiologists' decision-making patterns. These findings highlight the potential of the proposed approach to serve as an auxiliary diagnostic tool, enhancing early KOA detection and reducing clinical workload.