# Predictive uncertainty estimation in deep learning for lung carcinoma classification in digital pathology under real dataset shifts

arXiv: https://arxiv.org/abs/2408.08432 · HTML: https://mlsanity.com/paper/2408.08432/

## Key facts

- Cited by 1 papers in the map (data through 14 Oct 2026).
- Builds on 26 of its 46 references that are in the map.
- First posted on arXiv 15 Aug 2024.

## Builds on (most cited first, 26 of 26)

- [Deep Residual Learning for Image Recognition](https://mlsanity.com/paper/1512.03385/) (2015)
- [Very Deep Convolutional Networks for Large-Scale Image Recognition](https://mlsanity.com/paper/1409.1556/) (2014)
- [Distilling the Knowledge in a Neural Network](https://mlsanity.com/paper/1503.02531/) (2015)
- [Densely Connected Convolutional Networks](https://mlsanity.com/paper/1608.06993/) (2016)
- [EfficientNet: Rethinking Model Scaling for Convolutional Neural Networks](https://mlsanity.com/paper/1905.11946/) (2019)
- [mixup: Beyond Empirical Risk Minimization](https://mlsanity.com/paper/1710.09412/) (2017)
- [On Calibration of Modern Neural Networks](https://mlsanity.com/paper/1706.04599/) (2017)
- [Dropout as a Bayesian Approximation: Representing Model Uncertainty in Deep Learning](https://mlsanity.com/paper/1506.02142/) (2015)
- [Simple and Scalable Predictive Uncertainty Estimation using Deep Ensembles](https://mlsanity.com/paper/1612.01474/) (2016)
- [Prototypical Networks for Few-shot Learning](https://mlsanity.com/paper/1703.05175/) (2017)
- [Xception: Deep Learning with Depthwise Separable Convolutions](https://mlsanity.com/paper/1610.02357/) (2016)
- [Matching Networks for One Shot Learning](https://mlsanity.com/paper/1606.04080/) (2016)
- [Learning to Compare: Relation Network for Few-Shot Learning](https://mlsanity.com/paper/1711.06025/) (2017)
- [A Fine-Grained Analysis on Distribution Shift](https://mlsanity.com/paper/2110.11328/) (2021)
- [Confidence Calibration and Predictive Uncertainty Estimation for Deep Medical Image Segmentation](https://mlsanity.com/paper/1911.13273/) (2019)
- [Automatic Differentiation Variational Inference](https://mlsanity.com/paper/1603.00788/) (2016)
- [Exploring Uncertainty Measures in Deep Networks for Multiple Sclerosis Lesion Detection and Segmentation](https://mlsanity.com/paper/1808.01200/) (2018)
- [Subspace Inference for Bayesian Deep Learning](https://mlsanity.com/paper/1907.07504/) (2019)
- [Calibration tests in multi-class classification: A unifying framework](https://mlsanity.com/paper/1910.11385/) (2019)
- [Understanding Softmax Confidence and Uncertainty](https://mlsanity.com/paper/2106.04972/) (2021)
- [Pathologist-level classification of histologic patterns on resected lung adenocarcinoma slides with deep neural networks](https://mlsanity.com/paper/1901.11489/) (2019)
- [Is Synthetic Data all We Need? Benchmarking the Robustness of Models Trained with Synthetic Images](https://mlsanity.com/paper/2405.20469/) (2024)
- [Shifts 2.0: Extending The Dataset of Real Distributional Shifts](https://mlsanity.com/paper/2206.15407/) (2022)
- [The MBPEP: a deep ensemble pruning algorithm providing high quality uncertainty prediction](https://mlsanity.com/paper/1902.09238/) (2019)
- [Uncertainty-Aware Few-Shot Image Classification](https://mlsanity.com/paper/2010.04525/) (2020)
- [Generalisation effects of predictive uncertainty estimation in deep learning for digital pathology](https://mlsanity.com/paper/2112.09693/) (2021)

## Built on by (most cited first, 1 of 1)

- [Interpretable Deep Learning Framework for Improved Disease Classification in Medical Imaging](https://mlsanity.com/paper/2503.11851/) (2025)

## Abstract (arXiv)

Deep learning has shown tremendous progress in a wide range of digital pathology and medical image classification tasks. Its integration into safe clinical decision-making support requires robust and reliable models. However, real-world data comes with diversities that often lie outside the intended source distribution. Moreover, when test samples are dramatically different, clinical decision-making is greatly affected. Quantifying predictive uncertainty in models is crucial for well-calibrated predictions and determining when (or not) to trust a model. Unfortunately, many works have overlooked the importance of predictive uncertainty estimation. This paper evaluates whether predictive uncertainty estimation adds robustness to deep learning-based diagnostic decision-making systems. We investigate the effect of various carcinoma distribution shift scenarios on predictive performance and calibration. We first systematically investigate three popular methods for improving predictive uncertainty: Monte Carlo dropout, deep ensemble, and few-shot learning on lung adenocarcinoma classification as a primary disease in whole slide images. Secondly, we compare the effectiveness of the methods in terms of performance and calibration under clinically relevant distribution shifts such as in-distribution shifts comprising primary disease sub-types and other characterization analysis data; out-of-distribution shifts comprising well-differentiated cases, different organ origin, and imaging modality shifts. While studies on uncertainty estimation exist, to our best knowledge, no rigorous large-scale benchmark compares predictive uncertainty estimation including these dataset shifts for lung carcinoma classification.