# SURE-Med: Systematic Uncertainty Reduction for Enhanced Reliability in Medical Report Generation

arXiv: https://arxiv.org/abs/2508.01693 · HTML: https://mlsanity.com/paper/2508.01693/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 25 of its 47 references that are in the map.
- First posted on arXiv 3 Aug 2025.

## Builds on (most cited first, 25 of 25)

- [Show, Attend and Tell: Neural Image Caption Generation with Visual Attention](https://mlsanity.com/paper/1502.03044/) (2015)
- [CheXNet: Radiologist-Level Pneumonia Detection on Chest X-Rays with Deep Learning](https://mlsanity.com/paper/1711.05225/) (2017)
- [Generating Radiology Reports via Memory-driven Transformer](https://mlsanity.com/paper/2010.16056/) (2020)
- [Knowing When to Look: Adaptive Attention via A Visual Sentinel for Image Captioning](https://mlsanity.com/paper/1612.01887/) (2016)
- [On the Automatic Generation of Medical Imaging Reports](https://mlsanity.com/paper/1711.08195/) (2017)
- [Cross-modal Memory Networks for Radiology Report Generation](https://mlsanity.com/paper/2204.13258/) (2022)
- [When Radiology Report Generation Meets Knowledge Graph](https://mlsanity.com/paper/2002.08277/) (2020)
- [Dynamic Graph Enhanced Contrastive Learning for Chest X-ray Report Generation](https://mlsanity.com/paper/2303.10323/) (2023)
- [METransformer: Radiology Report Generation by Transformer with Multiple Learnable Expert Tokens](https://mlsanity.com/paper/2304.02211/) (2023)
- [CT2Rep: Automated Radiology Report Generation for 3D Medical Imaging](https://mlsanity.com/paper/2403.06801/) (2024)
- [Improving Chest X-Ray Report Generation by Leveraging Warm Starting](https://mlsanity.com/paper/2201.09405/) (2022)
- [PromptMRG: Diagnosis-Driven Prompts for Medical Report Generation](https://mlsanity.com/paper/2308.12604/) (2023)
- [Knowledge Matters: Radiology Report Generation with General and Specific Knowledge](https://mlsanity.com/paper/2112.15009/) (2021)
- [Improving Image Captioning by Leveraging Intra- and Inter-layer Global Representation in Transformer Network](https://mlsanity.com/paper/2012.07061/) (2020)
- [Improving Radiology Report Generation Systems by Removing Hallucinated References to Non-existent Priors](https://mlsanity.com/paper/2210.06340/) (2022)
- [HistGen: Histopathology Report Generation via Local-Global Feature Encoding and Cross-modal Context Interaction](https://mlsanity.com/paper/2403.05396/) (2024)
- [Enhanced Contrastive Learning with Multi-view Longitudinal Data for Chest X-ray Report Generation](https://mlsanity.com/paper/2502.20056/) (2025)
- [CXPMRG-Bench: Pre-training and Benchmarking for X-ray Medical Report Generation on CheXpert Plus Dataset](https://mlsanity.com/paper/2410.00379/) (2024)
- [ConZIC: Controllable Zero-shot Image Captioning by Sampling-Based Polishing](https://mlsanity.com/paper/2303.02437/) (2023)
- [HERGen: Elevating Radiology Report Generation with Longitudinal Data](https://mlsanity.com/paper/2407.15158/) (2024)
- [Fine-Grained Image-Text Alignment in Medical Imaging Enables Explainable Cyclic Image-Report Generation](https://mlsanity.com/paper/2312.08078/) (2023)
- [Structural Entities Extraction and Patient Indications Incorporation for Chest X-ray Report Generation](https://mlsanity.com/paper/2405.14905/) (2024)
- [Unlocking the Power of Spatial and Temporal Information in Medical Multimodal Pre-training](https://mlsanity.com/paper/2405.19654/) (2024)
- [Factual Serialization Enhancement: A Key Innovation for Chest X-ray Report Generation](https://mlsanity.com/paper/2405.09586/) (2024)
- [Deep Learning Models for Calculation of Cardiothoracic Ratio from Chest Radiographs for Assisted Diagnosis of Cardiomegaly](https://mlsanity.com/paper/2101.07606/) (2021)

## Abstract (arXiv)

Automated medical report generation (MRG) holds great promise for reducing the heavy workload of radiologists. However, its clinical deployment is hindered by three major sources of uncertainty. First, visual uncertainty, caused by noisy or incorrect view annotations, compromises feature extraction. Second, label distribution uncertainty, stemming from long-tailed disease prevalence, biases models against rare but clinically critical conditions. Third, contextual uncertainty, introduced by unverified historical reports, often leads to factual hallucinations. These challenges collectively limit the reliability and clinical trustworthiness of MRG systems. To address these issues, we propose SURE-Med, a unified framework that systematically reduces uncertainty across three critical dimensions: visual, distributional, and contextual. To mitigate visual uncertainty, a Frontal-Aware View Repair Resampling module corrects view annotation errors and adaptively selects informative features from supplementary views. To tackle label distribution uncertainty, we introduce a Token Sensitive Learning objective that enhances the modeling of critical diagnostic sentences while reweighting underrepresented diagnostic terms, thereby improving sensitivity to infrequent conditions. To reduce contextual uncertainty, our Contextual Evidence Filter validates and selectively incorporates prior information that aligns with the current image, effectively suppressing hallucinations. Extensive experiments on the MIMIC-CXR and IU-Xray benchmarks demonstrate that SURE-Med achieves state-of-the-art performance. By holistically reducing uncertainty across multiple input modalities, SURE-Med sets a new benchmark for reliability in medical report generation and offers a robust step toward trustworthy clinical decision support.