# ClinNet: Evidential Ordinal Regression with Bilateral Asymmetry and Prototype Memory for Knee Osteoarthritis Grading

arXiv: https://arxiv.org/abs/2601.17315 · HTML: https://mlsanity.com/paper/2601.17315/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 30 of its 54 references that are in the map.
- First posted on arXiv 24 Jan 2026.

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

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- [Momentum Contrast for Unsupervised Visual Representation Learning](https://mlsanity.com/paper/1911.05722/) (2019)
- [Grad-CAM: Visual Explanations from Deep Networks via Gradient-based Localization](https://mlsanity.com/paper/1610.02391/) (2016)
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- [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)
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- [What Uncertainties Do We Need in Bayesian Deep Learning for Computer Vision?](https://mlsanity.com/paper/1703.04977/) (2017)
- [Unsupervised Feature Learning via Non-Parametric Instance-level Discrimination](https://mlsanity.com/paper/1805.01978/) (2018)
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- [Enhancing The Reliability of Out-of-distribution Image Detection in Neural Networks](https://mlsanity.com/paper/1706.02690/) (2017)
- [Can You Trust Your Model's Uncertainty? Evaluating Predictive Uncertainty Under Dataset Shift](https://mlsanity.com/paper/1906.02530/) (2019)
- [A Survey on Deep Learning in Medical Image Analysis](https://mlsanity.com/paper/1702.05747/) (2017)
- [Selective Classification for Deep Neural Networks](https://mlsanity.com/paper/1705.08500/) (2017)
- [Evidential Deep Learning to Quantify Classification Uncertainty](https://mlsanity.com/paper/1806.01768/) (2018)
- [Deep Evidential Regression](https://mlsanity.com/paper/1910.02600/) (2019)
- [Rank consistent ordinal regression for neural networks with application to age estimation](https://mlsanity.com/paper/1901.07884/) (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)

## Abstract (arXiv)

Knee osteoarthritis (KOA) grading based on radiographic images is a critical yet challenging task due to subtle inter-grade differences, annotation uncertainty, and the inherently ordinal nature of disease progression. Conventional deep learning approaches typically formulate this problem as deterministic multi-class classification, ignoring both the continuous progression of degeneration and the uncertainty in expert annotations. In this work, we propose ClinNet, a novel trustworthy framework that addresses KOA grading as an evidential ordinal regression problem. The proposed method integrates three key components: (1) a Bilateral Asymmetry Encoder (BAE) that explicitly models medial-lateral structural discrepancies; (2) a Diagnostic Memory Bank that maintains class-wise prototypes to stabilize feature representations; and (3) an Evidential Ordinal Head based on the Normal-Inverse-Gamma (NIG) distribution to jointly estimate continuous KL grades and epistemic uncertainty. Extensive experiments demonstrate that ClinNet achieves a Quadratic Weighted Kappa of 0.892 and Accuracy of 0.768, statistically outperforming state-of-the-art baselines (p < 0.001). Crucially, we demonstrate that the model's uncertainty estimates successfully flag out-of-distribution samples and potential misdiagnoses, paving the way for safe clinical deployment.