# Risk-Aware Robust Learning: Reducing Clinical Risk under Label Noise in Medical Image Classification

arXiv: https://arxiv.org/abs/2604.23875 · HTML: https://mlsanity.com/paper/2604.23875/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 12 of its 22 references that are in the map.
- First posted on arXiv 26 Apr 2026.

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

- [Deep Residual Learning for Image Recognition](https://mlsanity.com/paper/1512.03385/) (2015)
- [MixMatch: A Holistic Approach to Semi-Supervised Learning](https://mlsanity.com/paper/1905.02249/) (2019)
- [Co-teaching: Robust Training of Deep Neural Networks with Extremely Noisy Labels](https://mlsanity.com/paper/1804.06872/) (2018)
- [A Closer Look at Memorization in Deep Networks](https://mlsanity.com/paper/1706.05394/) (2017)
- [DivideMix: Learning with Noisy Labels as Semi-supervised Learning](https://mlsanity.com/paper/2002.07394/) (2020)
- [MedMNIST v2 -- A large-scale lightweight benchmark for 2D and 3D biomedical image classification](https://mlsanity.com/paper/2110.14795/) (2021)
- [MentorNet: Learning Data-Driven Curriculum for Very Deep Neural Networks on Corrupted Labels](https://mlsanity.com/paper/1712.05055/) (2017)
- [Learning from Noisy Labels with Deep Neural Networks: A Survey](https://mlsanity.com/paper/2007.08199/) (2020)
- [Deep Learning for Medical Image Analysis](https://mlsanity.com/paper/1708.08987/) (2017)
- [Cost Sensitive Learning of Deep Feature Representations from Imbalanced Data](https://mlsanity.com/paper/1508.03422/) (2015)
- [LongReMix: Robust Learning with High Confidence Samples in a Noisy Label Environment](https://mlsanity.com/paper/2103.04173/) (2021)
- [ANNE: Adaptive Nearest Neighbors and Eigenvector-based Sample Selection for Robust Learning with Noisy Labels](https://mlsanity.com/paper/2411.01613/) (2024)

## Abstract (arXiv)

Noisy labels are a pervasive challenge in medical image classification, where annotation errors arise from inter-observer variability and diagnostic ambiguity. Although several noise-robust learning methods have been proposed, their evaluation predominantly relies on accuracy-oriented metrics, overlooking the clinical implications of asymmetric error costs. In medical diagnosis, a false negative (missed disease) carries substantially higher consequences than a false positive (false alarm), as delayed treatment can directly impact patient outcomes. In this work, we investigate whether noise-robust training methods preserve clinical safety under label noise. We conduct a systematic risk-aware evaluation of the state-of-the-art noise-robust methods Coteaching, DivideMix, UNICON, and a GMM-based filtering approach on binarized DermaMNIST and PathMNIST datasets under clean and label noise rates of 20%, and 40%. Beyond balanced accuracy, we adopt a cost-sensitive Global Risk formulation that explicitly penalizes false negatives. Our analysis reveals that the robustness of state-of-the-art methods does not guarantee clinical safety. Furthermore, we demonstrate that integrating cost-sensitive optimization into noise-robust training significantly reduces clinical risk, while mantaining model utility. These findings demonstrate that noise-robust learning must be evaluated through a clinical risk lens, and that combining robust training with cost-sensitive optimization can meaningfully reduce risk in noisy-label medical imaging scenarios.