# Adaptive Conformal Prediction for Reliable and Explainable Medical Image Classification

arXiv: https://arxiv.org/abs/2605.12917 · HTML: https://mlsanity.com/paper/2605.12917/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 17 of its 26 references that are in the map.
- First posted on arXiv 13 May 2026.

## Builds on (most cited first, 17 of 17)

- [Deep Residual Learning for Image Recognition](https://mlsanity.com/paper/1512.03385/) (2015)
- [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)
- [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)
- [A Gentle Introduction to Conformal Prediction and Distribution-Free Uncertainty Quantification](https://mlsanity.com/paper/2107.07511/) (2021)
- [MedMNIST v2 -- A large-scale lightweight benchmark for 2D and 3D biomedical image classification](https://mlsanity.com/paper/2110.14795/) (2021)
- [Distribution-Free Predictive Inference For Regression](https://mlsanity.com/paper/1604.04173/) (2016)
- [Classification with Valid and Adaptive Coverage](https://mlsanity.com/paper/2006.02544/) (2020)
- [Uncertainty Sets for Image Classifiers using Conformal Prediction](https://mlsanity.com/paper/2009.14193/) (2020)
- [On the Utility of Prediction Sets in Human-AI Teams](https://mlsanity.com/paper/2205.01411/) (2022)
- [A review of predictive uncertainty estimation with machine learning](https://mlsanity.com/paper/2209.08307/) (2022)
- [Conformal Prediction: A Data Perspective](https://mlsanity.com/paper/2410.06494/) (2024)
- [Conformal Prediction for Class-wise Coverage via Augmented Label Rank Calibration](https://mlsanity.com/paper/2406.06818/) (2024)
- [Improving Adaptive Conformal Prediction Using Self-Supervised Learning](https://mlsanity.com/paper/2302.12238/) (2023)
- [Conformal Prediction for Image Segmentation Using Morphological Prediction Sets](https://mlsanity.com/paper/2503.05618/) (2025)
- [Adaptive Coverage Policies in Conformal Prediction](https://mlsanity.com/paper/2510.04318/) (2025)

## Abstract (arXiv)

Deep learning models for medical imaging often exhibit overconfidence, creating safety risks in ambiguous diagnostic scenarios. While Conformal Prediction (CP) provides distribution-free statistical guarantees, standard methods such as Regularized Adaptive Prediction Sets (RAPS) optimize for average efficiency and can mask severe failures on difficult inputs. We propose an Adaptive Lambda Criterion for RAPS that minimizes the worst-case coverage violation across prediction set size strata. On OrganAMNIST (58,850 abdominal CT images, 11 classes), standard size-optimized RAPS converges to near-deterministic behavior with stratified undercoverage on uncertain samples, while our method achieves 95.72 percent global coverage with average set size 1.09 and at least 90 percent coverage across all strata. Cross-domain validation on PathMNIST (107,180 pathology images, 9 classes) confirms generalizability. Quantitative Grad-CAM analysis (rho = -0.30, p < 1e-22) shows that multi-label predictions correspond to focused attention on anatomically ambiguous regions. These results demonstrate that the proposed method improves reliability while maintaining efficiency, making it suitable for safety-critical medical AI applications.