# Evaluation Choices Shape Biomedical ML Claims: A Pediatric Pneumonia Benchmark Case Study

arXiv: https://arxiv.org/abs/2609.37848 · HTML: https://mlsanity.com/paper/2609.37848/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 17 of its 28 references that are in the map.
- First posted on arXiv 29 Sep 2026.

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

- [Deep Residual Learning for Image Recognition](https://mlsanity.com/paper/1512.03385/) (2015)
- [An Image is Worth 16x16 Words: Transformers for Image Recognition at Scale](https://mlsanity.com/paper/2010.11929/) (2020)
- [Very Deep Convolutional Networks for Large-Scale Image Recognition](https://mlsanity.com/paper/1409.1556/) (2014)
- [Swin Transformer: Hierarchical Vision Transformer using Shifted Windows](https://mlsanity.com/paper/2103.14030/) (2021)
- [Grad-CAM: Visual Explanations from Deep Networks via Gradient-based Localization](https://mlsanity.com/paper/1610.02391/) (2016)
- [Densely Connected Convolutional Networks](https://mlsanity.com/paper/1608.06993/) (2016)
- [A Unified Approach to Interpreting Model Predictions](https://mlsanity.com/paper/1705.07874/) (2017)
- [EfficientNet: Rethinking Model Scaling for Convolutional Neural Networks](https://mlsanity.com/paper/1905.11946/) (2019)
- [On Calibration of Modern Neural Networks](https://mlsanity.com/paper/1706.04599/) (2017)
- [A ConvNet for the 2020s](https://mlsanity.com/paper/2201.03545/) (2022)
- [Shortcut Learning in Deep Neural Networks](https://mlsanity.com/paper/2004.07780/) (2020)
- [Do ImageNet Classifiers Generalize to ImageNet?](https://mlsanity.com/paper/1902.10811/) (2019)
- [Confounding variables can degrade generalization performance of radiological deep learning models](https://mlsanity.com/paper/1807.00431/) (2018)
- [Common pitfalls and recommendations for using machine learning to detect and prognosticate for COVID-19 using chest radiographs and CT scans](https://mlsanity.com/paper/2008.06388/) (2020)
- [Do We Train on Test Data? Purging CIFAR of Near-Duplicates](https://mlsanity.com/paper/1902.00423/) (2019)
- [Exploring large scale public medical image datasets](https://mlsanity.com/paper/1907.12720/) (2019)
- [How I failed machine learning in medical imaging -- shortcomings and recommendations](https://mlsanity.com/paper/2103.10292/) (2021)

## Abstract (arXiv)

Biomedical machine learning papers often compress model performance into one headline number. That number can look like a property of the model even when it depends strongly on how the benchmark was evaluated. We study this problem on the widely used Kermany pediatric chest radiograph dataset using nine image classifiers and a controlled evaluation protocol. Under the same protocol, the eight pretrained backbones differ by only 0.026 AUROC. In contrast, changing whether the backbone is frozen or fine-tuned changes AUROC by 0.044 on average, and changing the decision threshold changes balanced accuracy by 0.090 on average. The official test split is also measurably different from the training pool: a partition classifier distinguishes them at AUC 0.697, rising to 0.898 for normal radiographs. Most strikingly, a classifier using only file properties, with no image anatomy, reaches 0.992 balanced accuracy within the training pool but falls to 0.496 on the official test split. Validation-fitted thresholds and calibration also transfer imperfectly. These results show that a high benchmark score can support different conclusions when the split, training policy, threshold, metric, calibration, and uncertainty are not communicated with it. We end with a seven-item reporting recommendation in which each item is tied to an effect measured in the study