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Beyond Performance Metrics: Uncertainty Mapping of Label Ambiguity in Fazekas Score Prediction

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arXiv:2609.17753v1 Announce Type: new Abstract: Reference labels used to train medical image classification models are not always as certain as they may appear, and this uncertainty has implications on performance metrics. In this study, we propose a framework to analyze model performance for periventricular Fazekas score prediction that goes beyond conventional metrics. The Fazekas score is an ordinal visual rating scale used to assess the severity of white matter hyperintensities and is known to be affected by inter-rater variability. While the best Fazekas score prediction model achieved a Matthews correlation coefficient (MCC) of 0.70, performance varied across data splits and loss functions, making interpretation of model capabilities difficult. Rather than interpreting epistemic unc…

SourcearXiv Computer VisionAuthor: Susanne Schmid, Johanna Ospel, Richard Frayne, Roberto Souza
Beyond Performance Metrics: Uncertainty Mapping of Label Ambiguity in Fazekas Score Prediction
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[Submitted on 15 Sep 2026]

Title:Beyond Performance Metrics: Uncertainty Mapping of Label Ambiguity in Fazekas Score Prediction

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Abstract:Reference labels used to train medical image classification models are not always as certain as they may appear, and this uncertainty has implications on performance metrics. In this study, we propose a framework to analyze model performance for periventricular Fazekas score prediction that goes beyond conventional metrics. The Fazekas score is an ordinal visual rating scale used to assess the severity of white matter hyperintensities and is known to be affected by inter-rater variability. While the best Fazekas score prediction model achieved a Matthews correlation coefficient (MCC) of 0.70, performance varied across data splits and loss functions, making interpretation of model capabilities difficult.

Rather than interpreting epistemic uncertainty of a model's prediction as an isolated scalar value, our approach of uncertainty mapping relates uncertainty to its position within the learned feature representation. This highlights regions of class-boundary transitions where cases appear more ambiguous and misclassifications are more likely. It also identifies potential label disagreement, including low-uncertainty misclassified cases that expert review found to be inconsistent with the original reference Fazekas score. Therefore, uncertainty mapping allows model behaviour to be examined in relation to class separation and potential model-label disagreement.

Loss function choice also influenced the uncertainty profile, with some models showing clearer class separation and more localized uncertainty in ambiguous regions than others. These findings suggest that uncertainty mapping for Fazekas score predictions can support model interpretation and targeted dataset review when reference labels are affected by ambiguity/ inter-rater variability.

Comments: 15 pages; 11 figures; 3 tables

Subjects:

Computer Vision and Pattern Recognition (cs.CV)

Cite as: arXiv:2609.17753 [cs.CV]

(or arXiv:2609.17753v1 [cs.CV] for this version)

https://doi.org/10.48550/arXiv.2609.17753

arXiv-issued DOI via DataCite (pending registration)

Submission history

From: Roberto Souza [view email] [v1] Tue, 15 Sep 2026 19:03:55 UTC (10,786 KB)

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  • arXiv:2609.17753v1 Announce Type: new Abstract: Reference labels used to train medical image classification models are not always as certain as they may appear, and this uncertain…

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