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Representational Smoothing to Improve Medical Image Decision Making

Abstract

We demonstrate how medical-image classification decisions can be denoised by aggregating decisions on similar images. In our algorithm, the final decision on a target image is cancerous if a percentage t of the k most similar images are cancerous, else it is not cancerous. Similarity between images is calculated as the distance between representations from an artificial neural network. We vary k and t for novice and expert participants using data from Trueblood et al. (2018) and Trueblood et al. (2021). We show that increasing k improves performance for novices, with their performance approaching that of experts. We also show that the algorithm is biased towards identifying cancerous cells, which is reflected in the representational space. The percentage t allows greater control over sensitivity and specificity and can be used to debias decisions. This algorithm is less effective for experts, partially explained by them giving similar responses on similar images.

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