Attention-guided convolutional network for bias-mitigated and interpretable oral lesion classification
Bibliographic record
Abstract
Accurate diagnosis of oral lesions, early indicators of oral cancer, is a complex clinical challenge. Recent advances in deep learning have demonstrated potential in supporting clinical decisions. This paper introduces a deep learning model for classifying oral lesions, focusing on accuracy, interpretability, and reducing dataset bias. The model integrates three components: (i) a Classification Stream, utilizing a CNN to categorize images into 16 lesion types (baseline model), (ii) a Guidance Stream, which aligns class activation maps with clinically relevant areas using ground truth segmentation masks (GAIN model), and (iii) an Anatomical Site Prediction Stream, improving interpretability by predicting lesion location (GAIN+ASP model). The development dataset comprised 2765 intra-oral digital images of 16 lesion types from 1079 patients seen at an oral pathology clinic between 1999 and 2021. The GAIN model demonstrated a 7.2% relative improvement in accuracy over the baseline for 16-class classification, with superior class-specific balanced accuracy and AUC scores. Additionally, the GAIN model enhanced lesion localization and improved the alignment between attention maps and ground truth. The proposed models also exhibited greater robustness against dataset bias, as shown in ablation studies.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".