TY - JOUR AU - Kurz, Alexander AU - Hauser, Katja AU - Mehrtens, Hendrik Alexander AU - Krieghoff-Henning, Eva AU - Hekler, Achim AU - Kather, Jakob Nikolas AU - Fröhling, Stefan AU - von Kalle, Christof AU - Brinker, Titus Josef PY - 2022 DA - 2022/8/2 TI - Uncertainty Estimation in Medical Image Classification: Systematic Review JO - JMIR Med Inform SP - e36427 VL - 10 IS - 8 KW - uncertainty estimation KW - network calibration KW - out-of-distribution detection KW - medical image classification KW - deep learning KW - medical imaging AB - Background: Deep neural networks are showing impressive results in different medical image classification tasks. However, for real-world applications, there is a need to estimate the network’s uncertainty together with its prediction. Objective: In this review, we investigate in what form uncertainty estimation has been applied to the task of medical image classification. We also investigate which metrics are used to describe the effectiveness of the applied uncertainty estimation Methods: Google Scholar, PubMed, IEEE Xplore, and ScienceDirect were screened for peer-reviewed studies, published between 2016 and 2021, that deal with uncertainty estimation in medical image classification. The search terms “uncertainty,” “uncertainty estimation,” “network calibration,” and “out-of-distribution detection” were used in combination with the terms “medical images,” “medical image analysis,” and “medical image classification.” Results: A total of 22 papers were chosen for detailed analysis through the systematic review process. This paper provides a table for a systematic comparison of the included works with respect to the applied method for estimating the uncertainty. Conclusions: The applied methods for estimating uncertainties are diverse, but the sampling-based methods Monte-Carlo Dropout and Deep Ensembles are used most frequently. We concluded that future works can investigate the benefits of uncertainty estimation in collaborative settings of artificial intelligence systems and human experts. International Registered Report Identifier (IRRID): RR2-10.2196/11936 SN - 2291-9694 UR - https://medinform.jmir.org/2022/8/e36427 UR - https://doi.org/10.2196/36427 UR - http://www.ncbi.nlm.nih.gov/pubmed/35916701 DO - 10.2196/36427 ID - info:doi/10.2196/36427 ER -