A Decision-Aware Evaluation Protocol for Uncertainty in Medical Image Segmentation

The paper introduces a decision‑aware evaluation protocol for medical image segmentation uncertainty that separates uncertainty estimation from deferral policy and assesses their joint performance under fixed review budgets. It reports metrics such as fixed‑budget error reduction, risk‑coverage behavior, region‑level review proxies, structural failure modes, and sensitivity to review assumptions. Experiments on retinal vessel, skin lesion, and polyp segmentation with various backbones and uncertainty estimators show that estimator rankings vary with review unit, uncertainty target, and cost model, and that boundary and thin‑structure failures are partly due to annotation ambiguity.

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• computer-vision