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MEGAN: Mixture of Experts for Robust Uncertainty Estimation in Endoscopy Videos

16 September 2025
Damola Agbelese
Krishna Chaitanya
Pushpak Pati
Chaitanya Parmar
Pooya Mobadersany
Shreyas Fadnavis
Lindsey Surace
Shadi Yarandi
Louis R. Ghanem
Molly V. Lucas
Tommaso Mansi
Oana Gabriela Cula
Pablo F. Damasceno
K. Standish
ArXiv (abs)PDFHTML
Main:8 Pages
2 Figures
Bibliography:3 Pages
1 Tables
Abstract

Reliable uncertainty quantification (UQ) is essential in medical AI. Evidential Deep Learning (EDL) offers a computationally efficient way to quantify model uncertainty alongside predictions, unlike traditional methods such as Monte Carlo (MC) Dropout and Deep Ensembles (DE). However, all these methods often rely on a single expert's annotations as ground truth for model training, overlooking the inter-rater variability in healthcare. To address this issue, we propose MEGAN, a Multi-Expert Gating Network that aggregates uncertainty estimates and predictions from multiple AI experts via EDL models trained with diverse ground truths and modeling strategies. MEGAN's gating network optimally combines predictions and uncertainties from each EDL model, enhancing overall prediction confidence and calibration. We extensively benchmark MEGAN on endoscopy videos for Ulcerative colitis (UC) disease severity estimation, assessed by visual labeling of Mayo Endoscopic Subscore (MES), where inter-rater variability is prevalent. In large-scale prospective UC clinical trial, MEGAN achieved a 3.5% improvement in F1-score and a 30.5% reduction in Expected Calibration Error (ECE) compared to existing methods. Furthermore, MEGAN facilitated uncertainty-guided sample stratification, reducing the annotation burden and potentially increasing efficiency and consistency in UC trials.

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