Cohort-attention Evaluation Metric against Tied Data: Studying Performance of Classification Models in Cancer Detection

Artificial intelligence (AI) has significantly improved medical screening accuracy, particularly in cancer detection and risk assessment. However, traditional classification metrics often fail to account for imbalanced data, varying performance across cohorts, and patient-level inconsistencies, leading to biased evaluations. We propose the Cohort-Attention Evaluation Metrics (CAT) framework to address these challenges. CAT introduces patient-level assessment, entropy-based distribution weighting, and cohort-weighted sensitivity and specificity. Key metrics like CATSensitivity (CATSen), CATSpecificity (CATSpe), and CATMean ensure balanced and fair evaluation across diverse populations. This approach enhances predictive reliability, fairness, and interpretability, providing a robust evaluation method for AI-driven medical screening models.