Gerardo A. Flores

Gerardo A. Flores, Yash Deshpande, Jannis R. Brea et al.

In sequential search, alternatives are tested until the true class is found. Standard proper scoring rules like log loss are local, ignoring the ranking of competitors and misaligning model evaluation with search utility. We show that sequential search induces a pairwise structure that overcomes this. By analyzing the expected cost of optimal search under varying testing costs, we derive Pandora's Regret: a closed-form, pairwise-additive, and strictly proper scoring rule. Pandora's Regret both elicits true probabilities and penalizes rank-reversing miscalibrations where distractors outrank the true class. Our construction yields a one-parameter Beta family that balances penalties for rank-swapping versus probability magnitude, while retaining a grounded interpretation as expected search cost. We prove that log loss, accuracy, and macro-F1 rely on implicit decision models misaligned with sequential search. Across 597 MedMNIST models, Pandora-based metrics better predict clinical diagnostic costs than standard alternatives, extending decision-theoretic scoring rule construction to the multiclass setting.

Gerardo A. Flores, Alyssa H. Smith, Julia A. Fukuyama et al.

Machine learning-based decision support systems are increasingly deployed in clinical settings, where probabilistic scoring functions are used to inform and prioritize patient management decisions. However, widely used scoring rules, such as accuracy and AUC-ROC, fail to adequately reflect key clinical priorities, including calibration, robustness to distributional shifts, and sensitivity to asymmetric error costs. In this work, we propose a principled yet practical evaluation framework for selecting calibrated thresholded classifiers that explicitly accounts for the uncertainty in class prevalences and domain-specific cost asymmetries often found in clinical settings. Building on the theory of proper scoring rules, particularly the Schervish representation, we derive an adjusted variant of cross-entropy (log score) that averages cost-weighted performance over clinically relevant ranges of class balance. The resulting evaluation is simple to apply, sensitive to clinical deployment conditions, and designed to prioritize models that are both calibrated and robust to real-world variations.