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arXiv · 2607.28148

What Makes Deep Learning Work for Traditional Chinese Medicine Tongue Diagnosis? A Comprehensive Ablation Study

Longxia Gao·Linan Wang·Yuhe Han·Junze Geng·Meng Zhang·Hanqing Zhao
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Abstract

Deep learning has shown promise for automated tongue diagnosis in traditional Chinese medicine (TCM), yet the design space remains underexplored. We conducted a systematic ablation study spanning 20+ model versions under rigorous 5-fold cross-validation on TongueDx2 (5,109 images, 976 expert-annotated) and a merged dataset of 11,101 samples. We compared six backbone architectures, four loss functions, five augmentation strategies, and six training strategies. The best 976-sample model achieved weighted-F1 of 0.6625 using ConvNeXt-Tiny with restrained augmentation and weak-group ensemble, while the best 11,101-sample model reached weighted-F1 of 0.7761. Six key design principles emerged: (1) ConvNeXt-Tiny offers optimal parameter efficiency; (2) BCE substantially outperforms Asymmetric Loss (+2.7%); (3) restrained color augmentation is critical; (4) weak-group ensemble replacement (+2.1%) outperforms probability averaging; (5) data scaling yielded +20.6% improvement; (6) expanding from 13 to 45 label dimensions caused catastrophic collapse (0.78 to 0.22). These principles are generalizable to multi-label medical image classification with class imbalance.

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Longxia Gao, Linan Wang, Yuhe Han, Junze Geng, Meng Zhang, Hanqing Zhao. 2026-07-30. What Makes Deep Learning Work for Traditional Chinese Medicine Tongue Diagnosis? A Comprehensive Ablation Study. https://arxiv.org/abs/2607.28148

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