MADE: A Living Benchmark for Multi-Label Text Classification with Uncertainty Quantification of Medical Device Adverse Events

Raunak Agarwal, Markus A. Wenzel, Simon Baur, Jonas Zimmer, George Harvey, Jackie Ma


Abstract
Machine learning in high-stakes domains such as healthcare requires not only strong predictive performance but also reliable uncertainty quantification (UQ) to support human oversight. Multi-label text classification (MLTC) is a central task in this domain, yet remains challenging due to label imbalances, dependencies, and combinatorial complexity. Existing MLTC benchmarks are increasingly saturated and may be affected by training data contamination, making it difficult to distinguish genuine reasoning capabilities from memorization. We introduce MADE, a living MLTC benchmark derived from medical device adverse event reports and continuously updated with newly published reports to prevent contamination. MADE features a long-tailed distribution of hierarchical labels and enables reproducible evaluation with strict temporal splits. We establish baselines across more than 20 encoder- and decoder-only models under fine-tuning and few-shot settings (instruction-tuned/reasoning variants, local/API-accessible). We systematically assess entropy-/consistency-based and self-verbalized UQ methods. Results show clear trade-offs: smaller discriminatively fine-tuned decoders achieve the strongest head-to-tail accuracy while maintaining competitive UQ; generative fine-tuning delivers the most reliable UQ; large reasoning models improve performance on rare labels yet exhibit surprisingly weak UQ; and self-verbalized confidence is not a reliable proxy for uncertainty. Our work is publicly available at https://hhi.fraunhofer.de/aml-demonstrator/made-benchmark.
Anthology ID:
2026.acl-long.2148
Volume:
Proceedings of the 64th Annual Meeting of the Association for Computational Linguistics (Volume 1: Long Papers)
Month:
July
Year:
2026
Address:
San Diego, California, United States
Editors:
Maria Liakata, Viviane P. Moreira, Jiajun Zhang, David Jurgens
Venue:
ACL
SIG:
Publisher:
Association for Computational Linguistics
Note:
Pages:
46308–46328
Language:
URL:
https://aclanthology.org/2026.acl-long.2148/
DOI:
10.18653/v1/2026.acl-long.2148
Bibkey:
Cite (ACL):
Raunak Agarwal, Markus A. Wenzel, Simon Baur, Jonas Zimmer, George Harvey, and Jackie Ma. 2026. MADE: A Living Benchmark for Multi-Label Text Classification with Uncertainty Quantification of Medical Device Adverse Events. In Proceedings of the 64th Annual Meeting of the Association for Computational Linguistics (Volume 1: Long Papers), pages 46308–46328, San Diego, California, United States. Association for Computational Linguistics.
Cite (Informal):
MADE: A Living Benchmark for Multi-Label Text Classification with Uncertainty Quantification of Medical Device Adverse Events (Agarwal et al., ACL 2026)
Copy Citation:
PDF:
https://aclanthology.org/2026.acl-long.2148.pdf
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