Comparative Analysis of Image Augmentation and Class Weighting on ResNet50-CBAM for Pneumonia Detection from Chest X-Ray Images

Abstract

Pneumonia remains one of the leading causes of morbidity and mortality worldwide, particularly among children, older adults, and immunocompromised individuals. Although chest X-ray (CXR) imaging is widely used for pneumonia diagnosis, manual interpretation is time-consuming, subjective, and highly dependent on radiologist expertise. Deep learning has shown promising performance for automated pneumonia classification; however, class imbalance remains a major challenge that can lead to biased predictions and reduced model generalization. Therefore, this study investigates the effectiveness of image augmentation and class weighting for handling class imbalance in pneumonia classification using chest X-ray images. The main contribution of this study is a systematic comparison of four experimental scenarios: Baseline, Augmentation Only, Class Weighting Only, and Hybrid (Image Augmentation and Class Weighting) implemented on a ResNet50 architecture integrated with the Convolutional Block Attention Module (CBAM). Experiments were conducted using the publicly available Chest X-Ray Images (Pneumonia) dataset from Kaggle, comprising 1,583 Normal and 4,273 Pneumonia images. Model performance was evaluated using Accuracy, ROC-AUC, Precision, Recall, F1-Score, confusion matrix analysis, and Youden’s J-Statistic for threshold optimization. The Hybrid model achieved the best overall performance, with an Accuracy of 95.74%, a ROC-AUC of 98.83%, a Macro Precision of 96.01%, a Macro Recall of 93.13%, and a Macro F1-Score of 94.44%. Moreover, the number of false negative predictions decreased from 25 in the Baseline model to 5 in the Hybrid model. These findings demonstrate that integrating image augmentation and class weighting within the ResNet50-CBAM framework effectively mitigates class imbalance and improves the reliability of automated pneumonia classification.