A Review on Explainable Artificial Intelligence for Healthcare: Why, How, and When?

Artificial intelligence (AI) models are increasingly finding applications in the field of medicine. Concerns have been raised about the explainability of the decisions that are made by these AI models. In this article, we give a systematic analysis of explainable artificial intelligence (XAI), with a primary focus on models that are currently being used in the field of healthcare. The literature search is conducted following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) standards for relevant work published from 1 January 2012 to 02 February 2022. The review analyzes the prevailing trends in XAI and lays out the major directions in which research is headed. We investigate the why, how, and when of the uses of these XAI models and their implications. We present a comprehensive examination of XAI methodologies as well as an explanation of how a trustworthy AI can be derived from describing AI models for healthcare fields. The discussion of this work will contribute to the formalization of the XAI field.Comment: 15 pages, 3 figures, accepted for publication in the IEEE Transactions on Artificial Intelligenc

Cervical cancer risk prediction with robust ensemble and explainable black boxes method

Clinical decision support systems (CDSS) that make use of algorithms based on intelligent systems, such as machine learning or deep learning, they sufer from the fact that often the methods used are hard to interpret and difcult to understand on how some decisions are made; the opacity ofsome methods, sometimes voluntary due to problems such as data privacy or the techniques used to protect intellectual property, makes these systems very complicated. Besides this series of problems, the results obtained also sufer from the poor possibility of being interpreted; in the clinical context therefore it is required that the methods used are as accurate as possible, transparent techniques and explainable results. In this work the problem of the development of cervical cancer is treated, a disease that mainly afects the female population. In order to introduce advanced machine learning techniques in a clinical decision support system that can be transparent and explainable, a robust, accurate ensemble method is presented, in terms of error and sensitivity linked to the classifcation of possible development of the aforementioned pathology and advanced techniques are also presented of explainability and interpretability (Explanaible Machine Learning) applied to the context of CDSS such as Lime and Shapley. The results obtained, as well as being interesting, are understandable and can be implemented in the treatment of this type of problem

Explainable Artificial Intelligence (XAI) from a user perspective- A synthesis of prior literature and problematizing avenues for future research

The final search query for the Systematic Literature Review (SLR) was conducted on 15th July 2022. Initially, we extracted 1707 journal and conference articles from the Scopus and Web of Science databases. Inclusion and exclusion criteria were then applied, and 58 articles were selected for the SLR. The findings show four dimensions that shape the AI explanation, which are format (explanation representation format), completeness (explanation should contain all required information, including the supplementary information), accuracy (information regarding the accuracy of the explanation), and currency (explanation should contain recent information). Moreover, along with the automatic representation of the explanation, the users can request additional information if needed. We have also found five dimensions of XAI effects: trust, transparency, understandability, usability, and fairness. In addition, we investigated current knowledge from selected articles to problematize future research agendas as research questions along with possible research paths. Consequently, a comprehensive framework of XAI and its possible effects on user behavior has been developed

Explainability Design Patterns in Clinical Decision Support Systems

This paper reports on the ongoing PhD project in the field of explaining the clinical decision support systems (CDSSs) recommendations to medical practitioners. Recently, the explainability research in the medical domain has witnessed a surge of advances with a focus on two main methods: The first focuses on developing models that are explainable and transparent in its nature (e.g. rule-based algorithms). The second investigates the interpretability of the black-box models without looking at the mechanism behind it (e.g. LIME) as a post-hoc explanation. However, overlooking the human-factors and the usability aspect of the explanation introduced new risks following the system recommendations, e.g. over-trust and under-trust. Due to such limitation, there is a growing demand for usable explanations for CDSSs to enable the integration of trust calibration and informed decision-making in these systems by identifying when the recommendation is correct to follow. This research aims to develop explainability design patterns with the aim of calibrating medical practitioners trust in the CDSSs. This paper concludes the PhD methodology and literature around the research problem is also discussed

“It Is a Moving Process”:Understanding the Evolution of Explainability Needs of Clinicians in Pulmonary Medicine

Clinicians increasingly pay attention to Artificial Intelligence (AI) to improve the quality and timeliness of their services. There are converging opinions on the need for Explainable AI (XAI) in healthcare. However, prior work considers explanations as stationary entities with no account for the temporal dynamics of patient care. In this work, we involve 16 Idiopathic Pulmonary Fibrosis (IPF) clinicians from a European university medical centre and investigate their evolving uses and purposes for explainability throughout patient care. By applying a patient journey map for IPF, we elucidate clinicians' informational needs, how human agency and patient-specific conditions can influence the interaction with XAI systems, and the content, delivery, and relevance of explanations over time. We discuss implications for integrating XAI in clinical contexts and more broadly how explainability is defined and evaluated. Furthermore, we reflect on the role of medical education in addressing epistemic challenges related to AI literacy.</p

“It Is a Moving Process”:Understanding the Evolution of Explainability Needs of Clinicians in Pulmonary Medicine

Clinicians increasingly pay attention to Artificial Intelligence (AI) to improve the quality and timeliness of their services. There are converging opinions on the need for Explainable AI (XAI) in healthcare. However, prior work considers explanations as stationary entities with no account for the temporal dynamics of patient care. In this work, we involve 16 Idiopathic Pulmonary Fibrosis (IPF) clinicians from a European university medical centre and investigate their evolving uses and purposes for explainability throughout patient care. By applying a patient journey map for IPF, we elucidate clinicians' informational needs, how human agency and patient-specific conditions can influence the interaction with XAI systems, and the content, delivery, and relevance of explanations over time. We discuss implications for integrating XAI in clinical contexts and more broadly how explainability is defined and evaluated. Furthermore, we reflect on the role of medical education in addressing epistemic challenges related to AI literacy.</p