Research Papers

As artificial intelligence (AI) becomes increasingly embedded in healthcare delivery, this chapter explores the critical aspects of developing reliable and ethical Clinical Decision Support Systems (CDSS). Beginning with the fundamental transition from traditional statistical models to sophisticated machine learning approaches, this work examines rigorous validation strategies and performance assessment methods, including the crucial role of model calibration and decision curve analysis. The chapter emphasizes that creating trustworthy AI systems in healthcare requires more than just technical accuracy; it demands careful consideration of fairness, explainability, and privacy. The challenge of ensuring equitable healthcare delivery through AI is stressed, discussing methods to identify and mitigate bias in clinical predictive models. The chapter then delves into explainability as a cornerstone of human-centered CDSS. This focus reflects the understanding that healthcare professionals must not only trust AI recommendations but also comprehend their underlying reasoning. The discussion advances in an analysis of privacy vulnerabilities in medical AI systems, from data leakage in deep learning models to sophisticated attacks against model explanations. The text explores privacy-preservation strategies such as differential privacy and federated learning, while acknowledging the inherent trade-offs between privacy protection and model performance. This progression, from technical validation to ethical considerations, reflects the multifaceted challenges of developing AI systems that can be seamlessly and reliably integrated into daily clinical practice while maintaining the highest standards of patient care and data protection.

Deep learning models in computer vision have made remarkable progress, but their lack of transparency and interpretability remains a challenge. The development of explainable AI can enhance the understanding and performance of these models. However, existing techniques often struggle to provide convincing explanations that non-experts easily understand, and they cannot accurately identify models' intrinsic decision-making processes. To address these challenges, we propose to develop a counterfactual explanation (CE) model that balances plausibility and faithfulness. This model generates easy-to-understand visual explanations by making minimum changes necessary in images without altering the pixel data. Instead, the proposed method identifies internal concepts and filters learned by models and leverages them to produce plausible counterfactual explanations. The provided explanations reflect the internal decision-making process of the model, thus ensuring faithfulness to the model.

Explainable AI (XAI) provides methods to understand non-interpretable machine learning models. However, we have little knowledge about what legal experts expect from these explanations, including their legal compliance with, and value against European Union legislation. To close this gap, we present the Explanation Dialogues, an expert focus study to uncover the expectations, reasoning, and understanding of legal experts and practitioners towards XAI, with a specific focus on the European General Data Protection Regulation. The study consists of an online questionnaire and follow-up interviews, and is centered around a use-case in the credit domain. We extract both a set of hierarchical and interconnected codes using grounded theory, and present the standpoints of the participating experts towards XAI. We find that the presented explanations are hard to understand and lack information, and discuss issues that can arise from the different interests of the data controller and subject. Finally, we present a set of recommendations for developers of XAI methods, and indications of legal areas of discussion. Among others, recommendations address the presentation, choice, and content of an explanation, technical risks as well as the end-user, while we provide legal pointers to the contestability of explanations, transparency thresholds, intellectual property rights as well as the relationship between involved parties.

Explaining the results of clustering pipelines by unraveling the characteristics of each cluster is a challenging task, often addressed manually through visualizations and queries. Existing solutions from the domain of Explainable Artificial Intelligence (XAI) are largely ineffective for cluster explanations, and interpretable-by-design clustering algorithms may be unsuitable when the clustering algorithm does not fit the data properties. To bridge this gap, we introduce Cluster-Explorer, a novel explainability tool for black-box clustering pipelines. Our approach formulates the explanation of clusters as the identification of concise conjunctions of predicates that maximize the coverage of the cluster's data points while minimizing separation from other clusters. We achieve this by reducing the problem to generalized frequent-itemsets mining (gFIM), where items correspond to explanation predicates, and itemset frequency indicates coverage. To enhance efficiency, we leverage inherent problem properties and implement attribute selection to further reduce computational costs. Experimental evaluations on a benchmark collection of 98 clustering results, as well as a user study, demonstrate the superiority of Cluster-Explorer in both explanation quality and execution times compared to XAI baselines.

Iterative Closest Point (ICP) is a commonly used algorithm to estimate transformation between two point clouds. The key idea of this work is to leverage recent advances in explainable AI for probabilistic ICP methods that provide uncertainty estimates. Concretely, we propose a method that can explain why a probabilistic ICP method produced a particular output. Our method is based on kernel SHAP (SHapley Additive exPlanations). With this, we assign an importance value to common sources of uncertainty in ICP such as sensor noise, occlusion, and ambiguous environments. The results of the experiment show that this explanation method can reasonably explain the uncertainty sources, providing a step towards robots that know when and why they failed in a human interpretable manner

Deep Learning systems excel in complex tasks but often lack transparency, limiting their use in critical applications. Counterfactual explanations, a core tool within eXplainable Artificial Intelligence (XAI), offer insights into model decisions by identifying minimal changes to an input to alter its predicted outcome. However, existing methods for time series data are limited by univariate assumptions, rigid constraints on modifications, or lack of validity guarantees. This paper introduces Multi-SpaCE, a multi-objective counterfactual explanation method for multivariate time series. Using non-dominated ranking genetic algorithm II (NSGA-II), Multi-SpaCE balances proximity, sparsity, plausibility, and contiguity. Unlike most methods, it ensures perfect validity, supports multivariate data and provides a Pareto front of solutions, enabling flexibility to different end-user needs. Comprehensive experiments in diverse datasets demonstrate the ability of Multi-SpaCE to consistently achieve perfect validity and deliver superior performance compared to existing methods.

The development of computing has made credit scoring approaches possible, with various machine learning (ML) and deep learning (DL) techniques becoming more and more valuable. While complex models yield more accurate predictions, their interpretability is often weakened, which is a concern for credit scoring that places importance on decision fairness. As features of the dataset are a crucial factor for the credit scoring system, we implement Linear Discriminant Analysis (LDA) as a feature reduction technique, which reduces the burden of the models complexity. We compared 6 different machine learning models, 1 deep learning model, and a hybrid model with and without using LDA. From the result, we have found our hybrid model, XG-DNN, outperformed other models with the highest accuracy of 99.45% and a 99% F1 score with LDA. Lastly, to interpret model decisions, we have applied 2 different explainable AI techniques named LIME (local) and Morris Sensitivity Analysis (global). Through this research, we showed how feature reduction techniques can be used without affecting the performance and explainability of the model, which can be very useful in resource-constrained settings to optimize the computational workload.

Pediatric heart diseases present a broad spectrum of congenital and acquired diseases. More complex congenital malformations require a differentiated and multimodal decision-making process, usually including echocardiography as a central imaging method. Artificial intelligence (AI) offers considerable promise for clinicians by facilitating automated interpretation of pediatric echocardiography data. However, adapting AI technologies for pediatric echocardiography analysis has challenges such as limited public data availability, data privacy, and AI model transparency. Recently, researchers have focused on disruptive technologies, such as federated learning (FL) and explainable AI (XAI), to improve automatic diagnostic and decision support workflows. This study offers a comprehensive overview of the limitations and opportunities of AI in pediatric echocardiography, emphasizing the synergistic workflow and role of XAI and FL, identifying research gaps, and exploring potential future developments. Additionally, three relevant clinical use cases demonstrate the functionality of XAI and FL with a focus on (i) view recognition, (ii) disease classification, (iii) segmentation of cardiac structures, and (iv) quantitative assessment of cardiac function.

Explainable AI (XAI) holds the promise of advancing the implementation and adoption of AI-based tools in practice, especially in high-stakes environments like healthcare. However, most of the current research lacks input from end users, and therefore their practical value is limited. To address this, we conducted semi-structured interviews with clinicians to discuss their thoughts, hopes, and concerns. Clinicians from our sample generally think positively about developing AI-based tools for clinical practice, but they have concerns about how these will fit into their workflow and how it will impact clinician-patient relations. We further identify training of clinicians on AI as a crucial factor for the success of AI in healthcare and highlight aspects clinicians are looking for in (X)AI-based tools. In contrast to other studies, we take on a holistic and exploratory perspective to identify general requirements for (X)AI products for healthcare before moving on to testing specific tools.

SPES: Spectrogram Perturbation for Explainable Speech-to-Text Generation

Dennis Fucci, Marco Gaido, Beatrice Savoldi +3

Spurred by the demand for interpretable models, research on eXplainable AI for language technologies has experienced significant growth, with feature attribution methods emerging as a cornerstone of this progress. While prior work in NLP explored such methods for classification tasks and textual applications, explainability intersecting generation and speech is lagging, with existing techniques failing to account for the autoregressive nature of state-of-the-art models and to provide fine-grained, phonetically meaningful explanations. We address this gap by introducing Spectrogram Perturbation for Explainable Speech-to-text Generation (SPES), a feature attribution technique applicable to sequence generation tasks with autoregressive models. SPES provides explanations for each predicted token based on both the input spectrogram and the previously generated tokens. Extensive evaluation on speech recognition and translation demonstrates that SPES generates explanations that are faithful and plausible to humans.

Artificial Intelligence (AI) techniques, particularly machine learning techniques, are rapidly transforming tactical operations by augmenting human decision-making capabilities. This paper explores AI-driven Human-Autonomy Teaming (HAT) as a transformative approach, focusing on how it empowers human decision-making in complex environments. While trust and explainability continue to pose significant challenges, our exploration focuses on the potential of AI-driven HAT to transform tactical operations. By improving situational awareness and supporting more informed decision-making, AI-driven HAT can enhance the effectiveness and safety of such operations. To this end, we propose a comprehensive framework that addresses the key components of AI-driven HAT, including trust and transparency, optimal function allocation between humans and AI, situational awareness, and ethical considerations. The proposed framework can serve as a foundation for future research and development in the field. By identifying and discussing critical research challenges and knowledge gaps in this framework, our work aims to guide the advancement of AI-driven HAT for optimizing tactical operations. We emphasize the importance of developing scalable and ethical AI-driven HAT systems that ensure seamless human-machine collaboration, prioritize ethical considerations, enhance model transparency through Explainable AI (XAI) techniques, and effectively manage the cognitive load of human operators.

Artificial Intelligence is rapidly advancing and radically impacting everyday life, driven by the increasing availability of computing power. Despite this trend, the adoption of AI in real-world healthcare is still limited. One of the main reasons is the trustworthiness of AI models and the potential hesitation of domain experts with model predictions. Explainable Artificial Intelligence (XAI) techniques aim to address these issues. However, explainability can mean different things to people with different backgrounds, expertise, and goals. To address the target audience with diverse needs, we develop storytelling XAI. In this research, we have developed an approach that combines multi-task distillation with interpretability techniques to enable audience-centric explainability. Using multi-task distillation allows the model to exploit the relationships between tasks, potentially improving interpretability as each task supports the other leading to an enhanced interpretability from the perspective of a domain expert. The distillation process allows us to extend this research to large deep models that are highly complex. We focus on both model-agnostic and model-specific methods of interpretability, supported by textual justification of the results in healthcare through our use case. Our methods increase the trust of both the domain experts and the machine learning experts to enable a responsible AI.