Research Papers

Model interpretability is crucial for establishing AI safety and clinician trust in medical applications for example, in survival modelling with competing risks. Recent deep learning models have attained very good predictive performance but their limited transparency, being black-box models, hinders their integration into clinical practice. To address this gap, we propose an intrinsically interpretable survival model called CRISPNAM-FG. Leveraging the structure of Neural Additive Models (NAMs) with separate projection vectors for each risk, our approach predicts the Cumulative Incidence Function using the Fine-Gray formulation, achieving high predictive power with intrinsically transparent and auditable predictions. We validated the model on several benchmark datasets and applied our model to predict future foot complications in diabetic patients across 29 Ontario hospitals (2016-2023). Our method achieves competitive performance compared to other deep survival models while providing transparency through shape functions and feature importance plots.

We developed an explainable deep learning framework integrating protein-protein interaction (PPI) network centrality metrics with node embeddings for cancer therapeutic target prioritization. A high-confidence PPI network was constructed from STRING database interactions, computing six centrality metrics: degree, strength, betweenness, closeness, eigenvector centrality, and clustering coefficient. Node2Vec embeddings captured latent network topology. Combined features trained XGBoost and neural network classifiers using DepMap CRISPR essentiality scores as ground truth. Model interpretability was assessed through GradientSHAP analysis quantifying feature contributions. We developed a novel blended scoring approach combining model probability predictions with SHAP attribution magnitudes for enhanced gene prioritization. Our framework achieved state-of-the-art performance with AUROC of 0.930 and AUPRC of 0.656 for identifying the top 10\% most essential genes. GradientSHAP analysis revealed centrality measures contributed significantly to predictions, with degree centrality showing strongest correlation ($ρ$ = -0.357) with gene essentiality. The blended scoring approach created robust gene prioritization rankings, successfully identifying known essential genes including ribosomal proteins (RPS27A, RPS17, RPS6) and oncogenes (MYC). This study presents a human-based, combinatorial in silico framework successfully integrating network biology with explainable AI for therapeutic target discovery. The framework provides mechanistic transparency through feature attribution analysis while maintaining state-of-the-art predictive performance. Its reproducible design and reliance on human molecular datasets demonstrate a reduction-to-practice example of next-generation, animal-free modeling for cancer therapeutic target discovery and prioritization.

Conventional, classification-based AI-generated image detection methods cannot explain why an image is considered real or AI-generated in a way a human expert would, which reduces the trustworthiness and persuasiveness of these detection tools for real-world applications. Leveraging Multimodal Large Language Models (MLLMs) has recently become a trending solution to this issue. Further, to evaluate the quality of generated explanations, a common approach is to adopt an "MLLM as a judge" methodology to evaluate explanations generated by other MLLMs. However, how well those MLLMs perform when judging explanations for AI-generated image detection generated by themselves or other MLLMs has not been well studied. We therefore propose \textbf{XAIGID-RewardBench}, the first benchmark designed to evaluate the ability of current MLLMs to judge the quality of explanations about whether an image is real or AI-generated. The benchmark consists of approximately 3,000 annotated triplets sourced from various image generation models and MLLMs as policy models (detectors) to assess the capabilities of current MLLMs as reward models (judges). Our results show that the current best reward model scored 88.76\% on this benchmark (while human inter-annotator agreement reaches 98.30\%), demonstrating that a visible gap remains between the reasoning abilities of today's MLLMs and human-level performance. In addition, we provide an analysis of common pitfalls that these models frequently encounter. Code and benchmark are available at https://github.com/RewardBench/XAIGID-RewardBench.

Multiple instance learning (MIL) has emerged as the dominant paradigm for whole slide image (WSI) analysis in computational pathology, achieving strong diagnostic performance through patch-level feature aggregation. However, existing MIL methods face critical limitations: (1) they rely on attention mechanisms that lack causal interpretability, and (2) they fail to integrate patient demographics (age, gender, race), leading to fairness concerns across diverse populations. These shortcomings hinder clinical translation, where algorithmic bias can exacerbate health disparities. We introduce \textbf{MeCaMIL}, a causality-aware MIL framework that explicitly models demographic confounders through structured causal graphs. Unlike prior approaches treating demographics as auxiliary features, MeCaMIL employs principled causal inference -- leveraging do-calculus and collider structures -- to disentangle disease-relevant signals from spurious demographic correlations. Extensive evaluation on three benchmarks demonstrates state-of-the-art performance across CAMELYON16 (ACC/AUC/F1: 0.939/0.983/0.946), TCGA-Lung (0.935/0.979/0.931), and TCGA-Multi (0.977/0.993/0.970, five cancer types). Critically, MeCaMIL achieves superior fairness -- demographic disparity variance drops by over 65% relative reduction on average across attributes, with notable improvements for underserved populations. The framework generalizes to survival prediction (mean C-index: 0.653, +0.017 over best baseline across five cancer types). Ablation studies confirm causal graph structure is essential -- alternative designs yield 0.048 lower accuracy and 4.2x times worse fairness. These results establish MeCaMIL as a principled framework for fair, interpretable, and clinically actionable AI in digital pathology. Code will be released upon acceptance.

Post-hoc explainability methods are a subset of Machine Learning (ML) that aim to provide a reason for why a model behaves in a certain way. In this paper, we show a new black-box model-agnostic adversarial attack for post-hoc explainable Artificial Intelligence (XAI), particularly in the image domain. The goal of the attack is to modify the original explanations while being undetected by the human eye and maintain the same predicted class. In contrast to previous methods, we do not require any access to the model or its weights, but only to the model's computed predictions and explanations. Additionally, the attack is accomplished in a single step while significantly changing the provided explanations, as demonstrated by empirical evaluation. The low requirements of our method expose a critical vulnerability in current explainability methods, raising concerns about their reliability in safety-critical applications. We systematically generate attacks based on the explanations generated by post-hoc explainability methods (saliency maps, integrated gradients, and DeepLIFT SHAP) for pretrained ResNet-18 and ViT-B16 on ImageNet. The results show that our attacks could lead to dramatically different explanations without changing the predictive probabilities. We validate the effectiveness of our attack, compute the induced change based on the explanation with mean absolute difference, and verify the closeness of the original image and the corrupted one with the Structural Similarity Index Measure (SSIM).

Artificial intelligence has shown promise in medical imaging, yet most existing systems lack flexibility, interpretability, and adaptability - challenges especially pronounced in ophthalmology, where diverse imaging modalities are essential. We present EyeAgent, the first agentic AI framework for comprehensive and interpretable clinical decision support in ophthalmology. Using a large language model (DeepSeek-V3) as its central reasoning engine, EyeAgent interprets user queries and dynamically orchestrates 53 validated ophthalmic tools across 23 imaging modalities for diverse tasks including classification, segmentation, detection, image/report generation, and quantitative analysis. Stepwise ablation analysis demonstrated a progressive improvement in diagnostic accuracy, rising from a baseline of 69.71% (using only 5 general tools) to 80.79% when the full suite of 53 specialized tools was integrated. In an expert rating study on 200 real-world clinical cases, EyeAgent achieved 93.7% tool selection accuracy and received expert ratings of more than 88% across accuracy, completeness, safety, reasoning, and interpretability. In human-AI collaboration, EyeAgent matched or exceeded the performance of senior ophthalmologists and, when used as an assistant, improved overall diagnostic accuracy by 18.51% and report quality scores by 19%, with the greatest benefit observed among junior ophthalmologists. These findings establish EyeAgent as a scalable and trustworthy AI framework for ophthalmology and provide a blueprint for modular, multimodal, and clinically aligned next-generation AI systems.

ProbLog4Fairness: A Neurosymbolic Approach to Modeling and Mitigating Bias

Rik Adriaensen, Lucas Van Praet, Jessa Bekker +3

Operationalizing definitions of fairness is difficult in practice, as multiple definitions can be incompatible while each being arguably desirable. Instead, it may be easier to directly describe algorithmic bias through ad-hoc assumptions specific to a particular real-world task, e.g., based on background information on systemic biases in its context. Such assumptions can, in turn, be used to mitigate this bias during training. Yet, a framework for incorporating such assumptions that is simultaneously principled, flexible, and interpretable is currently lacking. Our approach is to formalize bias assumptions as programs in ProbLog, a probabilistic logic programming language that allows for the description of probabilistic causal relationships through logic. Neurosymbolic extensions of ProbLog then allow for easy integration of these assumptions in a neural network's training process. We propose a set of templates to express different types of bias and show the versatility of our approach on synthetic tabular datasets with known biases. Using estimates of the bias distortions present, we also succeed in mitigating algorithmic bias in real-world tabular and image data. We conclude that ProbLog4Fairness outperforms baselines due to its ability to flexibly model the relevant bias assumptions, where other methods typically uphold a fixed bias type or notion of fairness.

Wildfires pose a significant global threat to ecosystems worldwide, with California experiencing recurring fires due to various factors, including climate, topographical features, vegetation patterns, and human activities. This study aims to develop a comprehensive wildfire risk map for California by applying the random forest (RF) algorithm, augmented with Explainable Artificial Intelligence (XAI) through Shapley Additive exPlanations (SHAP), to interpret model predictions. Model performance was assessed using both spatial and temporal validation strategies. The RF model demonstrated strong predictive performance, achieving near-perfect discrimination for grasslands (AUC = 0.996) and forests (AUC = 0.997). Spatial cross-validation revealed moderate transferability, yielding ROC-AUC values of 0.6155 for forests and 0.5416 for grasslands. In contrast, temporal split validation showed enhanced generalization, especially for forests (ROC-AUC = 0.6615, PR-AUC = 0.8423). SHAP-based XAI analysis identified key ecosystem-specific drivers: soil organic carbon, tree cover, and Normalized Difference Vegetation Index (NDVI) emerged as the most influential in forests, whereas Land Surface Temperature (LST), elevation, and vegetation health indices were dominant in grasslands. District-level classification revealed that Central Valley and Northern Buttes districts had the highest concentration of high-risk grasslands, while Northern Buttes and North Coast Redwoods dominated forested high-risk areas. This RF-SHAP framework offers a robust, comprehensible, and adaptable method for assessing wildfire risks, enabling informed decisions and creating targeted strategies to mitigate dangers.

Deep learning models have been successful in many areas but understanding their behaviors still remains a black-box. Most prior explainable AI (XAI) approaches have focused on interpreting and explaining how models make predictions. In contrast, we would like to understand how data can be explained with deep learning model training and propose a novel approach to understand the data via one of the most common media - language - so that humans can easily understand. Our approach proposes a pipeline to generate textual descriptions that can explain the data with large language models by incorporating external knowledge bases. However, generated data descriptions may still include irrelevant information, so we introduce to exploit influence estimation to choose the most informative textual descriptions, along with the CLIP score. Furthermore, based on the phenomenon of cross-modal transferability, we propose a novel benchmark task named cross-modal transfer classification to examine the effectiveness of our textual descriptions. In the experiment of zero-shot setting, we show that our textual descriptions are more effective than other baseline descriptions, and furthermore, we successfully boost the performance of the model trained only on images across all nine image classification datasets. These results are further supported by evaluation using GPT-4o. Through our approach, we may gain insights into the inherent interpretability of the decision-making process of the model.

Wolff-Parkinson-White (WPW) syndrome is a cardiac electrophysiology (EP) disorder caused by the presence of an accessory pathway (AP) that bypasses the atrioventricular node, faster ventricular activation rate, and provides a substrate for atrio-ventricular reentrant tachycardia (AVRT). Accurate localization of the AP is critical for planning and guiding catheter ablation procedures. While traditional diagnostic tree (DT) methods and more recent machine learning (ML) approaches have been proposed to predict AP location from surface electrocardiogram (ECG), they are often constrained by limited anatomical localization resolution, poor interpretability, and the use of small clinical datasets. In this study, we present a Deep Learning (DL) model for the localization of single manifest APs across 24 cardiac regions, trained on a large, physiologically realistic database of synthetic ECGs generated using a personalized virtual heart model. We also integrate eXplainable Artificial Intelligence (XAI) methods, Guided Backpropagation, Grad-CAM, and Guided Grad-CAM, into the pipeline. This enables interpretation of DL decision-making and addresses one of the main barriers to clinical adoption: lack of transparency in ML predictions. Our model achieves localization accuracy above 95%, with a sensitivity of 94.32% and specificity of 99.78%. XAI outputs are physiologically validated against known depolarization patterns, and a novel index is introduced to identify the most informative ECG leads for AP localization. Results highlight lead V2 as the most critical, followed by aVF, V1, and aVL. This work demonstrates the potential of combining cardiac digital twins with explainable DL to enable accurate, transparent, and non-invasive AP localization.

Cultural infrastructures, such as libraries, museums, theaters, and galleries, support learning, civic life, health, and local economies, yet access is uneven across cities. We present a novel, scalable, and open-data framework to measure spatial equity in cultural access. We map cultural infrastructures and compute a metric called Cultural Infrastructure Accessibility Score (CIAS) using exponential distance decay at fine spatial resolution, then aggregate the score per capita and integrate socio-demographic indicators. Interpretable tree-ensemble models with SHapley Additive exPlanation (SHAP) are used to explain associations between accessibility, income, density, and tract-level racial/ethnic composition. Results show a pronounced core-periphery gradient, where non-library cultural infrastructures cluster near urban cores, while libraries track density and provide broader coverage. Non-library accessibility is modestly higher in higher-income tracts, and library accessibility is slightly higher in denser, lower-income areas.

The financial industry faces a significant challenge modeling and risk portfolios: balancing the predictability of advanced machine learning models, neural network models, and explainability required by regulatory entities (such as Office of the Comptroller of the Currency, Consumer Financial Protection Bureau). This paper intends to fill the gap in the application between these "black box" models and explainability frameworks, such as LIME and SHAP. Authors elaborate on the application of these frameworks on different models and demonstrates the more complex models with better prediction powers could be applied and reach the same level of the explainability, using SHAP and LIME. Beyond the comparison and discussion of performances, this paper proposes a novel five dimensional framework evaluating Inherent Interpretability, Global Explanations, Local Explanations, Consistency, and Complexity to offer a nuanced method for assessing and comparing model explainability beyond simple accuracy metrics. This research demonstrates the feasibility of employing sophisticated, high performing ML models in regulated financial environments by utilizing modern explainability techniques and provides a structured approach to evaluate the crucial trade offs between model performance and interpretability.