Dermatologist-like explainable AI enhances trust and confidence in diagnosing melanoma.
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ABSTRACT:
SUBMITTER: Chanda T
PROVIDER: S-EPMC10789736 | biostudies-literature | 2024 Jan
REPOSITORIES: biostudies-literature
Publications
Dermatologist-like explainable AI enhances trust and confidence in diagnosing melanoma.
Chanda Tirtha T Hauser Katja K Hobelsberger Sarah S Bucher Tabea-Clara TC Garcia Carina Nogueira CN Wies Christoph C Kittler Harald H Tschandl Philipp P Navarrete-Dechent Cristian C Podlipnik Sebastian S Chousakos Emmanouil E Crnaric Iva I Majstorovic Jovana J Alhajwan Linda L Foreman Tanya T Peternel Sandra S Sarap Sergei S Özdemir İrem İ Barnhill Raymond L RL Llamas-Velasco Mar M Poch Gabriela G Korsing Sören S Sondermann Wiebke W Gellrich Frank Friedrich FF Heppt Markus V MV Erdmann Michael M Haferkamp Sebastian S Drexler Konstantin K Goebeler Matthias M Schilling Bastian B Utikal Jochen S JS Ghoreschi Kamran K Fröhling Stefan S Krieghoff-Henning Eva E Brinker Titus J TJ
Nature communications 20240115 1
Artificial intelligence (AI) systems have been shown to help dermatologists diagnose melanoma more accurately, however they lack transparency, hindering user acceptance. Explainable AI (XAI) methods can help to increase transparency, yet often lack precise, domain-specific explanations. Moreover, the impact of XAI methods on dermatologists' decisions has not yet been evaluated. Building upon previous research, we introduce an XAI system that provides precise and domain-specific explanations alon ...[more]
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Project description:BackgroundArtificial intelligence (AI) has significant potential in clinical practice. However, its "black box" nature can lead clinicians to question its value. The challenge is to create sufficient trust for clinicians to feel comfortable using AI, but not so much that they defer to it even when it produces results that conflict with their clinical judgment in ways that lead to incorrect decisions. Explainable AI (XAI) aims to address this by providing explanations of how AI algorithms reach their conclusions. However, it remains unclear whether such explanations foster an appropriate degree of trust to ensure the optimal use of AI in clinical practice.ObjectiveThis study aims to systematically review and synthesize empirical evidence on the impact of XAI on clinicians' trust in AI-driven clinical decision-making.MethodsA systematic review was conducted in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, searching PubMed and Web of Science databases. Studies were included if they empirically measured the impact of XAI on clinicians' trust using cognition- or affect-based measures. Out of 778 articles screened, 10 met the inclusion criteria. We assessed the risk of bias using standard tools appropriate to the methodology of each paper.ResultsThe risk of bias in all papers was moderate or moderate to high. All included studies operationalized trust primarily through cognitive-based definitions, with 2 also incorporating affect-based measures. Out of these, 5 studies reported that XAI increased clinicians' trust compared with standard AI, particularly when the explanations were clear, concise, and relevant to clinical practice. In addition, 3 studies found no significant effect of XAI on trust, and the presence of explanations does not automatically improve trust. Notably, 2 studies highlighted that XAI could either enhance or diminish trust, depending on the complexity and coherence of the provided explanations. The majority of studies suggest that XAI has the potential to enhance clinicians' trust in recommendations generated by AI. However, complex or contradictory explanations can undermine this trust. More critically, trust in AI is not inherently beneficial, as AI recommendations are not infallible. These findings underscore the nuanced role of explanation quality and suggest that trust can be modulated through the careful design of XAI systems.ConclusionsExcessive trust in incorrect advice generated by AI can adversely impact clinical accuracy, just as can happen when correct advice is distrusted. Future research should focus on refining both cognitive and affect-based measures of trust and on developing strategies to achieve an appropriate balance in terms of trust, preventing both blind trust and undue skepticism. Optimizing trust in AI systems is essential for their effective integration into clinical practice.
| S-EPMC11561425 | biostudies-literature
Project description:Artificial intelligence (AI) provides considerable opportunities to assist human work. However, one crucial challenge of human-AI collaboration is that many AI algorithms operate in a black-box manner where the way how the AI makes predictions remains opaque. This makes it difficult for humans to validate a prediction made by AI against their own domain knowledge. For this reason, we hypothesize that augmenting humans with explainable AI improves task performance in human-AI collaboration. To test this hypothesis, we implement explainable AI in the form of visual heatmaps in inspection tasks conducted by domain experts. Visual heatmaps have the advantage that they are easy to understand and help to localize relevant parts of an image. We then compare participants that were either supported by (a) black-box AI or (b) explainable AI, where the latter supports them to follow AI predictions when the AI is accurate or overrule the AI when the AI predictions are wrong. We conducted two preregistered experiments with representative, real-world visual inspection tasks from manufacturing and medicine. The first experiment was conducted with factory workers from an electronics factory, who performed [Formula: see text] assessments of whether electronic products have defects. The second experiment was conducted with radiologists, who performed [Formula: see text] assessments of chest X-ray images to identify lung lesions. The results of our experiments with domain experts performing real-world tasks show that task performance improves when participants are supported by explainable AI with heatmaps instead of black-box AI. We find that explainable AI as a decision aid improved the task performance by 7.7 percentage points (95% confidence interval [CI]: 3.3% to 12.0%, [Formula: see text]) in the manufacturing experiment and by 4.7 percentage points (95% CI: 1.1% to 8.3%, [Formula: see text]) in the medical experiment compared to black-box AI. These gains represent a significant improvement in task performance.
| S-EPMC11681242 | biostudies-literature
Project description:The accuracy and flexibility of artificial intelligence (AI) systems often comes at the cost of a decreased ability to offer an intuitive explanation of their predictions. This hinders trust and discourage adoption of AI in healthcare, exacerbated by concerns over liabilities and risks to patients' health in case of misdiagnosis. Providing an explanation for a model's prediction is possible due to recent advances in the field of interpretable machine learning. We considered a data set of hospital admissions linked to records of antibiotic prescriptions and susceptibilities of bacterial isolates. An appropriately trained gradient boosted decision tree algorithm, supplemented by a Shapley explanation model, predicts the likely antimicrobial drug resistance, with the odds of resistance informed by characteristics of the patient, admission data, and historical drug treatments and culture test results. Applying this AI-based system, we found that it substantially reduces the risk of mismatched treatment compared with the observed prescriptions. The Shapley values provide an intuitive association between observations/data and outcomes; the associations identified are broadly consistent with expectations based on prior knowledge from health specialists. The results, and the ability to attribute confidence and explanations, support the wider adoption of AI in healthcare.
| S-EPMC9931350 | biostudies-literature
Project description:Indecipherable black boxes are common in machine learning (ML), but applications increasingly require explainable artificial intelligence (XAI). The core of XAI is to establish transparent and interpretable data-driven algorithms. This work provides concrete tools for XAI in situations where prior knowledge must be encoded and untrustworthy inferences flagged. We use the "learn to optimize" (L2O) methodology wherein each inference solves a data-driven optimization problem. Our L2O models are straightforward to implement, directly encode prior knowledge, and yield theoretical guarantees (e.g. satisfaction of constraints). We also propose use of interpretable certificates to verify whether model inferences are trustworthy. Numerical examples are provided in the applications of dictionary-based signal recovery, CT imaging, and arbitrage trading of cryptoassets. Code and additional documentation can be found at https://xai-l2o.research.typal.academy .
| S-EPMC10284861 | biostudies-literature
Project description:Melanoma, one of the most dangerous types of skin cancer, results in a very high mortality rate. Early detection and resection are two key points for a successful cure. Recent researches have used artificial intelligence to classify melanoma and nevus and to compare the assessment of these algorithms to that of dermatologists. However, training neural networks on an imbalanced dataset leads to imbalanced performance, the specificity is very high but the sensitivity is very low. This study proposes a method for improving melanoma prediction on an imbalanced dataset by reconstructed appropriate CNN architecture and optimized algorithms. The contributions involve three key features as custom loss function, custom mini-batch logic, and reformed fully connected layers. In the experiment, the training dataset is kept up to date including 17,302 images of melanoma and nevus which is the largest dataset by far. The model performance is compared to that of 157 dermatologists from 12 university hospitals in Germany based on the same dataset. The experimental results prove that our proposed approach outperforms all 157 dermatologists and achieves higher performance than the state-of-the-art approach with area under the curve of 94.4%, sensitivity of 85.0%, and specificity of 95.0%. Moreover, using the best threshold shows the most balanced measure compare to other researches, and is promisingly application to medical diagnosis, with sensitivity of 90.0% and specificity of 93.8%. To foster further research and allow for replicability, we made the source code and data splits of all our experiments publicly available.
| S-EPMC8410796 | biostudies-literature
Project description:Explainable artificial intelligence (XAI) is of paramount importance to various domains, including healthcare, fitness, skill assessment, and personal assistants, to understand and explain the decision-making process of the artificial intelligence (AI) model. Smart homes embedded with smart devices and sensors enabled many context-aware applications to recognize physical activities. This study presents XAI-HAR, a novel XAI-empowered human activity recognition (HAR) approach based on key features identified from the data collected from sensors located at different places in a smart home. XAI-HAR identifies a set of new features (i.e., the total number of sensors used in a specific activity), as physical key features selection (PKFS) based on weighting criteria. Next, it presents statistical key features selection (SKFS) (i.e., mean, standard deviation) to handle the outliers and higher class variance. The proposed XAI-HAR is evaluated using machine learning models, namely, random forest (RF), K-nearest neighbor (KNN), support vector machine (SVM), decision tree (DT), naive Bayes (NB) and deep learning models such as deep neural network (DNN), convolution neural network (CNN), and CNN-based long short-term memory (CNN-LSTM). Experiments demonstrate the superior performance of XAI-HAR using RF classifier over all other machine learning and deep learning models. For explainability, XAI-HAR uses Local Interpretable Model Agnostic (LIME) with an RF classifier. XAI-HAR achieves 0.96% of F-score for health and dementia classification and 0.95 and 0.97% for activity recognition of dementia and healthy individuals, respectively.
| S-EPMC10033697 | biostudies-literature
Project description:In the high-stakes realm of critical care, where daily decisions are crucial and clear communication is paramount, comprehending the rationale behind Artificial Intelligence (AI)-driven decisions appears essential. While AI has the potential to improve decision-making, its complexity can hinder comprehension and adherence to its recommendations. "Explainable AI" (XAI) aims to bridge this gap, enhancing confidence among patients and doctors. It also helps to meet regulatory transparency requirements, offers actionable insights, and promotes fairness and safety. Yet, defining explainability and standardising assessments are ongoing challenges and balancing performance and explainability can be needed, even if XAI is a growing field.
| S-EPMC11391805 | biostudies-literature
Project description:During the 20th century, the discovery of modern vaccines and ensuing mass vaccination dramatically decreased the incidence of many infectious diseases and in some cases eliminated them. Despite this, we are now witnessing a decrease in vaccine confidence that threatens to reverse the progress made. Considering the different extents of low vaccine confidence in different countries of the world, both developed and developing, we aim to contribute to the discussion of the reasons for this, and to propose some viable scientific solutions to build or help restore vaccine confidence worldwide.
| S-EPMC7227637 | biostudies-literature
Project description:BackgroundDiagnosing genetic disorders requires extensive manual curation and interpretation of candidate variants, a labor-intensive task even for trained geneticists. Although artificial intelligence (AI) shows promise in aiding these diagnoses, existing AI tools have only achieved moderate success for primary diagnosis.MethodsAI-MARRVEL (AIM) uses a random-forest machine-learning classifier trained on over 3.5 million variants from thousands of diagnosed cases. AIM additionally incorporates expert-engineered features into training to recapitulate the intricate decision-making processes in molecular diagnosis. The online version of AIM is available at https://ai.marrvel.org. To evaluate AIM, we benchmarked it with diagnosed patients from three independent cohorts.ResultsAIM improved the rate of accurate genetic diagnosis, doubling the number of solved cases as compared with benchmarked methods, across three distinct real-world cohorts. To better identify diagnosable cases from the unsolved pools accumulated over time, we designed a confidence metric on which AIM achieved a precision rate of 98% and identified 57% of diagnosable cases out of a collection of 871 cases. Furthermore, AIM's performance improved after being fine-tuned for targeted settings including recessive disorders and trio analysis. Finally, AIM demonstrated potential for novel disease gene discovery by correctly predicting two newly reported disease genes from the Undiagnosed Diseases Network.ConclusionsAIM achieved superior accuracy compared with existing methods for genetic diagnosis. We anticipate that this tool may aid in primary diagnosis, reanalysis of unsolved cases, and the discovery of novel disease genes. (Funded by the NIH Common Fund and others.).
| S-EPMC11221788 | biostudies-literature
Project description:The black-box nature of most artificial intelligence (AI) models encourages the development of explainability methods to engender trust into the AI decision-making process. Such methods can be broadly categorized into two main types: post hoc explanations and inherently interpretable algorithms. We aimed at analyzing the possible associations between COVID-19 and the push of explainable AI (XAI) to the forefront of biomedical research. We automatically extracted from the PubMed database biomedical XAI studies related to concepts of causality or explainability and manually labeled 1,603 papers with respect to XAI categories. To compare the trends pre- and post-COVID-19, we fit a change point detection model and evaluated significant changes in publication rates. We show that the advent of COVID-19 in the beginning of 2020 could be the driving factor behind an increased focus concerning XAI, playing a crucial role in accelerating an already evolving trend. Finally, we present a discussion with future societal use and impact of XAI technologies and potential future directions for those who pursue fostering clinical trust with interpretable machine learning models.
| S-EPMC10500028 | biostudies-literature