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Explainable AI in medicine: challenges of integrating XAI into the future clinical routine.

作者信息

Räz Tim, Pahud De Mortanges Aurélie, Reyes Mauricio

机构信息

Institute of Philosophy, University of Bern, Bern, Switzerland.

ARTORG Center for Biomedical Research, University of Bern, Bern, Switzerland.

出版信息

Front Radiol. 2025 Aug 5;5:1627169. doi: 10.3389/fradi.2025.1627169. eCollection 2025.


DOI:10.3389/fradi.2025.1627169
PMID:40896521
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12391920/
Abstract

Future AI systems may need to provide medical professionals with explanations of AI predictions and decisions. While current XAI methods match these requirements in principle, they are too inflexible and not sufficiently geared toward clinicians' needs to fulfill this role. This paper offers a conceptual roadmap for how XAI may be integrated into future medical practice. We identify three desiderata of increasing difficulty: First, explanations need to be provided in a context- and user-dependent manner. Second, explanations need to be created through a genuine dialogue between AI and human users. Third, AI systems need genuine social capabilities. We use an imaginary stroke treatment scenario as a foundation for our roadmap to explore how the three challenges emerge at different stages of clinical practice. We provide definitions of key concepts such as genuine dialogue and social capability, we discuss why these capabilities are desirable, and we identify major roadblocks. Our goal is to help practitioners and researchers in developing future XAI that is capable of operating as a participant in complex medical environments. We employ an interdisciplinary methodology that integrates medical XAI, medical practice, and philosophy.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/011c/12391920/c1769b318af2/fradi-05-1627169-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/011c/12391920/b083b9b1561d/fradi-05-1627169-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/011c/12391920/c1769b318af2/fradi-05-1627169-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/011c/12391920/b083b9b1561d/fradi-05-1627169-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/011c/12391920/c1769b318af2/fradi-05-1627169-g002.jpg

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本文引用的文献

[1]
Predicting and explaining with machine learning models: Social science as a touchstone.

Stud Hist Philos Sci. 2023-10-28

[2]
Evaluating Explainable Artificial Intelligence (XAI) techniques in chest radiology imaging through a human-centered Lens.

PLoS One. 2024

[3]
Orchestrating explainable artificial intelligence for multimodal and longitudinal data in medical imaging.

NPJ Digit Med. 2024-7-22

[4]
ML interpretability: Simple isn't easy.

Stud Hist Philos Sci. 2024-2

[5]
Intravenous Thrombolysis for Acute Ischemic Stroke in Patients With Recent Direct Oral Anticoagulant Use: A Systematic Review and Meta-Analysis.

J Am Heart Assoc. 2023-12-19

[6]
A scoping review of interpretability and explainability concerning artificial intelligence methods in medical imaging.

Eur J Radiol. 2023-12

[7]
Can we improve healthcare with centralized management systems, supported by information technology, predictive analytics, and real-time data?: A review.

Medicine (Baltimore). 2023-11-10

[8]
Machines and empathy in medicine.

Lancet. 2023-10-21

[9]
The enlightening role of explainable artificial intelligence in medical & healthcare domains: A systematic literature review.

Comput Biol Med. 2023-11

[10]
Comparison of Diagnostic and Triage Accuracy of Ada Health and WebMD Symptom Checkers, ChatGPT, and Physicians for Patients in an Emergency Department: Clinical Data Analysis Study.

JMIR Mhealth Uhealth. 2023-10-3

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