让脑神经AI解释更贴近临床需求,提升治疗效果与信任度。
Clinically Meaningful Explainability for NeuroAI: An ethical, technical, and clinical perspective
- 聚焦临床可用的解释,而非技术细节堆砌。
- 提出神经刺激设备可落地的可视化设计框架。
- 适合医疗开发者与监管机构参考,推动伦理合规应用。
尽管可解释人工智能(XAI)常被视作提升精神与神经系统疾病闭环神经技术透明度和可信度的关键,但其在实际中的应用仍十分有限。现有XAI方法提供的解释类型往往与临床医生的实际需求不符。本文主张,在神经科技领域,临床有意义的可解释性(CME)至关重要,需从伦理、技术和临床三方面协同推进。临床医生更关注具有行动意义的解释,如输入输出关系与特征重要性的清晰呈现,而非全貌的技术透明。过度技术化解释反而造成信息过载。因此,我们提出一种名为NeuroXplain的参考架构,将CME转化为未来神经刺激设备可执行的设计建议,旨在指导行业与监管机构,确保解释满足正确利益相关方的真实需求,最终实现更优患者治疗与照护。
原文摘要 · Abstract (English)
While explainable AI (XAI) is often heralded as a means to enhance transparency and trustworthiness in closed-loop neurotechnology for psychiatric and neurological conditions, its real-world prevalence remains low. Moreover, empirical evidence suggests that the type of explanations provided by current XAI methods often fails to align with clinicians' end-user needs. In this viewpoint, we argue that clinically meaningful explainability (CME) is essential for AI-enabled closed-loop medical neurotechnology and must be addressed from an ethical, technical, and clinical perspective. Instead of exhaustive technical detail, clinicians prioritize clinically relevant, actionable explanations, such as clear representations of input-output relationships and feature importance. Full technical transparency, although theoretically desirable, often proves irrelevant or even overwhelming in practice, as it may lead to informational overload. Therefore, we advocate for CME in the neurotechnology domain: prioritizing actionable clarity over technical completeness and designing interface visualizations that intuitively map AI outputs and key features into clinically meaningful formats. To this end, we introduce a reference architecture called NeuroXplain, which translates CME into actionable technical design recommendations for any future neurostimulation device. Our aim is to inform stakeholders working in neurotechnology and regulatory framework development to ensure that explainability fulfills the right needs for the right stakeholders and ultimately leads to better patient treatment and care.
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