arXiv:2603.18752cs.CVcs.AI2026-03

用极少标注解释生成胸部X光多标签分类的可信自然语言解释。

WeNLEX: Weakly Supervised Natural Language Explanations for Multilabel Chest X-ray Classification

  • 弱监督框架通过图像与解释生成的匹配确保推理忠实性。
  • 仅需每诊断5条真实解释,即可生成可信且合理的解释。
  • 支持医生与普通人两种版本,可适配不同受众。

自然语言解释以人类可理解的方式揭示黑箱模型决策,贴近放射科医生的报告习惯。现有方法依赖大量人工标注解释进行显式监督,导致生成解释虽合理却未必忠实于模型推理。本文提出WeNLEX,一种弱监督的多标签胸部X光分类自然语言解释生成模型。通过将解释生成的图像与原图在黑箱模型特征空间中匹配,保证解释的忠实性;同时利用少量临床医生标注的解释数据库进行分布对齐,维持解释的合理性。实验表明,WeNLEX在多个指标上均表现优异,仅需每诊断5条真实解释即可生成高质量解释。该模型支持后处理与联合训练两种模式,在联合训练时使分类AUC提升2.21%。此外,通过更换解释数据库,WeNLEX可轻松适配不同用户群体,我们展示了面向非医学用户的简化版解释生成能力。

原文摘要 · Abstract (English)

Natural language explanations provide an inherently human-understandable way to explain black-box models, closely reflecting how radiologists convey their diagnoses in textual reports. Most works explicitly supervise the explanation generation process using datasets annotated with explanations. Thus, though plausible, the generated explanations are not faithful to the model's reasoning. In this work, we propose WeNLEX, a weakly supervised model for the generation of natural language explanations for multilabel chest X-ray classification. Faithfulness is ensured by matching images generated from their corresponding natural language explanations with original images, in the black-box model's feature space. Plausibility is maintained via distribution alignment with a small database of clinician-annotated explanations. We empirically demonstrate, through extensive validation on multiple metrics to assess faithfulness, simulatability, diversity, and plausibility, that WeNLEX is able to produce faithful and plausible explanations, using as little as 5 ground-truth explanations per diagnosis. Furthermore, WeNLEX can operate in both post-hoc and in-model settings. In the latter, i.e., when the multilabel classifier is trained together with the rest of the network, WeNLEX improves the classification AUC of the standalone classifier by 2.21%, thus showing that adding interpretability to the training process can actually increase the downstream task performance. Additionally, simply by changing the database, WeNLEX explanations are adaptable to any target audience, and we showcase this flexibility by training a layman version of WeNLEX, where explanations are simplified for non-medical users.

医疗AI自然语言解释弱监督多标签分类

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