arXiv:2603.24828cs.LGcs.AI2026-03

对比多种方法,发现注意力机制最适合作时序临床模型解释。

A Practical Guide Towards Interpreting Time-Series Deep Clinical Predictive Models: A Reproducibility Study

  • 用注意力机制可高效准确解释临床预测模型。
  • LIME和KernelSHAP在时序任务中计算成本过高无法使用。
  • 多数解释方法可靠性差,不适合临床部署。

临床决策风险高,需明确解释,因此在部署前对深度临床模型进行可解释性审计至关重要。随着模型架构与解释方法日益丰富,关键问题仍存:注意力等结构特征是否提升可解释性?解释方法能否跨任务通用?现有基准常缺乏可扩展性与可复现性,且未系统考察临床任务与模型架构交互对可解释性的影响。为此,我们构建了一个涵盖多样临床预测任务与模型架构的全面基准评估。结果表明:(1)正确使用注意力机制是忠实解释模型预测的高效方式;(2)LIME和KernelSHAP等黑箱解释器在时序临床任务中计算不可行;(3)部分解释方法可靠性不足,难以信赖。基于此,我们提出改进临床预测流程可解释性的若干建议。为支持可复现与可扩展,所有代码通过PyHealth开源框架提供:https://github.com/sunlabuiuc/PyHealth。

原文摘要 · Abstract (English)

Clinical decisions are high-stakes and require explicit justification, making model interpretability essential for auditing deep clinical models prior to deployment. As the ecosystem of model architectures and explainability methods expands, critical questions remain: Do architectural features like attention improve explainability? Do interpretability approaches generalize across clinical tasks? While prior benchmarking efforts exist, they often lack extensibility and reproducibility, and critically, fail to systematically examine how interpretability varies across the interplay of clinical tasks and model architectures. To address these gaps, we present a comprehensive benchmark evaluating interpretability methods across diverse clinical prediction tasks and model architectures. Our analysis reveals that: (1) attention when leveraged properly is a highly efficient approach for faithfully interpreting model predictions; (2) black-box interpreters like KernelSHAP and LIME are computationally infeasible for time-series clinical prediction tasks; and (3) several interpretability approaches are too unreliable to be trustworthy. From our findings, we discuss several guidelines on improving interpretability within clinical predictive pipelines. To support reproducibility and extensibility, we provide our implementations via PyHealth, a well-documented open-source framework: https://github.com/sunlabuiuc/PyHealth.

临床预测可解释性时间序列注意力机制

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