用最小证据生成可解释的医学诊断说明,让AI决策更可信。
Med-CAM: Minimal Evidence for Explaining Medical Decision Making

- 通过匹配分类器激活,训练分割网络生成最小关键区域
- 解释结果精准匹配模型预测,比传统方法更清晰聚焦
- 适合病理、影像等高风险医疗场景,提升医生信任
可靠的可解释决策在医学影像中至关重要,因为诊断结果直接影响患者治疗。尽管深度学习取得进展,多数医学AI系统仍为难以理解的黑箱,无法说明诊断依据。本文提出Med-CAM框架,通过分类器激活匹配(Classifier Activation Matching)生成最小且精确的视觉证据图,用于解释医学决策。该框架从零训练分割网络,为任意图像生成能反映模型决策关键证据的掩码,确保解释既忠实于模型行为,又便于临床医生理解。实验表明,与梯度加权类激活映射(Grad-CAM)和注意力图等传统空间解释方法相比,后者仅生成模糊的重要性区域,而Med-CAM凭借对形状、纹理和边界的更强空间感知,提供明确、基于证据的解释,并能准确复现模型预测。通过显式约束解释区域紧凑、符合模型激活模式及诊断一致性,Med-CAM推动透明化AI发展,增强医生在病理学和放射学等高风险应用中的理解和信任。
原文摘要 · Abstract (English)
Reliable and interpretable decision-making is essential in medical imaging, where diagnostic outcomes directly influence patient care. Despite advances in deep learning, most medical AI systems operate as opaque black boxes, providing little insight into why a particular diagnosis was reached. In this paper, we introduce Med-CAM, a framework for generating minimal and sharp maps as evidence-based explanations for Medical decision making via Classifier Activation Matching. Med-CAM trains a segmentation network from scratch to produce a mask that highlights the minimal evidence critical to model's decision for any seen or unseen image. This ensures that the explanation is both faithful to the network's behaviour and interpretable to clinicians. Experiments show, unlike prior spatial explanation methods, such as Grad-CAM and attention maps, which yield only fuzzy regions of relative importance, Med-CAM with its superior spatial awareness to shapes, textures, and boundaries, delivers conclusive, evidence-based explanations that faithfully replicate the model's prediction for any given image. By explicitly constraining explanations to be compact, consistent with model activations, and diagnostic alignment, Med-CAM advances transparent AI to foster clinician understanding and trust in high-stakes medical applications such as pathology and radiology.
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