arXiv:2608.28052cs.LGcs.AI2026-08中稿 · the 26th IEEE Inte…

让医疗AI不仅知道预测靠不靠谱,还知道哪里出问题了。

Explainable Uncertainty Estimation for Reliable Medical AI

论文配图:Explainable Uncertainty Estimation for Reliable Medical AI
图 1 · 摘自论文原文
  • 将不确定性估计与解释性结合,分解每项特征的贡献
  • 在多个数据集上提升预测可靠性,错误时降低信心
  • 适合临床医生信任医疗AI决策,需理解不确定原因

人工智能在临床决策中潜力巨大,但因缺乏可信度而应用受限。不确定性估计可警示不可靠预测,可解释AI(XAI)能说明预测依据,但现有方法各自独立,无法提供特征层面为何不确定或如何改进的指导。为此,我们提出可解释的不确定性估计,统一不确定性量化与特征级解释。引入期望梯度重建不确定性估计(egRUE),将预测解释融入不确定性计算,并分解为特征级贡献。理论上证明了egRUE性质,实验表明其优于现有方法,在多个医学数据集(包括MIMIC-III、National Trauma Data Bank)上提升了可靠性与可解释性。医学专家用户研究显示,egRUE的解释使校准后信任度显著提高:正确预测更自信,错误预测信心下降。通过融合预测不确定性与特征级解释,egRUE增强了高风险医疗场景下的决策支持,明确指出预测可能不可靠的环节及驱动因素。

原文摘要 · Abstract (English)

Artificial intelligence has strong potential to support clinical decision-making, yet its adoption in healthcare remains limited due to a lack of trust. Uncertainty estimation can signal unreliable predictions, and explainable AI (XAI) can clarify how predictions are made but existing methods treat them separately, providing no feature-level insight into why a prediction is uncertain or which tests to prioritize to reduce it. To address this gap, we propose explainable uncertainty estimation, which unifies uncertainty estimation and XAI to both quantify uncertainty and explain feature-level contributions. We introduce the Expected Gradients Reconstruction Uncertainty Estimate (egRUE), which incorporates prediction explanations into its uncertainty computation and decomposes uncertainty into feature-wise contributions. We prove theoretical properties of egRUE and show through experiments that it improves reliability and interpretability compared to existing methods. A user study with medical experts further demonstrates that egRUE's explanations improve calibrated trust over uncertainty scores alone, increasing confidence in correct predictions and reducing confidence in incorrect ones. By combining prediction uncertainty with feature-level explanations, egRUE strengthens decision-making support in safety-critical healthcare settings, clarifying both when predictions may be unreliable and which features drive that uncertainty.

医疗AI不确定性可解释性

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