Raghvendra Narain Tripathi, Dr. Arun Deep Singh, 2025. "Explainable AI (XAI) for the High-Stakes Decision of Healthcare" International Journal of Computer Science & Information Technology Volume 1, Issue 3: 1-11.
The application of Artificial Intelligence (AI) in healthcare has improved the diagnosis of diseases, forecasting outcomes and supported complex clinical decision making with intelligent systems. Yet the lack of transparency in a lot of AI models, especially those deep learning ones—which makes them hard to trust—presents an enormous safety and accountability problem, not least when lives are at stake. Now with the help of Explainable AI (XAI), we can fill this gap by providing an AI model that outputs explainable and interpretable results used for unbiased decision making. Abstract: The aim of this paper is to review the role of XAI in healthcare decision-making, investigate different interpretability methods reported so far and their impact on clinical research & practice with respect to real-world applications, and propose a framework to operationalize them into routine practice in the field of health care. We next present current challenges, regulatory issues and what research is needed in the future to develop AI that is not only effective but also morally appropriate in health.
[1] Adadi, A., & Berrada, M. (2018). Investigating Explainable AI: A Survey of Black-Box Explanations. IEEE Access, 6, 52138–52160.
[2] Ribeiro, M. T., Singh, S., & Guestrin, C. (2016). "Why should I trust you?": Explaining the predictions of any classifier. KDD, 1135–1144.
[3] Viswanath, B., Nagarajan, M., & Getoor, L. (2016). KDD Workshop Proceedings.
[4] Lundberg, S. M., & Lee, S.-I. (2017). A Unified Approach to Interpreting Model Predictions. NeurIPS, 30.
[5] Holzinger, A., et al. (2019). Is Artificial Intelligence Causable and Explainable in Medicine? Wiley Interdisciplinary Reviews: Data Mining and Knowledge Discovery, 9(4), e1312.
[6] Rajpurkar, P., et al. (2017). CheXNet: Radiologist-Level Pneumonia Detection on Chest X-Rays with Deep Learning. arXiv:1711.05225.
[7] Tonekaboni, S., et al. (2019). Explainable Machine Learning for Clinical End Use: The Clinician Perspective. Proceedings of Machine Learning Research, 106, 359–380.
[8] Arrieta, A. B., et al. (2020). SAAAKI: Semantic-Driven Approaches for Adaptive Experimentation in Explainable AI. Information Fusion, 58, 82–115.
[9] Ghassemi, M., Oakden-Rayner, L., & Beam, A. L. (2021). The Promise of Current Approaches to XAI in Health Care is Misleading. Lancet Digital Health, 3(11), e745–e750.
[10] Kelly, C. J., et al. (2019). The Promises and Pitfalls of AI for the Future of Medicine. Nature, 574, 208.
[11] Lipton, Z. C. (2018). The Mythos of Model Interpretability. Communications of the ACM, 61(10), 36–43.
[12] Caruana, R., et al. (2015). Interpretable Health Models: Predicting Pneumonia Risk and 30-Day Hospital Readmission. KDD, 1721–1730.
[13] Doshi-Velez, F., & Kim, B. (2017). Towards a Rigorous Science of Interpretable Machine Learning. arXiv:1702.08608.
[14] Samek, W., Wiegand, T., & Müller, K.-R. (2017). Explainable Artificial Intelligence: Understanding, Visualizing and Interpreting Deep Learning Models. arXiv:1708.08296.
[15] Rajkomar, A., et al. (2018). Scalable and Accurate Deep Learning with Electronic Health Records. npj Digital Medicine, 1(18).
[16] Esteva, A., et al. (2017). Dermatologist-Level Classification of Skin Cancer with Deep Neural Networks. Nature, 542, 115–118.
[17] Dovhalets, O., & Kacprzyk, J. (2021). Challenges of Explainable AI in Healthcare. AI in Medicine, 1(1), 45–57.
[18] European Union. (2018). General Data Protection Regulation (GDPR). Official Journal of the European Union.
[19] U.S. FDA. (2021). Artificial Intelligence/Machine Learning (AI/ML)-Based Software as a Medical Device (SaMD): Action Plan.
[20] Watson, D. S., et al. (2019). Clinical Applications of ML Algorithms: Beyond the Black Box. BMJ, 364, l886.
[21] Barredo Arrieta, A., et al. (2021). Explainable AI in Healthcare: A Survey. Artificial Intelligence in Medicine, 117, 102083.
[22] London, A. J. (2019). Artificial Intelligence and Black-Box Medical Decisions: Accuracy vs. Explainability. Hastings Center Report, 49, 15–21.
[23] Haibe-Kains, B., et al. (2020). Transparency and Reproducibility in Artificial Intelligence. Nature, 586, E14–E16.
[24] Holzinger, A., et al. (2020). Toward the Next Level of AI in Medicine. Nature Biomedical Engineering, 4(4), 370–379.
[25] Gilpin, L. H., et al. (2018). Explaining Explanations: An Overview of Interpretability of Machine Learning. IEEE DSAA, 80–89.
[26] Watson Health. (2019). IBM Watson for Oncology: Challenges and Learnings.
[27] Buhrmester, V., Münch, D., & Arens, M. (2021). Analysis of Explainers of Black-Box Deep Neural Networks for Computer Vision: A Survey. Machine Learning and Knowledge Extraction, 3, 966–989.
[28] Xie, Y., et al. (2020). Explainable Deep Learning: A Field Guide. Journal of Artificial Intelligence Research, 69, 1439–1482.
[29] Singh, R. P., et al. (2020). Deployment and Utility of Explainable AI in Ophthalmology. Comput Biol Med, 120, 103758.
[30] Chen, I. Y., et al. (2020). Machine Learning in Healthcare: Ethical Concerns. Annual Review of Biomedical Data Science, 3, 123–144.
[31] Azodi, C. B., et al. (2020). Interpretable Machine Learning for Geneticists. Trends in Genetics, 36(6), 442–455.
[32] Rajan, J., et al. (2022). Explanation-Oriented Algorithms in Digital Pathology. Computerized Medical Imaging and Graphics, 92, 101970.
[33] Kovalerchuk, B., & Vityaev, E. (2019). Human-Centric Explainable AI. Springer.
[34] Keane, M. T., & Smyth, B. (2020). Good Counterfactuals and Where to Find Them. IJCAI, 5934–5940.
[35] van der Waa, J., et al. (2018). Contrastive Explanations for Reinforcement Learning. AIES, 285–291.
[36] Hall, P. (2018). Thoughts on Interpretability: How to Put the Human in the Machine Side. Medium: Towards Data Science.
[37] Singh, S., et al. (2022). Benchmarking Explainable AI Methods for Time Series Classification. Data Mining and Knowledge Discovery, 36(5), 1602–1630.
[38] Zhang, Q., et al. (2020). Transparent CNNs on Reading Disease Images. IEEE Transactions on Medical Imaging, 39(12), 4075–4085.
[39] Baek, Y., et al. (2021). Interpretability in Medical AI for Clinical Practice. Nature Communications, 12, 5802.
[40] Topol, E. J. (2019). Deep Medicine: How Artificial Intelligence Can Make Healthcare Human Again. Basic Books.
[41] Gerke, S., Minssen, T., & Cohen, G. (2020). Ethical and Legal Issues with AI in Health Care. Cambridge Quarterly of Healthcare Ethics, 29(1), 61–73.
[42] Gunning, D. (2017). Explainable Artificial Intelligence (XAI). DARPA Program Overview.
[43] Miller, T. (2019). Explanation in Artificial Intelligence: Insights from the Social Sciences. Artificial Intelligence, 267, 1–38.
[44] Holzinger, A., et al. (2017). What Do We Need to Build Explainable AI Systems for Medical Applications? Biomedical Engineering Reviews, 10, 13–27.
[45] Danks, D., & London, A. J. (2017). Algorithmic Bias in Healthcare. Hastings Center Report, 47(1), 21–29.
[46] Poursabzi-Sangdeh, F., et al. (2021). Manipulating and Measuring Model Interpretability. CHI, 1–14.
[47] Amann, J., et al. (2020). Explainability for Artificial Intelligence in Healthcare: A Multidisciplinary Perspective. BMC Medical Informatics and Decision Making, 20, 310.
[48] Tjoa, E., & Guan, C. (2020). A Survey on Explainable AI: Towards Medical Transparency. Information Fusion, 70, 1–35.
[49] Campanella, G., et al. (2019). Clinical-Grade Computational Pathology Using Weakly Supervised Deep Learning. Nature Medicine, 25(8), 1301–1309.
[50] Ribeiro, M. T., et al. (2020). Anchors: High-Precision Model-Agnostic Explanations. AAAI, 1527–1535.
Explainable AI, Healthcare, Deep Learning, Interpretability, Clinical Decision Support, Medical Ethics, Black-Box Models.