From Blackbox to Explainable AI in Healthcare: Existing Tools and Case Studies

Introduction. Artificial intelligence (AI) models have been employed to automate decision-making, from commerce to more critical fields directly affecting human lives, including healthcare. Although the vast majority of these proposed AI systems are considered black box models that lack explainability, there is an increasing trend of attempting to create medical explainable Artificial Intelligence (XAI) systems using approaches such as attention mechanisms and surrogate models. An AI system is said to be explainable if humans can tell how the system reached its decision. Various XAI-driven healthcare approaches and their performances in the current study are discussed. The toolkits used in local and global post hoc explainability and the multiple techniques for explainability pertaining the Rational, Data, and Performance explainability are discussed in the current study. Methods. The explainability of the artificial intelligence model in the healthcare domain is implemented through the Local Interpretable Model-Agnostic Explanations and Shapley Additive Explanations for better comprehensibility of the internal working mechanism of the original AI models and the correlation among the feature set that influences decision of the model. Results. The current state-of-the-art XAI-based and future technologies through XAI are reported on research findings in various implementation aspects, including research challenges and limitations of existing models. The role of XAI in the healthcare domain ranging from the earlier prediction of future illness to the disease’s smart diagnosis is discussed. The metrics considered in evaluating the model’s explainability are presented, along with various explainability tools. Three case studies about the role of XAI in the healthcare domain with their performances are incorporated for better comprehensibility. Conclusion. The future perspective of XAI in healthcare will assist in obtaining research insight in the healthcare domain.