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August 10, 2023AI272 citationsOpen Access

Explainable Artificial Intelligence (XAI): Concepts and Challenges in Healthcare

THTim Hulsen

Key Points

  • Review central concepts, applications, and challenges of explainable artificial intelligence (XAI) in healthcare to determine how algorithmic interpretability impacts clinical trust and adoption.
  • Narrative review synthesizing theoretical frameworks, practical applications, and limitations of explainable artificial intelligence across clinical domains.
  • Assessed specific healthcare use cases including clinical decision support systems, medical imaging interpretation, and diagnostic report analysis.
  • Identified algorithmic opacity ('black box' systems) as a primary operational risk that restricts clinician trust during high-stakes medical decision-making.
  • Characterized key technological and workflow barriers to deploying XAI in clinical settings and highlighted alternative validation pathways to enhance artificial intelligence reliability.

Abstract

Artificial Intelligence (AI) describes computer systems able to perform tasks that normally require human intelligence, such as visual perception, speech recognition, decision-making, and language translation. Examples of AI techniques are machine learning, neural networks, and deep learning. AI can be applied in many different areas, such as econometrics, biometry, e-commerce, and the automotive industry. In recent years, AI has found its way into healthcare as well, helping doctors make better decisions (“clinical decision support”), localizing tumors in magnetic resonance images, reading and analyzing reports written by radiologists and pathologists, and much more. However, AI has one big risk: it can be perceived as a “black box”, limiting trust in its reliability, which is a very big issue in an area in which a decision can mean life or death. As a result, the term Explainable Artificial Intelligence (XAI) has been gaining momentum. XAI tries to ensure that AI algorithms (and the resulting decisions) can be understood by humans. In this narrative review, we will have a look at some central concepts in XAI, describe several challenges around XAI in healthcare, and discuss whether it can really help healthcare to advance, for example, by increasing understanding and trust. Finally, alternatives to increase trust in AI are discussed, as well as future research possibilities in the area of XAI.

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Cite This Study

Tim Hulsen (2023) studied this question.

synapsesocial.com/papers/6a0c7e5463ad68335d234637https://doi.org/10.3390/ai4030034
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