This article presents a groundbreaking framework for understanding AI models in medical imaging, leveraging generative AI and interdisciplinary expert review to identify and interpret visual cues associated with model predictions. The framework operates in four stages: classifier training, StylEx training, automatic attribute selection, and expert panel review. By applying this approach to three imaging modalities – external eye photographs, fundus photos, and chest X-rays – the researchers were able to identify both known and novel visual attributes that drive ML decisions. The study demonstrates the potential of generative models to enhance the explainability of ML models in medical imaging, and highlights the importance of interdisciplinary collaboration to ensure rigorous interpretation and reduce bias. The framework has far-reaching implications for improving medical diagnostics and addressing biases in healthcare.

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