This paper focuses on the use of local Explainable Artificial Intelligence (XAI) methods, particularly the Local Rule-Based Explanations (LORE) technique, within healthcare and medical settings. It emphasizes the critical role of interpretability and transparency in AI systems for diagnosing diseases, predicting patient outcomes, and creating personalized treatment plans. While acknowledging the complexities and inherent trade-offs between interpretability and model performance, our work underscores the significance of local XAI methods in enhancing decision-making processes in healthcare. By providing granular, case-specific insights, local XAI methods like LORE enhance physicians’ and patients’ understanding of machine learning models and their outcome. Our paper reviews significant contributions to local XAI in healthcare, highlighting its potential to improve clinical decision making, ensure fairness, and comply with regulatory standards.

A crucial challenge in critical settings like medical diagnosis is making deep learning models used in decision-making systems interpretable. Efforts in Explainable Artificial Intelligence (XAI) are underway to address this challenge. Yet, many XAI methods are evaluated on broad classifiers and fail to address complex, real-world issues, such as medical diagnosis. In our study, we focus on enhancing user trust and confidence in automated AI decision-making systems, particularly for diagnosing skin lesions, by tailoring an XAI method to explain an AI model’s ability to identify various skin lesion types. We generate explanations using synthetic images of skin lesions as examples and counterexamples, offering a method for practitioners to pinpoint the critical features influencing the classification outcome. A validation survey involving domain experts, novices, and laypersons has demonstrated that explanations increase trust and confidence in the automated decision system. Furthermore, our exploration of the model’s latent space reveals clear separations among the most common skin lesion classes, a distinction that likely arises from the unique characteristics of each class and could assist in correcting frequent misdiagnoses by human professionals.

A key issue in critical contexts such as medical diagnosis is the interpretability of the deep learning models adopted in decision-making systems. Research in eXplainable Artificial Intelligence (XAI) is trying to solve this issue. However, often XAI approaches are only tested on generalist classifier and do not represent realistic problems such as those of medical diagnosis. In this paper, we aim at improving the trust and confidence of users towards automatic AI decision systems in the field of medical skin lesion diagnosis by customizing an existing XAI approach for explaining an AI model able to recognize different types of skin lesions. The explanation is generated through the use of synthetic exemplar and counter-exemplar images of skin lesions and our contribution offers the practitioner a way to highlight the crucial traits responsible for the classification decision. A validation survey with domain experts, beginners, and unskilled people shows that the use of explanations improves trust and confidence in the automatic decision system. Also, an analysis of the latent space adopted by the explainer unveils that some of the most frequent skin lesion classes are distinctly separated. This phenomenon may stem from the intrinsic characteristics of each class and may help resolve common misclassifications made by human experts.