Inherently Interpretable Multi-Label Classification Using Class-Specific Counterfactuals
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Abstract (arXiv)
Interpretability is essential for machine learning algorithms in high-stakes application fields such as medical image analysis. However, high-performing black-box neural networks do not provide explanations for their predictions, which can lead to mistrust and suboptimal human-ML collaboration. Post-hoc explanation techniques, which are widely used in practice, have been shown to suffer from severe conceptual problems. Furthermore, as we show in this paper, current explanation techniques do not perform adequately in the multi-label scenario, in which multiple medical findings may co-occur in a single image. We propose Attri-Net, an inherently interpretable model for multi-label classification. Attri-Net is a powerful classifier that provides transparent, trustworthy, and human-understandable explanations. The model first generates class-specific attribution maps based on counterfactuals to identify which image regions correspond to certain medical findings. Then a simple logistic regression classifier is used to make predictions based solely on these attribution maps. We compare Attri-Net to five post-hoc explanation techniques and one inherently interpretable classifier on three chest X-ray datasets. We find that Attri-Net produces high-quality multi-label explanations consistent with clinical knowledge and has comparable classification performance to state-of-the-art classification models.
Key facts. Cited by 10 papers in the map (data through 7 Oct 2026). Builds on 32 of its 44 references that are in the map. First posted on arXiv 1 Mar 2023.
Builds on
32 of 44 references.
References · 32
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20 more
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Built on by
Citing papers per year: 2023: 4; 2024: 3; 2025: 3.
10 papers.
- 2023Right for the Wrong Reason: Can Interpretable ML Techniques Detect Spurious Correlations?cited by 16
- 2024Robust image representations with counterfactual contrastive learningcited by 12
- 2024Counterfactual contrastive learning: robust representations via causal image synthesiscited by 11
- 2023A Framework for Interpretability in Machine Learning for Medical Imagingcited by 9
- 2025Conditional Diffusion Models are Medical Image Classifiers that Provide Explainability and Uncertainty for Freecited by 9
- 2025Label-free Concept Based Multiple Instance Learning for Gigapixel Histopathologycited by 8
- 2024DeCoDEx: Confounder Detector Guidance for Improved Diffusion-based Counterfactual Explanationscited by 6
- 2023Generating Realistic Counterfactuals for Retinal Fundus and OCT Images using Diffusion Modelscited by 3
- 2023Is visual explanation with Grad-CAM more reliable for deeper neural networks? a case study with automatic pneumothorax diagnosiscited by 2
- 2025DifCluE: Generating Counterfactual Explanations with Diffusion Autoencoders and modal clusteringcited by 1
- 2025DifCluE: Generating Counterfactual Explanations with Diffusion Autoencoders and modal clustering17 Feb 2025
- 2025Conditional Diffusion Models are Medical Image Classifiers that Provide Explainability and Uncertainty for Free6 Feb 2025
- 2025Label-free Concept Based Multiple Instance Learning for Gigapixel Histopathology6 Jan 2025
- 2024Robust image representations with counterfactual contrastive learning16 Sep 2024
- 2024DeCoDEx: Confounder Detector Guidance for Improved Diffusion-based Counterfactual Explanations15 May 2024
- 2024Counterfactual contrastive learning: robust representations via causal image synthesis14 Mar 2024
- 2023Generating Realistic Counterfactuals for Retinal Fundus and OCT Images using Diffusion Models20 Nov 2023
- 2023A Framework for Interpretability in Machine Learning for Medical Imaging2 Oct 2023
- 2023Is visual explanation with Grad-CAM more reliable for deeper neural networks? a case study with automatic pneumothorax diagnosis29 Aug 2023
- 2023Right for the Wrong Reason: Can Interpretable ML Techniques Detect Spurious Correlations?23 Jul 2023