Towards Trustable Skin Cancer Diagnosis via Rewriting Model's Decision
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Abstract (arXiv)
Deep neural networks have demonstrated promising performance on image recognition tasks. However, they may heavily rely on confounding factors, using irrelevant artifacts or bias within the dataset as the cue to improve performance. When a model performs decision-making based on these spurious correlations, it can become untrustable and lead to catastrophic outcomes when deployed in the real-world scene. In this paper, we explore and try to solve this problem in the context of skin cancer diagnosis. We introduce a human-in-the-loop framework in the model training process such that users can observe and correct the model's decision logic when confounding behaviors happen. Specifically, our method can automatically discover confounding factors by analyzing the co-occurrence behavior of the samples. It is capable of learning confounding concepts using easily obtained concept exemplars. By mapping the black-box model's feature representation onto an explainable concept space, human users can interpret the concept and intervene via first order-logic instruction. We systematically evaluate our method on our newly crafted, well-controlled skin lesion dataset and several public skin lesion datasets. Experiments show that our method can effectively detect and remove confounding factors from datasets without any prior knowledge about the category distribution and does not require fully annotated concept labels. We also show that our method enables the model to focus on clinical-related concepts, improving the model's performance and trustworthiness during model inference.
Key facts. Cited by 27 papers in the map (data through 7 Oct 2026). Builds on 29 of its 45 references that are in the map. First posted on arXiv 2 Mar 2023.
Builds on
29 of 45 references.
References · 29
- 2015Deep Residual Learning for Image Recognitioncited by 51,809
- 2020An Image is Worth 16x16 Words: Transformers for Image Recognition at Scalecited by 29,915
- 2014Very Deep Convolutional Networks for Large-Scale Image Recognitioncited by 15,267
- 2016Grad-CAM: Visual Explanations from Deep Networks via Gradient-based Localizationcited by 6,690
- 2015Rethinking the Inception Architecture for Computer Visioncited by 5,451
- 2017Axiomatic Attribution for Deep Networkscited by 3,350
- 2015Learning Deep Features for Discriminative Localizationcited by 2,430
- 2017Interpretability Beyond Feature Attribution: Quantitative Testing with Concept Activation Vectors (TCAV)cited by 1,309
- 2020Concept Bottleneck Modelscited by 1,022
- 2019Attention is not Explanationcited by 916
- 2017Skin Lesion Analysis Toward Melanoma Detection: A Challenge at the 2017 International Symposium on Biomedical Imaging (ISBI), Hosted by the International Skin Imaging Collaboration (ISIC)cited by 549
- 2019Unmasking Clever Hans Predictors and Assessing What Machines Really Learncited by 359
17 more
- 2017Right for the Right Reasons: Training Differentiable Models by Constraining their Explanationscited by 293
- 2022Post-hoc Concept Bottleneck Modelscited by 289
- 2016Skin Lesion Analysis toward Melanoma Detection: A Challenge at the International Symposium on Biomedical Imaging (ISBI) 2016, hosted by the International Skin Imaging Collaboration (ISIC)cited by 197
- 2021Evaluating Deep Neural Networks Trained on Clinical Images in Dermatology with the Fitzpatrick 17k Datasetcited by 184
- 2020A Patient-Centric Dataset of Images and Metadata for Identifying Melanomas Using Clinical Contextcited by 146
- 2019Interpretations are useful: penalizing explanations to align neural networks with prior knowledgecited by 144
- 2020Making deep neural networks right for the right scientific reasons by interacting with their explanationscited by 141
- 2021Disparities in Dermatology AI: Assessments Using Diverse Clinical Imagescited by 132
- 2016Human Attention in Visual Question Answering: Do Humans and Deep Networks Look at the Same Regions?cited by 111
- 2020Right for the Right Concept: Revising Neuro-Symbolic Concepts by Interacting with their Explanationscited by 94
- 2021Entropy-based Logic Explanations of Neural Networkscited by 51
- 2023SkinCon: A skin disease dataset densely annotated by domain experts for fine-grained model debugging and analysiscited by 44
- 2020On Interpretability of Deep Learning based Skin Lesion Classifiers using Concept Activation Vectorscited by 39
- 2021DISSECT: Disentangled Simultaneous Explanations via Concept Traversalscited by 37
- 2019(De)Constructing Bias on Skin Lesion Datasetscited by 30
- 2022The (de)biasing effect of GAN-based augmentation methods on skin lesion imagescited by 9
- 2020Cost-effective Interactive Attention Learning with Neural Attention Processescited by 5
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Citing papers per year: 2023: 5; 2024: 13; 2025: 7; 2026: 2.
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- 2023Concept-based Explainable Artificial Intelligence: A Surveycited by 97
- 2025Derm1M: A Million-scale Vision-Language Dataset Aligned with Clinical Ontology Knowledge for Dermatologycited by 28
- 2023NurViD: A Large Expert-Level Video Database for Nursing Procedure Activity Understandingcited by 20
- 2024MICA: Towards Explainable Skin Lesion Diagnosis via Multi-Level Image-Concept Alignmentcited by 18
- 2024Self-eXplainable AI for Medical Image Analysis: A Survey and New Outlookscited by 18
- 2025A Comprehensive Survey on Self-Interpretable Neural Networkscited by 18
- 2024Integrating Clinical Knowledge into Concept Bottleneck Modelscited by 17
- 2025MAKE: Multi-Aspect Knowledge-Enhanced Vision-Language Pretraining for Zero-shot Dermatological Assessmentcited by 12
- 2025Interactive Medical Image Analysis with Concept-based Similarity Reasoningcited by 11
- 2023Deep Learning in Breast Cancer Imaging: A Decade of Progress and Future Directionscited by 10
- 2023EPVT: Environment-aware Prompt Vision Transformer for Domain Generalization in Skin Lesion Recognitioncited by 9
- 2024Prompt-driven Latent Domain Generalization for Medical Image Classificationcited by 8
15 more
- 2024Investigating the Quality of DermaMNIST and Fitzpatrick17k Dermatological Image Datasetscited by 7
- 2025Enhancing Interpretable Image Classification Through LLM Agents and Conditional Concept Bottleneck Modelscited by 6
- 2024SLIM: Spuriousness Mitigation with Minimal Human Annotationscited by 5
- 2024PatchAlign:Fair and Accurate Skin Disease Image Classification by Alignment with Clinical Labelscited by 5
- 2025WISE: Weak-Supervision-Guided Step-by-Step Explanations for Multimodal LLMs in Image Classificationcited by 4
- 2024From Evidence to Decision: Exploring Evaluative AIcited by 3
- 2024Diffusion Model Driven Test-Time Image Adaptation for Robust Skin Lesion Classificationcited by 2
- 2024A Novel Perspective for Multi-modal Multi-label Skin Lesion Classificationcited by 2
- 2024On-device Federated Learning in Smartphones for Detecting Depression from Reddit Postscited by 2
- 2023Representing visual classification as a linear combination of wordscited by 1
- 2024Visual Evaluative AI: A Hypothesis-Driven Tool with Concept-Based Explanations and Weight of Evidencecited by 1
- 2024Hierarchical Multi-Relational Graph Representation Learning for Large-Scale Prediction of Drug-Drug Interactionscited by 0
- 2025Can We Go Beyond Visual Features? Neural Tissue Relation Modeling for Relational Graph Analysis in Non-Melanoma Skin Histologycited by 0
- 2026Visual concept ranking uncovers medical shortcuts used by large multimodal modelscited by 0
- 2026NeRD: Neuro-Symbolic Rule Distillation for Efficient Ontology-Grounded Chain-of-Thought in Medical Image Diagnosiscited by 0
- 2026NeRD: Neuro-Symbolic Rule Distillation for Efficient Ontology-Grounded Chain-of-Thought in Medical Image Diagnosis14 Jun 2026
- 2026Visual concept ranking uncovers medical shortcuts used by large multimodal models4 Feb 2026
- 2025Can We Go Beyond Visual Features? Neural Tissue Relation Modeling for Relational Graph Analysis in Non-Melanoma Skin Histology7 Dec 2025
- 2025WISE: Weak-Supervision-Guided Step-by-Step Explanations for Multimodal LLMs in Image Classification22 Sep 2025
- 2025Enhancing Interpretable Image Classification Through LLM Agents and Conditional Concept Bottleneck Models2 Jun 2025
- 2025MAKE: Multi-Aspect Knowledge-Enhanced Vision-Language Pretraining for Zero-shot Dermatological Assessment14 May 2025
- 2025Derm1M: A Million-scale Vision-Language Dataset Aligned with Clinical Ontology Knowledge for Dermatology19 Mar 2025
- 2025Interactive Medical Image Analysis with Concept-based Similarity Reasoning10 Mar 2025
- 2025A Comprehensive Survey on Self-Interpretable Neural Networks26 Jan 2025
- 2024On-device Federated Learning in Smartphones for Detecting Depression from Reddit Posts17 Oct 2024
- 2024Self-eXplainable AI for Medical Image Analysis: A Survey and New Outlooks3 Oct 2024
- 2024A Novel Perspective for Multi-modal Multi-label Skin Lesion Classification19 Sep 2024
15 more
- 2024PatchAlign:Fair and Accurate Skin Disease Image Classification by Alignment with Clinical Labels8 Sep 2024
- 2024Integrating Clinical Knowledge into Concept Bottleneck Models9 Jul 2024
- 2024SLIM: Spuriousness Mitigation with Minimal Human Annotations8 Jul 2024
- 2024Diffusion Model Driven Test-Time Image Adaptation for Robust Skin Lesion Classification18 May 2024
- 2024Visual Evaluative AI: A Hypothesis-Driven Tool with Concept-Based Explanations and Weight of Evidence13 May 2024
- 2024Hierarchical Multi-Relational Graph Representation Learning for Large-Scale Prediction of Drug-Drug Interactions28 Feb 2024
- 2024From Evidence to Decision: Exploring Evaluative AI2 Feb 2024
- 2024Investigating the Quality of DermaMNIST and Fitzpatrick17k Dermatological Image Datasets25 Jan 2024
- 2024MICA: Towards Explainable Skin Lesion Diagnosis via Multi-Level Image-Concept Alignment16 Jan 2024
- 2024Prompt-driven Latent Domain Generalization for Medical Image Classification5 Jan 2024
- 2023Concept-based Explainable Artificial Intelligence: A Survey20 Dec 2023
- 2023Representing visual classification as a linear combination of words18 Nov 2023
- 2023NurViD: A Large Expert-Level Video Database for Nursing Procedure Activity Understanding20 Oct 2023
- 2023Deep Learning in Breast Cancer Imaging: A Decade of Progress and Future Directions13 Apr 2023
- 2023EPVT: Environment-aware Prompt Vision Transformer for Domain Generalization in Skin Lesion Recognition4 Apr 2023
- 2025Derm1M: A Million-scale Vision-Language Dataset Aligned with Clinical Ontology Knowledge for Dermatologycited by 28
- 2025MAKE: Multi-Aspect Knowledge-Enhanced Vision-Language Pretraining for Zero-shot Dermatological Assessmentcited by 12
- 2026Visual concept ranking uncovers medical shortcuts used by large multimodal modelscited by 0
- 2026Visual concept ranking uncovers medical shortcuts used by large multimodal models4 Feb 2026
- 2025MAKE: Multi-Aspect Knowledge-Enhanced Vision-Language Pretraining for Zero-shot Dermatological Assessment14 May 2025
- 2025Derm1M: A Million-scale Vision-Language Dataset Aligned with Clinical Ontology Knowledge for Dermatology19 Mar 2025
- 2023Concept-based Explainable Artificial Intelligence: A Surveycited by 97
- 2023NurViD: A Large Expert-Level Video Database for Nursing Procedure Activity Understandingcited by 20
- 2024MICA: Towards Explainable Skin Lesion Diagnosis via Multi-Level Image-Concept Alignmentcited by 18
- 2024Self-eXplainable AI for Medical Image Analysis: A Survey and New Outlookscited by 18
- 2025A Comprehensive Survey on Self-Interpretable Neural Networkscited by 18
- 2024Integrating Clinical Knowledge into Concept Bottleneck Modelscited by 17
- 2025Interactive Medical Image Analysis with Concept-based Similarity Reasoningcited by 11
- 2023Deep Learning in Breast Cancer Imaging: A Decade of Progress and Future Directionscited by 10
- 2023EPVT: Environment-aware Prompt Vision Transformer for Domain Generalization in Skin Lesion Recognitioncited by 9
- 2024Prompt-driven Latent Domain Generalization for Medical Image Classificationcited by 8
- 2024Investigating the Quality of DermaMNIST and Fitzpatrick17k Dermatological Image Datasetscited by 7
- 2024SLIM: Spuriousness Mitigation with Minimal Human Annotationscited by 5
12 most cited of 20 All 20 (JSON)
- 2025Can We Go Beyond Visual Features? Neural Tissue Relation Modeling for Relational Graph Analysis in Non-Melanoma Skin Histology7 Dec 2025
- 2025Interactive Medical Image Analysis with Concept-based Similarity Reasoning10 Mar 2025
- 2025A Comprehensive Survey on Self-Interpretable Neural Networks26 Jan 2025
- 2024On-device Federated Learning in Smartphones for Detecting Depression from Reddit Posts17 Oct 2024
- 2024Self-eXplainable AI for Medical Image Analysis: A Survey and New Outlooks3 Oct 2024
- 2024A Novel Perspective for Multi-modal Multi-label Skin Lesion Classification19 Sep 2024
- 2024PatchAlign:Fair and Accurate Skin Disease Image Classification by Alignment with Clinical Labels8 Sep 2024
- 2024Integrating Clinical Knowledge into Concept Bottleneck Models9 Jul 2024
- 2024SLIM: Spuriousness Mitigation with Minimal Human Annotations8 Jul 2024
- 2024Visual Evaluative AI: A Hypothesis-Driven Tool with Concept-Based Explanations and Weight of Evidence13 May 2024
- 2024Hierarchical Multi-Relational Graph Representation Learning for Large-Scale Prediction of Drug-Drug Interactions28 Feb 2024
- 2024From Evidence to Decision: Exploring Evaluative AI2 Feb 2024
12 newest of 20 All 20 (JSON)