# MiMICRI: Towards Domain-centered Counterfactual Explanations of Cardiovascular Image Classification Models

arXiv: https://arxiv.org/abs/2404.16174 · HTML: https://mlsanity.com/paper/2404.16174/

## Key facts

- Cited by 1 papers in the map (data through 14 Oct 2026).
- Builds on 44 of its 84 references that are in the map.
- First posted on arXiv 24 Apr 2024.

## Builds on (most cited first, 30 of 44)

- [Deep Residual Learning for Image Recognition](https://mlsanity.com/paper/1512.03385/) (2015)
- [Very Deep Convolutional Networks for Large-Scale Image Recognition](https://mlsanity.com/paper/1409.1556/) (2014)
- [Segment Anything](https://mlsanity.com/paper/2304.02643/) (2023)
- [Grad-CAM: Visual Explanations from Deep Networks via Gradient-based Localization](https://mlsanity.com/paper/1610.02391/) (2016)
- [mixup: Beyond Empirical Risk Minimization](https://mlsanity.com/paper/1710.09412/) (2017)
- [CutMix: Regularization Strategy to Train Strong Classifiers with Localizable Features](https://mlsanity.com/paper/1905.04899/) (2019)
- [Deep Inside Convolutional Networks: Visualising Image Classification Models and Saliency Maps](https://mlsanity.com/paper/1312.6034/) (2013)
- [Improved Regularization of Convolutional Neural Networks with Cutout](https://mlsanity.com/paper/1708.04552/) (2017)
- [Interpretability Beyond Feature Attribution: Quantitative Testing with Concept Activation Vectors (TCAV)](https://mlsanity.com/paper/1711.11279/) (2017)
- [Explanation in Artificial Intelligence: Insights from the Social Sciences](https://mlsanity.com/paper/1706.07269/) (2017)
- [Sanity Checks for Saliency Maps](https://mlsanity.com/paper/1810.03292/) (2018)
- [Counterfactual Explanations without Opening the Black Box: Automated Decisions and the GDPR](https://mlsanity.com/paper/1711.00399/) (2017)
- [Adversarial Attacks on Neural Network Policies](https://mlsanity.com/paper/1702.02284/) (2017)
- [Segment Anything in Medical Images](https://mlsanity.com/paper/2304.12306/) (2023)
- [The What-If Tool: Interactive Probing of Machine Learning Models](https://mlsanity.com/paper/1907.04135/) (2019)
- [Grad-CAM: Why did you say that?](https://mlsanity.com/paper/1611.07450/) (2016)
- [Explainable artificial intelligence (XAI) in deep learning-based medical image analysis](https://mlsanity.com/paper/2107.10912/) (2021)
- [SimpleClick: Interactive Image Segmentation with Simple Vision Transformers](https://mlsanity.com/paper/2210.11006/) (2022)
- [Human-Centered Tools for Coping with Imperfect Algorithms during Medical Decision-Making](https://mlsanity.com/paper/1902.02960/) (2019)
- [If Only We Had Better Counterfactual Explanations: Five Key Deficits to Rectify in the Evaluation of Counterfactual XAI Techniques](https://mlsanity.com/paper/2103.01035/) (2021)
- [Automated Rationale Generation: A Technique for Explainable AI and its Effects on Human Perceptions](https://mlsanity.com/paper/1901.03729/) (2019)
- [Good Counterfactuals and Where to Find Them: A Case-Based Technique for Generating Counterfactuals for Explainable AI (XAI)](https://mlsanity.com/paper/2005.13997/) (2020)
- [Impossibility Theorems for Feature Attribution](https://mlsanity.com/paper/2212.11870/) (2022)
- [Unbox the Black-box for the Medical Explainable AI via Multi-modal and Multi-centre Data Fusion: A Mini-Review, Two Showcases and Beyond](https://mlsanity.com/paper/2102.01998/) (2021)
- [Towards Better Analysis of Deep Convolutional Neural Networks](https://mlsanity.com/paper/1604.07043/) (2016)
- [Generalist Vision Foundation Models for Medical Imaging: A Case Study of Segment Anything Model on Zero-Shot Medical Segmentation](https://mlsanity.com/paper/2304.12637/) (2023)
- [GANterfactual - Counterfactual Explanations for Medical Non-Experts using Generative Adversarial Learning](https://mlsanity.com/paper/2012.11905/) (2020)
- [CheXplain: Enabling Physicians to Explore and UnderstandData-Driven, AI-Enabled Medical Imaging Analysis](https://mlsanity.com/paper/2001.05149/) (2020)
- [STEEX: Steering Counterfactual Explanations with Semantics](https://mlsanity.com/paper/2111.09094/) (2021)
- [DECE: Decision Explorer with Counterfactual Explanations for Machine Learning Models](https://mlsanity.com/paper/2008.08353/) (2020)

## Built on by (most cited first, 1 of 1)

- [Who Benefits from AI Explanations? Towards Accessible and Interpretable Systems](https://mlsanity.com/paper/2508.10806/) (2025)

## Abstract (arXiv)

The recent prevalence of publicly accessible, large medical imaging datasets has led to a proliferation of artificial intelligence (AI) models for cardiovascular image classification and analysis. At the same time, the potentially significant impacts of these models have motivated the development of a range of explainable AI (XAI) methods that aim to explain model predictions given certain image inputs. However, many of these methods are not developed or evaluated with domain experts, and explanations are not contextualized in terms of medical expertise or domain knowledge. In this paper, we propose a novel framework and python library, MiMICRI, that provides domain-centered counterfactual explanations of cardiovascular image classification models. MiMICRI helps users interactively select and replace segments of medical images that correspond to morphological structures. From the counterfactuals generated, users can then assess the influence of each segment on model predictions, and validate the model against known medical facts. We evaluate this library with two medical experts. Our evaluation demonstrates that a domain-centered XAI approach can enhance the interpretability of model explanations, and help experts reason about models in terms of relevant domain knowledge. However, concerns were also surfaced about the clinical plausibility of the counterfactuals generated. We conclude with a discussion on the generalizability and trustworthiness of the MiMICRI framework, as well as the implications of our findings on the development of domain-centered XAI methods for model interpretability in healthcare contexts.