# Ensuring Medical AI Safety: Interpretability-Driven Detection and Mitigation of Spurious Model Behavior and Associated Data

arXiv: https://arxiv.org/abs/2501.13818 · HTML: https://mlsanity.com/paper/2501.13818/

## Key facts

- Cited by 2 papers in the map (data through 14 Oct 2026).
- Builds on 62 of its 88 references that are in the map.
- First posted on arXiv 23 Jan 2025.

## Builds on (most cited first, 30 of 62)

- [Deep Residual Learning for Image Recognition](https://mlsanity.com/paper/1512.03385/) (2015)
- [An Image is Worth 16x16 Words: Transformers for Image Recognition at Scale](https://mlsanity.com/paper/2010.11929/) (2020)
- [PyTorch: An Imperative Style, High-Performance Deep Learning Library](https://mlsanity.com/paper/1912.01703/) (2019)
- [Very Deep Convolutional Networks for Large-Scale Image Recognition](https://mlsanity.com/paper/1409.1556/) (2014)
- [Grad-CAM: Visual Explanations from Deep Networks via Gradient-based Localization](https://mlsanity.com/paper/1610.02391/) (2016)
- [A Unified Approach to Interpreting Model Predictions](https://mlsanity.com/paper/1705.07874/) (2017)
- [Intriguing properties of neural networks](https://mlsanity.com/paper/1312.6199/) (2013)
- [Learning Deep Features for Discriminative Localization](https://mlsanity.com/paper/1512.04150/) (2015)
- [Shortcut Learning in Deep Neural Networks](https://mlsanity.com/paper/2004.07780/) (2020)
- [CheXpert: A Large Chest Radiograph Dataset with Uncertainty Labels and Expert Comparison](https://mlsanity.com/paper/1901.07031/) (2019)
- [Sparse Autoencoders Find Highly Interpretable Features in Language Models](https://mlsanity.com/paper/2309.08600/) (2023)
- [Understanding intermediate layers using linear classifier probes](https://mlsanity.com/paper/1610.01644/) (2016)
- [Interpretability Beyond Feature Attribution: Quantitative Testing with Concept Activation Vectors (TCAV)](https://mlsanity.com/paper/1711.11279/) (2017)
- [Toy Models of Superposition](https://mlsanity.com/paper/2209.10652/) (2022)
- [Probing Classifiers: Promises, Shortcomings, and Advances](https://mlsanity.com/paper/2102.12452/) (2021)
- [Skin Lesion Analysis Toward Melanoma Detection: A Challenge at the 2017 International Symposium on Biomedical Imaging (ISBI), Hosted by the International Skin Imaging Collaboration (ISIC)](https://mlsanity.com/paper/1710.05006/) (2017)
- [Null It Out: Guarding Protected Attributes by Iterative Nullspace Projection](https://mlsanity.com/paper/2004.07667/) (2020)
- [Bag of Tricks for Image Classification with Convolutional Neural Networks](https://mlsanity.com/paper/1812.01187/) (2018)
- [Confounding variables can degrade generalization performance of radiological deep learning models](https://mlsanity.com/paper/1807.00431/) (2018)
- [Unmasking Clever Hans Predictors and Assessing What Machines Really Learn](https://mlsanity.com/paper/1902.10178/) (2019)
- [Right for the Right Reasons: Training Differentiable Models by Constraining their Explanations](https://mlsanity.com/paper/1703.03717/) (2017)
- [LEACE: Perfect linear concept erasure in closed form](https://mlsanity.com/paper/2306.03819/) (2023)
- [Understanding the Role of Individual Units in a Deep Neural Network](https://mlsanity.com/paper/2009.05041/) (2020)
- [BCN20000: Dermoscopic Lesions in the Wild](https://mlsanity.com/paper/1908.02288/) (2019)
- [Predicting Parameters in Deep Learning](https://mlsanity.com/paper/1306.0543/) (2013)
- [CRAFT: Concept Recursive Activation FacTorization for Explainability](https://mlsanity.com/paper/2211.10154/) (2022)
- [Deep Learning for ECG Analysis: Benchmarks and Insights from PTB-XL](https://mlsanity.com/paper/2004.13701/) (2020)
- [Learning to Generate Reviews and Discovering Sentiment](https://mlsanity.com/paper/1704.01444/) (2017)
- [CLIP-Dissect: Automatic Description of Neuron Representations in Deep Vision Networks](https://mlsanity.com/paper/2204.10965/) (2022)
- [Interpretations are useful: penalizing explanations to align neural networks with prior knowledge](https://mlsanity.com/paper/1909.13584/) (2019)

## Built on by (most cited first, 2 of 2)

- [ProMedical: Hierarchical Fine-Grained Criteria Modeling for Medical LLM Alignment via Explicit Injection](https://mlsanity.com/paper/2604.08326/) (2026)
- [Building Safe and Deployable Clinical Natural Language Processing under Temporal Leakage Constraints](https://mlsanity.com/paper/2602.15852/) (2026)

## Abstract (arXiv)

Deep neural networks are increasingly employed in high-stakes medical applications, despite their tendency for shortcut learning in the presence of spurious correlations, which can have potentially fatal consequences in practice. Whereas a multitude of works address either the detection or mitigation of such shortcut behavior in isolation, the Reveal2Revise approach provides a comprehensive bias mitigation framework combining these steps. However, effectively addressing these biases often requires substantial labeling efforts from domain experts. In this work, we review the steps of the Reveal2Revise framework and enhance it with semi-automated interpretability-based bias annotation capabilities. This includes methods for the sample- and feature-level bias annotation, providing valuable information for bias mitigation methods to unlearn the undesired shortcut behavior. We show the applicability of the framework using four medical datasets across two modalities, featuring controlled and real-world spurious correlations caused by data artifacts. We successfully identify and mitigate these biases in VGG16, ResNet50, and contemporary Vision Transformer models, ultimately increasing their robustness and applicability for real-world medical tasks. Our code is available at https://github.com/frederikpahde/medical-ai-safety.