# UniCoMTE: A Universal Counterfactual Framework for Explaining Time-Series Classifiers on ECG Data

arXiv: https://arxiv.org/abs/2512.17100 · HTML: https://mlsanity.com/paper/2512.17100/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 14 of its 36 references that are in the map.
- First posted on arXiv 18 Dec 2025.

## Builds on (most cited first, 14 of 14)

- [A Unified Approach to Interpreting Model Predictions](https://mlsanity.com/paper/1705.07874/) (2017)
- ["Why Should I Trust You?": Explaining the Predictions of Any Classifier](https://mlsanity.com/paper/1602.04938/) (2016)
- [An Introduction to Convolutional Neural Networks](https://mlsanity.com/paper/1511.08458/) (2015)
- [Automatic diagnosis of the 12-lead ECG using a deep neural network](https://mlsanity.com/paper/1904.01949/) (2019)
- [A Survey on Active Learning and Human-in-the-Loop Deep Learning for Medical Image Analysis](https://mlsanity.com/paper/1910.02923/) (2019)
- [Resnet in Resnet: Generalizing Residual Architectures](https://mlsanity.com/paper/1603.08029/) (2016)
- [Learning Active Learning from Data](https://mlsanity.com/paper/1703.03365/) (2017)
- [Cardiologist-Level Arrhythmia Detection with Convolutional Neural Networks](https://mlsanity.com/paper/1707.01836/) (2017)
- [GANterfactual - Counterfactual Explanations for Medical Non-Experts using Generative Adversarial Learning](https://mlsanity.com/paper/2012.11905/) (2020)
- [Counterfactual Explanations for Machine Learning on Multivariate Time Series Data](https://mlsanity.com/paper/2008.10781/) (2020)
- [A Comprehensive Overview and Comparative Analysis on Deep Learning Models: CNN, RNN, LSTM, GRU](https://mlsanity.com/paper/2305.17473/) (2023)
- [The Three Ghosts of Medical AI: Can the Black-Box Present Deliver?](https://mlsanity.com/paper/2012.06000/) (2020)
- [Active Learning on Medical Image](https://mlsanity.com/paper/2306.01827/) (2023)
- [A lightweight hybrid CNN-LSTM model for ECG-based arrhythmia detection](https://mlsanity.com/paper/2209.00988/) (2022)

## Abstract (arXiv)

Machine learning models, particularly deep neural networks, have demonstrated strong performance in classifying complex time series data. However, their black-box nature limits trust and adoption, especially in high-stakes domains such as healthcare. To address this challenge, we introduce UniCoMTE, a model-agnostic framework for generating counterfactual explanations for multivariate time series classifiers. The framework identifies temporal features that most heavily influence a model's prediction by modifying the input sample and assessing its impact on the model's prediction. UniCoMTE is compatible with a wide range of model architectures and operates directly on raw time series inputs. In this study, we evaluate UniCoMTE's explanations on a time series ECG classifier. We quantify explanation quality by comparing our explanations' comprehensibility to comprehensibility of established techniques (LIME and SHAP) and assessing their generalizability to similar samples. Furthermore, clinical utility is assessed through a questionnaire completed by medical experts who review counterfactual explanations presented alongside original ECG samples. Results show that our approach produces concise, stable, and human-aligned explanations that outperform existing methods in both clarity and applicability. By linking model predictions to meaningful signal patterns, the framework advances the interpretability of deep learning models for real-world time series applications.