# ShifaMind: A Multiplicative Concept Bottleneck for Interpretable ICD-10 Coding

arXiv: https://arxiv.org/abs/2605.08482 · HTML: https://mlsanity.com/paper/2605.08482/

## Key facts

- Cited by 1 papers in the map (data through 14 Oct 2026).
- Builds on 20 of its 27 references that are in the map.
- First posted on arXiv 8 May 2026.

## Builds on (most cited first, 20 of 20)

- [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)
- [Deep Inside Convolutional Networks: Visualising Image Classification Models and Saliency Maps](https://mlsanity.com/paper/1312.6034/) (2013)
- [Towards A Rigorous Science of Interpretable Machine Learning](https://mlsanity.com/paper/1702.08608/) (2017)
- [Interpretability Beyond Feature Attribution: Quantitative Testing with Concept Activation Vectors (TCAV)](https://mlsanity.com/paper/1711.11279/) (2017)
- [Concept Bottleneck Models](https://mlsanity.com/paper/2007.04612/) (2020)
- [This Looks Like That: Deep Learning for Interpretable Image Recognition](https://mlsanity.com/paper/1806.10574/) (2018)
- [Towards Faithfully Interpretable NLP Systems: How should we define and evaluate faithfulness?](https://mlsanity.com/paper/2004.03685/) (2020)
- [Smarter, Better, Faster, Longer: A Modern Bidirectional Encoder for Fast, Memory Efficient, and Long Context Finetuning and Inference](https://mlsanity.com/paper/2412.13663/) (2024)
- [On Completeness-aware Concept-Based Explanations in Deep Neural Networks](https://mlsanity.com/paper/1910.07969/) (2019)
- [Explainable Prediction of Medical Codes from Clinical Text](https://mlsanity.com/paper/1802.05695/) (2018)
- [Promises and Pitfalls of Black-Box Concept Learning Models](https://mlsanity.com/paper/2106.13314/) (2021)
- [GlanceNets: Interpretabile, Leak-proof Concept-based Models](https://mlsanity.com/paper/2205.15612/) (2022)
- [Interpretable Neural-Symbolic Concept Reasoning](https://mlsanity.com/paper/2304.14068/) (2023)
- [PLM-ICD: Automatic ICD Coding with Pretrained Language Models](https://mlsanity.com/paper/2207.05289/) (2022)
- [Automated Medical Coding on MIMIC-III and MIMIC-IV: A Critical Review and Replicability Study](https://mlsanity.com/paper/2304.10909/) (2023)
- [A Label Attention Model for ICD Coding from Clinical Text](https://mlsanity.com/paper/2007.06351/) (2020)
- [Knowledge Injected Prompt Based Fine-tuning for Multi-label Few-shot ICD Coding](https://mlsanity.com/paper/2210.03304/) (2022)
- [BioClinical ModernBERT: A State-of-the-Art Long-Context Encoder for Biomedical and Clinical NLP](https://mlsanity.com/paper/2506.10896/) (2025)
- [A General Knowledge Injection Framework for ICD Coding](https://mlsanity.com/paper/2505.18708/) (2025)

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

- [Feedback-Robust AI for Patient Knowledge Graphs](https://mlsanity.com/paper/2609.33248/) (2026)

## Abstract (arXiv)

Automated ICD-10 coding from clinical discharge summaries requires models that are both accurate on long-tailed multi-label classification tasks and interpretable to clinicians. Concept Bottleneck Models (CBMs) offer a principled framework for interpretability by routing predictions through human-interpretable concepts, but this transparency often comes at a cost: compressing rich clinical text representations into a narrow concept layer can restrict gradient flow and limit predictive capacity. We present ShifaMind, a concept-grounded architecture built around a Multiplicative Concept Bottleneck (MCB), which changes the form, rather than the width, of the bottleneck. Instead of projecting through a narrow concept layer, ShifaMind uses a learned multiplicative gate over a concept-grounded representation while retaining a scalar concept interface for inspection. On MIMIC-IV top-50 ICD-10 coding, ShifaMind achieves performance competitive with LAAT, the strongest baseline, across F1, AUC, and ranking metrics, while outperforming five additional ICD-coding baselines and providing concept-mediated explanations. Its substantial gains over a capacity-matched Vanilla CBM in both predictive performance and interpretability-oriented metrics highlight the importance of the bottleneck design.