International Peer-Reviewed Journal•Open Access•ISSN 2456-8880
irejournals@gmail.com•+91-7433024337

Home / Current Issue / Paper 1710495

1710495 Vol 9 · Issue 3 Download Paper

Enhancing Medical Transparency: An Explainable AI Approach to Machine Learning-Based Healthcare Diagnostics

SUJON SARKAR

Subject area: Science,Engineering and Technology  ·  Area of research: Computer Science

Abstract

The application of AI in the healthcare diagnostics has further developed the state of disease detection, risk assessment of patients, and clinical decision-making, yet the black-box nature of the vast majority of machine learning (ML) models serves as a major factor preventing such approaches to be used in clinical practice. This project investigates the potential benefit of explainable AI (XAI) on medical transparency through optimising the trade-off between predictive performance and interpretability. We compare convolutional neural networks (CNNs), CNNs augmented with Gradient-weighted Class Activation Mapping (Grad-CAM) and Random Forests with SHapley Additive Explanations (SHAP) using the NIH ChestXray14 dataset. The results indicate that CNNs have the highest accuracy of 91 percent and AUC of 0.95, which however reflects less on clinical trust and accountability due to lack of clear interpretability. CNN + Grad-CAM models have comparable (90%) accuracy with the closest alignment with radiological reasoning in the visual explanation, whereas Random Forest + SHAP models did not necessarily perform any worse with a slightly lower accuracy (90%) but have the highest level of interpretability (fidelity = 0.89). These results highlight one of the key tradeoffs between the raw predictive performances and medical transparency: interpretability is a necessary procedure and not a luxury.

Keywords

Explainable AI, Healthcare Diagnostics, Machine Learning, Transparency, SHAP, Grad-CAM, Interpretability

References

[1] Haq, I. U., Rather, A. H., Rufai, S. Z., Shah, A., Sheetal, & Khanday, A. M. U. D. (2025). Transparency in Disease Diagnosis: Leveraging Interpretable Machine Learning in Healthcare. Explainable Artificial Intelligence in the Healthcare Industry, 105-130.

[2] Srinivasan, K., Ramamurthy, C. K. V., Matheswaran, S., & Shamsudheen, S. (2025). Introduction to Explainable AI in Healthcare: Enhancing Transparency and Trust. Explainable Artificial Intelligence in the Healthcare Industry, 161-183.

[3] Metta, C., Beretta, A., Pellungrini, R., Rinzivillo, S., & Giannotti, F. (2024). Towards transparent healthcare: advancing local explanation methods in explainable artificial intelligence. Bioengineering, 11(4), 369.

[4] Alam, M. N., Kaur, M., & Kabir, M. S. (2023). Explainable AI in healthcare: enhancing transparency and trust upon legal and ethical consideration. Int Res J Eng Technol, 10(6), 1-9.

[5] Sanghavi, D., Bhatt, A., Patel, D., & Bhowmick, K. (2024). Transparency in Medical Recommendations: A Comprehensive Methodology of Explainable AI Techniques in Healthcare. Journal of Computational Analysis & Applications, 33(4).

[6] Roy, S., Pal, D., & Meena, T. (2023). Explainable artificial intelligence to increase transparency for revolutionizing the healthcare ecosystem and the road ahead. Network Modeling Analysis in Health Informatics and Bioinformatics, 13(1), 4.

[7] Shahzad, T., Saleem, M., Farooq, M. S., Abbas, S., Khan, M. A., & Ouahada, K. (2024). Developing a transparent diagnosis model for diabetic retinopathy using explainable AI. IEEE Access.

[8] Wani, N. A., Kumar, R., & Bedi, J. (2024). DeepXplainer: An interpretable deep learning based approach for lung cancer detection using explainable artificial intelligence. Computer Methods and Programs in Biomedicine, 243, 107879.

[9] Curia, F. (2023). Explainable and transparent machine learning approach to predict diabetes development. Health and Technology, 13(5), 769-780.

[10] Ambaliya, M., Chauhan, S., Paliwal, M., & Shastri, A. (2024). Transparency: Exploring Explainable AI. Power Engineering and Intelligent Systems: Proceedings of PEIS 2024, Volume 1, 1246, 465.

[11] Deshpande, N. M., Gite, S., Pradhan, B., & Assiri, M. E. (2022). Explainable artificial intelligence–a new step towards the trust in medical diagnosis with AI frameworks: a review. CMES-Computer Modeling in Engineering and Sciences.

[12] Muhammad, D., Salman, M., Keles, A., & Bendechache, M. (2025). ALL diagnosis: can efficiency and transparency coexist? An explainable deep learning approach. Scientific Reports, 15(1), 12812.

[13] Khan, N., Nauman, M., Almadhor, A. S., Akhtar, N., Alghuried, A., & Alhudhaif, A. (2024). Guaranteeing correctness in black-box machine learning: A fusion of explainable AI and formal methods for healthcare decision-making. IEEE Access, 12, 90299-90316.

[14] Eke, C. I., & Shuib, L. (2025). The role of explainability and transparency in fostering trust in AI healthcare systems: a systematic literature review, open issues and potential solutions. Neural Computing and Applications, 37(4), 1999-2034.

[15] Ahmad, W., Ramzan, M., Farooq, A., & Satti, Z. K. (2025). Explainable AI-Enhanced Machine Learning Models for Early Detection of Cardiovascular Disease: Improving Predictive Performance and Clinical Transparency through Optimization. Annual Methodological Archive Research Review, 3(6), 170-189.

[16] Liu, W., Zhao, F., Shankar, A., Maple, C., Peter, J. D., Kim, B. G., ... & Lv, J. (2023). Explainable AI for medical image analysis in medical cyber-physical systems: Enhancing transparency and trustworthiness of iomt. IEEE Journal of Biomedical and Health Informatics.

[17] Hassan, M. M., Alqahtani, S. A., Alrakhami, M. S., & Elhendi, A. Z. (2024). Transparent and Accurate COVID-19 Diagnosis: Integrating Explainable AI with Advanced Deep Learning in CT Imaging. Computer Modeling in Engineering & Sciences (CMES), 139(3).

[18] Panahi, O. (2025). Deep Learning in Diagnostics. Journal of Medical Discoveries, 2(1), 1-6.

[19] Zade, N., Langote, M., & Verma, P. (2025, February). Enhancing Interpretability: The Role of Explainable AI in Healthcare Diagnostics. In 2025 International Conference on Electronics and Renewable Systems (ICEARS) (pp. 1-6). IEEE.

[20] Saraswat, D., Bhattacharya, P., Verma, A., Prasad, V. K., Tanwar, S., Sharma, G., ... & Sharma, R. (2022). Explainable AI for healthcare 5.0: opportunities and challenges. IEEe Access, 10, 84486-84517.

[21] Dhar, T., Dey, N., Borra, S., & Sherratt, R. S. (2023). Challenges of deep learning in medical image analysis—improving explainability and trust. IEEE Transactions on Technology and Society, 4(1), 68-75.

[22] Sakshi, & Verma, G. (2025). Explainable Artificial Intelligence in Healthcare: Transparency and Trustworthiness. Artificial Intelligence and Cybersecurity in Healthcare, 243-272.

[23] Taneja, A. (2023). Explainable AI in Healthcare: Ensuring Trust and Transparency in ML Clinical Decision Systems: Explainable AI in Healthcare: Ensuring Trust and Transparency in ML Clinical Decision Systems. International Journal of Artificial Intelligence, Data Science, and Machine Learning, 4(1), 51-59.

[24] Bala, K., Kumar, K. A., Venu, D., Dudi, B. P., Veluri, S. P., & Nirmala, V. (2025). Covid-19 diagnosis using privacy-preserving data monitoring: an explainable AI deep learning model with blockchain security. Journal of Medical Engineering & Technology, 1-19.

[25] Wankhede, D., Mishra, V., Mazodkar, A., & Brahmankar, S. Enhancing Healthcare Diagnostics with explainable AI (XAI): A Review. JOURNAL OF TECHNICAL EDUCATION, 90.

[26] Ansari, Z. A., Tripathi, M. M., & Ahmed, R. (2025). The role of explainable AI in enhancing breast cancer diagnosis using machine learning and deep learning models. Discover Artificial Intelligence, 5(1), 75.

[27] Chaudhari, G., Suryawanshi, S., & Chaudhari, S. (2024). AI-driven diagnostics: Transforming medical imaging with precision, efficiency and enhanced clinical accuracy.

[28] Purwono, P., Wulandari, A. N. E., & Nisa, K. (2025). Explainable Artificial Intelligence (XAI) in Medical Imaging: Techniques, Applications, Challenges, and Future Directions. Advanced Mechanical and Mechatronic Systems, 1(1), 52-66.

[29] Lai, T. (2024). Interpretable medical imagery diagnosis with self-attentive transformers: a review of explainable AI for health care. BioMedInformatics, 4(1), 113-126.

[30] Anderson, K. (2024). Explainable AI in Healthcare: Interpreting Predictions of Machine Learning Models for Heart Disease Diagnosis.

[31] Huang, M., Zhang, X. S., Bhatti, U. A., Wu, Y., Zhang, Y., & Ghadi, Y. Y. (2024). An interpretable approach using hybrid graph networks and explainable AI for intelligent diagnosis recommendations in chronic disease care. Biomedical Signal Processing and Control, 91, 105913.

[32] Alsaleh, M. M., Allery, F., Choi, J. W., Hama, T., McQuillin, A., Wu, H., & Thygesen, J. H. (2023). Prediction of disease comorbidity using explainable artificial intelligence and machine learning techniques: A systematic review. International journal of medical informatics, 175, 105088.

[33] Alsaleh, M. M., Allery, F., Choi, J. W., Hama, T., McQuillin, A., Wu, H., & Thygesen, J. H. (2023). Prediction of disease comorbidity using explainable artificial intelligence and machine learning techniques: A systematic review. International journal of medical informatics, 175, 105088.

[34] Yadav, S. K. (2025). Explainable AI in MRI-Based Cancer Diagnosis: Improving Accuracy and Clinical Trust.

[35] Jabeen, M., Ibrar, M., Hussain, M., & Hassan, M. A. S. (2025). Blockchain-Based Explainable AI for Secure and Privacy-Preserving Automated Machine Learning in IoT-Edge for Smart Medical Healthcare. In AI and Blockchain Applications for Privacy and Security in Smart Medical Systems (pp. 59-80). IGI Global Scientific Publishing.

[36] Wang, Y. C., Chen, T. C. T., & Chiu, M. C. (2023). A systematic approach to enhance the explainability of artificial intelligence in healthcare with application to diagnosis of diabetes. Healthcare Analytics, 3, 100183.

[37] Ambaliya, M., Chauhan, S., Paliwal, M., Shastri, A., & Sabale, K. (2024, March). Enhancing Pneumonia Detection Transparency: Exploring Explainable AI Model. In the International Conference on Power Engineering and Intelligent Systems (PEIS) (pp. 465-478). Singapore: Springer Nature Singapore.

[38] Chinnaraju, A. (2025). Explainable AI (XAI) for trustworthy and transparent decision-making: A theoretical framework for AI interpretability. World Journal of Advanced Engineering Technology and Sciences, 14(3), 170-207.

[39] Marey, A., Arjmand, P., Alerab, A. D. S., Eslami, M. J., Saad, A. M., Sanchez, N., & Umair, M. (2024). Explainability, transparency and black box challenges of AI in radiology: impact on patient care in cardiovascular radiology. Egyptian Journal of Radiology and Nuclear Medicine, 55(1), 183.

[40] Sanchula, S. A. (2025). EXPLAINABLE AI (XAI) FOR A MACHINE LEARNING HEART DISEASE PREDICTION MODEL.

[41] Karthiga, B., Praneeth, K. R., Saravanan, V., & Rao, T. R. K. (2025). Enhancing cancer detection in medical imaging through federated learning and explainable artificial intelligence: A hybrid approach for optimized diagnostics. Egyptian Informatics Journal, 31, 100751.

[42] Houssein, E. H., Gamal, A. M., Younis, E. M., & Mohamed, E. (2025). Explainable artificial intelligence for medical imaging systems using deep learning: a comprehensive review. Cluster Computing, 28(7), 469.

[43] Kumar, A., Veeraiah, V., Gongada, T. N., Ahamad, S., Khan, H., & Gupta, A. (2024, June). Explainable Machine Learning Models for Clinical Decision Support Systems. In 2024 15th International Conference on Computing Communication and Networking Technologies (ICCCNT) (pp. 1-6). IEEE.

[44] Sheu, R. K., & Pardeshi, M. S. (2022). A survey on medical explainable AI (XAI): recent progress, explainability approach, human interaction and scoring system. Sensors, 22(20), 8068.

[45] Sun, Q., Akman, A., & Schuller, B. W. (2025). Explainable artificial intelligence for medical applications: A review. ACM Transactions on Computing for Healthcare, 6(2), 1-31.

[46] Abbas, S., Qaisar, A., Farooq, M. S., Saleem, M., Ahmad, M., & Khan, M. A. (2024). Smart vision transparency: Efficient ocular disease prediction model using explainable artificial intelligence. Sensors, 24(20), 6618.

[47] Hulsen, T. (2023). Explainable artificial intelligence (XAI): concepts and challenges in healthcare. Ai, 4(3), 652-666.

[48] Ghnemat, R., Alodibat, S., & Abu Al-Haija, Q. (2023). Explainable artificial intelligence (XAI) for deep learning based medical imaging classification. Journal of Imaging, 9(9), 177.

[49] Antoniadi, A. M., Du, Y., Guendouz, Y., Wei, L., Mazo, C., Becker, B. A., & Mooney, C. (2021). Current challenges and future opportunities for XAI in machine learning-based clinical decision support systems: a systematic review. Applied Sciences, 11(11), 5088.

[50] Rahman, A., Debnath, T., Kundu, D., Khan, M. S. I., Aishi, A. A., Sazzad, S., ... & Band, S. S. (2024). Machine learning and deep learning-based approach in smart healthcare: Recent advances, applications, challenges and opportunities. AIMS Public Health, 11(1), 58.

[51] Kumar, K., & Jyoti, K. (2025). Enhancing Transparency and Trust in Brain Tumor Diagnosis: An In-Depth Analysis of Deep Learning and Explainable AI Techniques.

[52] Murad, N. Y., Hasan, M. H., Azam, M. H., Yousuf, N., & Yalli, J. S. (2024). Unraveling the black box: A review of explainable deep learning healthcare techniques. IEEE Access, 12, 66556-66568.

[53] Metta, C., Beretta, A., Guidotti, R., Yin, Y., Gallinari, P., Rinzivillo, S., & Giannotti, F. (2025). Improving trust and confidence in medical skin lesion diagnosis through explainable deep learning. International Journal of Data Science and Analytics, 20(1), 183-195.

[54] Dharmarathne, G., Bogahawaththa, M., McAfee, M., Rathnayake, U., & Meddage, D. P. P. (2024). On the diagnosis of chronic kidney disease using a machine learning-based interface with explainable artificial intelligence. Intelligent Systems with Applications, 22, 200397.

[55] Moreno-Sánchez, P. A. (2023). Data-driven early diagnosis of chronic kidney disease: development and evaluation of an explainable AI model. IEEE Access, 11, 38359-38369.

[56] Koul, A., Bawa, R. K., & Kumar, Y. (2024). Enhancing the detection of airway disease by applying deep learning and explainable artificial intelligence. Multimedia Tools and Applications, 83(31), 76773-76805.

[57] Kashyap, P. P., Prakasha, G., Kumar, S., KN, S. K., Raksha, P. R., & Rastogi, S. (2025, March). Unified Model Agnostic Computation and Explainable AI for Enhanced Accuracy and Transparency in Medical Image Classification. In 2025 3rd International Conference on Smart Systems for applications in Electrical Sciences (ICSSES) (pp. 1-5). IEEE.

[58] Bouderhem, R. (2024). A comprehensive framework for transparent and explainable AI sensors in healthcare. Engineering Proceedings, 82(1), 49.

[59] Rizwan, H., Saravanakumar, A., Silva, V., & Rajapaksha, Y. Transparency Beyond Accuracy: A Comparative Study of Explainable AI in Credit Scoring and Medical Diagnosis.

[60] Pillai, V. (2024). Enhancing the transparency of data and ml models using explainable AI (XAI). Available at SSRN 4991713.

[61] Awotunde, J. B., Imoize, A. L., Adeniyi, A. E., Abiodun, K. M., Ayo, E. F., Kavitha, K. V. N., ... & Ogundokun, R. O. (2023). Explainable machine learning (XML) for multimedia-based healthcare systems: opportunities, challenges, ethical and future prospects. Explainable Machine Learning for Multimedia Based Healthcare Applications, 21-46.

[62] Singh, S. K., Virdee, B. S., Aggarwal, S., & Maroju, A. (2025). Incorporation of XAI and deep learning in biomedical imaging: a review. Polytechnic Journal, 15(1), 1-15.

[63] Shaban-Nejad, A., Michalowski, M., Brownstein, J. S., & Buckeridge, D. L. (2021). Guest editorial explainable AI: towards fairness, accountability, transparency and trust in healthcare. IEEE Journal of Biomedical and Health Informatics, 25(7), 2374-2375.

[64] Muhammad, D., Ahmed, I., Ahmad, M. O., & Bendechache, M. (2024). Randomized explainable machine learning models for efficient medical diagnosis. IEEE journal of biomedical and health informatics.

[65] Mahmood, T., Wang, Y., Khan, A. R., & Ayesha, N. (2025). Advancing explainable AI and deep learning in medical imaging for precision medicine and ethical healthcare. In Explainable AI in Healthcare Imaging for Medical Diagnoses (pp. 305-338). Academic Press.

[66] Ayesha, A., & Ahamed, N. N. Explainable artificial intelligence (EAI): For healthcare applications and improvements. In Explainable Artificial Intelligence for Biomedical and Healthcare Applications (pp. 162-196). CRC Press.

[67] Jeon, I., Kim, M., So, D., Kim, E. Y., Nam, Y., Kim, S., ... & Moon, J. (2024). Reliable autism spectrum disorder diagnosis for pediatrics using machine learning and explainable AI. Diagnostics, 14(22), 2504.

[68] Zhang, Y., Weng, Y., & Lund, J. (2022). Applications of explainable artificial intelligence in diagnosis and surgery. Diagnostics, 12(2), 237.

[69] Sushmitha, G. L. N. D., & Utukuru, S. (2025). Age-based disease prediction and health monitoring: integrating explainable AI and deep learning techniques. Iran Journal of Computer Science, 1-10.

[70] Hossain, M. I., Zamzmi, G., Mouton, P. R., Salekin, M. S., Sun, Y., & Goldgof, D. (2025). Explainable AI for medical data: Current methods, limitations, and future directions. ACM Computing Surveys, 57(6), 1-46.

How to cite this paper

SUJON SARKAR "Enhancing Medical Transparency: An Explainable AI Approach to Machine Learning-Based Healthcare Diagnostics" Iconic Research And Engineering Journals Volume 9 Issue 3 2025 Page 2101-2113
SUJON SARKAR "Enhancing Medical Transparency: An Explainable AI Approach to Machine Learning-Based Healthcare Diagnostics" Iconic Research And Engineering Journals, vol. 9, no. 3, Sep. 2025
SUJON SARKAR (2025). Enhancing Medical Transparency: An Explainable AI Approach to Machine Learning-Based Healthcare Diagnostics. Iconic Research And Engineering Journals, 9(3).
SUJON SARKAR "Enhancing Medical Transparency: An Explainable AI Approach to Machine Learning-Based Healthcare Diagnostics" Iconic Research And Engineering Journals, vol. 9, no. 3, Sep. 2025.
@article{1710495,
      author = {SUJON SARKAR},
      title = {Enhancing Medical Transparency: An Explainable AI Approach to Machine Learning-Based Healthcare Diagnostics},
      journal = {Iconic Research And Engineering Journals},
      year = {2025},
      volume = {9},
      number = {3},
      pages = {2101-2113},
      issn = {2456-8880},
      url = {https://www.irejournals.com/formatedpaper/1710495.pdf},
      abstract = {The application of AI in the healthcare diagnostics has further developed the state of disease detection, risk assessment of patients, and clinical decision-making, yet the black-box nature of the vast majority of machine learning (ML) models serves as a major factor preventing such approaches to be used in clinical practice. This project investigates the potential benefit of explainable AI (XAI) on medical transparency through optimising the trade-off between predictive performance and interpretability. We compare convolutional neural networks (CNNs), CNNs augmented with Gradient-weighted Class Activation Mapping (Grad-CAM) and Random Forests with SHapley Additive Explanations (SHAP) using the NIH ChestXray14 dataset. The results indicate that CNNs have the highest accuracy of 91 percent and AUC of 0.95, which however reflects less on clinical trust and accountability due to lack of clear interpretability. CNN + Grad-CAM models have comparable (90%) accuracy with the closest alignment with radiological reasoning in the visual explanation, whereas Random Forest + SHAP models did not necessarily perform any worse with a slightly lower accuracy (90%) but have the highest level of interpretability (fidelity = 0.89). These results highlight one of the key tradeoffs between the raw predictive performances and medical transparency: interpretability is a necessary procedure and not a luxury.},
      keywords = {Explainable AI, Healthcare Diagnostics, Machine Learning, Transparency, SHAP, Grad-CAM, Interpretability},
      month = {September},
  }