Benchmarking Interpretability in Healthcare Using Pattern Discovery and Disentanglement
Bibliographic record
Abstract
The healthcare industry seeks to integrate AI into clinical applications, yet understanding AI decision making remains a challenge for healthcare practitioners as these systems often function as black boxes. Our work benchmarks the Pattern Discovery and Disentanglement (PDD) system's unsupervised learning algorithm, which provides interpretable outputs and clustering results from clinical notes to aid decision making. Using the MIMIC-IV dataset, we process free-text clinical notes and ICD-9 codes with Term Frequency-Inverse Document Frequency and Topic Modeling. The PDD algorithm discretizes numerical features into event-based features, discovers association patterns from a disentangled statistical feature value association space, and clusters clinical records. The output is an interpretable knowledge base linking knowledge, patterns, and data to support decision making. Despite being unsupervised, PDD demonstrated performance comparable to supervised deep learning models, validating its clustering ability and knowledge representation. We benchmark interpretability techniques-Feature Permutation, Gradient SHAP, and Integrated Gradients-on the best-performing models (in terms of F1, ROC AUC, balanced accuracy, etc.), evaluating these based on sufficiency, comprehensiveness, and sensitivity metrics. Our findings highlight the limitations of feature importance ranking and post hoc analysis for clinical diagnosis. Meanwhile, PDD's global interpretability effectively compensates for these issues, helping healthcare practitioners understand the decision-making process and providing suggestive clusters of diseases to assist their diagnosis.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.009 | 0.039 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.004 | 0.002 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".