Attri-Net: A Globally and Locally Inherently Interpretable Model for Multi-Label Classification Using Class-Specific Counterfactuals

Susu Sun1Orcid, Stefano Woerner1, Andreas Maier2Orcid, Lisa M. Koch3,4Orcid, Christian F. Baumgartner1,5Orcid
1: Cluster of Excellence: Machine Learning - New Perspectives for Science, University of Tübingen, Tübingen, Germany, 2: Department of Computer Science, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany, 3: Hertie Institute for Artificial Intelligence in Brain Health, University of Tübingen, Tübingen, Germany, 4: Department of Diabetes, Endocrinology, Nutritional Medicine and Metabolism, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland, 5: Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
Publication date: 2025/10/30
https://doi.org/10.59275/j.melba.2025-gb33
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Abstract

Interpretability is crucial for machine learning algorithms in high-stakes medical applications. However, high-performing neural networks typically cannot explain their predictions. Post-hoc explanation methods provide a way to understand neural networks but have been shown to suffer from conceptual problems. Moreover, current research largely focuses on providing local explanations for individual samples rather than global explanations for the model itself. In this paper, we propose Attri-Net, an inherently interpretable model for multi-label classification that provides both local and global explanations. Attri-Net first counterfactually generates class-specific attribution maps to highlight the disease evidence, then performs classification with logistic regression classifiers based solely on the attribution maps. Local explanations for each prediction can be obtained by interpreting the attribution maps weighted by the classifiers’ weights. Global explanation of whole model can be obtained by jointly considering learned average representations of the attribution maps for each class (called the class centers) and the weights of the linear classifiers. To ensure the model is “right for the right reason”, we introduce a mechanism to guide the model’s explanations to align with human knowledge. Our comprehensive evaluations show that Attri-Net can generate high-quality explanations consistent with clinical knowledge while not sacrificing classification performance. Our code is available at https://github.com/ss-sun/Attri-Net-V2

Keywords

Explainable machine learning · Inherently interpretable model · Multi-label classification · Model guidance

Bibtex @article{melba:2025:028:sun, title = "Attri-Net: A Globally and Locally Inherently Interpretable Model for Multi-Label Classification Using Class-Specific Counterfactuals", author = "Sun, Susu and Woerner, Stefano and Maier, Andreas and Koch, Lisa M. and Baumgartner, Christian F.", journal = "Machine Learning for Biomedical Imaging", volume = "3", issue = "October 2025 issue", year = "2025", pages = "636--664", issn = "2766-905X", doi = "https://doi.org/10.59275/j.melba.2025-gb33", url = "https://melba-journal.org/2025:028" }
RISTY - JOUR AU - Sun, Susu AU - Woerner, Stefano AU - Maier, Andreas AU - Koch, Lisa M. AU - Baumgartner, Christian F. PY - 2025 TI - Attri-Net: A Globally and Locally Inherently Interpretable Model for Multi-Label Classification Using Class-Specific Counterfactuals T2 - Machine Learning for Biomedical Imaging VL - 3 IS - October 2025 issue SP - 636 EP - 664 SN - 2766-905X DO - https://doi.org/10.59275/j.melba.2025-gb33 UR - https://melba-journal.org/2025:028 ER -

2025:028 cover