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Hauser, Katja; Kurz, Alexander; Haggenmueller, Sarah; Maron, Roman C.; Kalle, Christof von; Utikal, Jochen S.; Meier, Friedegund; Hobelsberger, Sarah; Gellrich, Frank F.; Sergon, Mildred; Hauschild, Axel; French, Lars E.; Heinzerling, Lucie; Schlager, Justin G.; Ghoreschi, Kamran; Schlaak, Max; Hilke, Franz J.; Poch, Gabriela; Kutzner, Heinz; Berking, Carola; Heppt, Markus V.; Erdmann, Michael; Haferkamp, Sebastian; Schadendorf, Dirk; Sondermann, Wiebke; Goebeler, Matthias; Schilling, Bastian; Kather, Jakob N.; Froehling, Stefan; Lipka, Daniel B.; Hekler, Achim; Krieghoff-Henning, Eva und Brinker, Titus J. (2022): Explainable artificial intelligence in skin cancer recognition: A systematic review. In: European Journal of Cancer, Bd. 167: S. 54-69

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Abstract

Background: Due to their ability to solve complex problems, deep neural networks (DNNs) are becoming increasingly popular in medical applications. However, decisionmaking by such algorithms is essentially a black-box process that renders it difficult for physicians to judge whether the decisions are reliable. The use of explainable artificial intelligence We investigate how XAI is used for skin cancer detection: how is it used during the development of new DNNs? What kinds of visualisations are commonly used? Are there systematic Methods: Google Scholar, PubMed, IEEE Explore, Science Direct and Scopus were searched for peer-reviewed studies published between January 2017 and October 2021 applying XAI to dermatological images: the search terms histopathological image, whole-slide image, clinical image, dermoscopic image, skin, dermatology, explainable, interpretable and XAI were used isting XAI methods to their classifier to interpret its decision-making. Some studies (4/37) proposed new XAI methods or improved upon existing techniques. 14/37 studies addressed specific questions such as bias detection and impact of XAI on man-machine-interactions. However, only three of them evaluated the performance and confidence of humans using Conclusion: XAI is commonly applied during the development of DNNs for skin cancer detection. However, a systematic and rigorous evaluation of its usefulness in this scenario is lacking. 2022 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC

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