QXAI: Explainable AI Framework for Quantitative Analysis in Patient Monitoring Systems

Abstract: Artificial Intelligence techniques can be used to classify a patient's physical activities and predict vital signs for remote patient monitoring. Regression analysis based on non-linear models like deep learning models has limited explainability due to its black-box nature. This can require decision-makers to make blind leaps of faith based on non-linear model results, especially in healthcare applications. In non-invasive monitoring, patient data from tracking sensors and their predisposing clinical attributes act as input features for predicting future vital signs. Explaining the contributions of various features to the overall output of the monitoring application is critical for a clinician's decision-making. In this study, an Explainable AI for Quantitative analysis (QXAI) framework is proposed with post-hoc model explainability and intrinsic explainability for regression and classification tasks in a supervised learning approach. This was achieved by utilizing the Shapley values concept and incorporating attention mechanisms in deep learning models. We adopted the artificial neural networks (ANN) and attention-based Bidirectional LSTM (BiLSTM) models for the prediction of heart rate and classification of physical activities based on sensor data. The deep learning models achieved state-of-the-art results in both prediction and classification tasks. Global explanation and local explanation were conducted on input data to understand the feature contribution of various patient data. The proposed QXAI framework was evaluated using PPG-DaLiA data to predict heart rate and mobile health (MHEALTH) data to classify physical activities based on sensor data. Monte Carlo approximation was applied to the framework to overcome the time complexity and high computation power requirements required for Shapley value calculations.