arXiv subjects

Kerol Djoumessi

Publications and source records attributed to Kerol Djoumessi.

9 recordsLinked to original sources

arXiv2026

Beyond Predictive Fairness: Quantifying Attribution Consistency Across Demographic Groups in Diabetic Retinopathy Screening

Fairness in medical imaging is commonly evaluated through subgroup performance metrics, yet it remains unclear whether models rely on consistent visual evidence across demographic groups. This work introduces the Explanation Consistency Score (ECS), a fairness-aware metric based on Jensen-Shannon divergence that quantifies the similarity of attribution maps across subgroups. Using diabetic retinopathy screening as a case study, ECS is evaluated globally and within disease severity. Experiments reveal that while predictive performance differs across ethnic groups, explanation consistency remains relatively high and shows no significant association with performance disparities. These findings suggest that predictive fairness and explanation consistency capture complementary dimensions of model behavior, motivating fairness evaluations that extend beyond predictive performance.

cs.LG↗

arXiv2026

MIFR: A Modality-Invariant and Fair Representation Framework for Skin Disease Classification

Skin diseases represent a major global public health burden, yet machine learning tools developed to assist in their diagnosis suffer from two critical limitations: reliance on only one modality for diagnosis and systematic performance disparities across skin tones. While existing approaches address each challenge separately, this work proposes a modality-invariant framework with fair representation (MIFR) for skin disease classification. The architecture pairs clinical photographs with dermoscopic images using ViT-based encoders, projecting each input into a high-dimensional embedding space via modality-specific projection heads. The resulting model is trained with a five-component multi-objective loss including weighted cross-entropy for classification, confusion and skin-type classification losses for fairness, per-modality supervised contrastive loss for class alignment, and a modality-invariance loss for clinical and dermoscopic modality alignment. Experiments on the HIBA+Derm7pt paired dataset and the external PAD-UFES-20 and ISIC 2019 datasets showed that modality-invariant representation learning provides competitive predictive performance compare to relevant baseline models and competitive fairness on the internal dataset. t-SNE visualizations confirmed that clinical and dermoscopic embeddings of the same disease are geometrically aligned, validating the joint objectives.

cs.CV↗

arXiv2026

Towards Interpretable Foundation Models for Retinal Fundus Images

Foundation models are used to extract transferable representations from large amounts of unlabeled data, typically via self-supervised learning (SSL). However, many of these models rely on architectures that offer limited interpretability, a critical issue in high-stakes domains such as medical imaging. We propose DualIFM, a foundation model that is interpretable-by-design via a BagNet backbone whose small receptive fields generate class evidence maps that are faithful to the model's decision-making process. Additionally, DualIFM incorporates a $2D$ projection layer during pretraining that enables direct visualization of the representation space, providing a dataset-level view of the learned structure including meaningful clinical clusters as well as potential spurious correlations. We trained DualIFM on over 800,000 color fundus photographs from various sources to learn generalizable representations for different downstream tasks. Our model achieves performance comparable to RETFound, which has $16\times$ more parameters, while providing interpretable predictions on out-of-distribution data. These results suggest that large-scale SSL pretraining paired with inherent interpretability can lead to robust representations for retinal imaging. Code and pretrained models are available at github.com/berenslab/interpretable_FM.

cs.CV↗

arXiv2026

TTE-CAM: Self-Explainable Class Activation Maps for Pretrained Black-Box CNNs

Convolutional neural networks (CNNs) achieve state-of-the-art performance in medical image analysis yet remain opaque, limiting adoption in high-stakes clinical settings. Existing approaches face a fundamental trade-off: post-hoc methods provide unfaithful approximate explanations, while inherently interpretable architectures are faithful but often sacrifice predictive performance. We introduce TTE-CAM, a test-time framework that bridges this gap by converting pretrained black-box CNNs into self-explainable models via a convolution-based replacement of their classification head, initialized from the original weights. The resulting model preserves black-box predictive performance while delivering built-in faithful explanations competitive with post-hoc methods, both qualitatively and quantitatively. The code is available at https://github.com/kdjoumessi/Test-Time-Explainability

cs.CV↗

arXiv2026

Beyond Accuracy: Evaluating Efficiency, Robustness and Explainability in Deep Learning for Malaria Diagnosis

Malaria remains a leading cause of mortality in sub-Saharan Africa, where scarce diagnostic infrastructure makes timely, accurate diagnosis particularly challenging. While deep learning offers a compelling path toward automated malaria screening, clinical adoption is hindered by computational cost and opacity in decision-making. This work benchmarks four deep learning models spanning a wide range of designed design architectures and model capacities on the NLM-Malaria dataset, jointly evaluating predictive performance, robustness, and post-hoc explainability. We find that lightweight, efficient-by-design models match their heavier counterparts in predictive performance, and the Friedman test confirms no statistically significant performance differences. CAM-based XAI methods consistently localize diagnostically relevant regions, while fine-grained attribution methods produce less targeted explanations, particularly with heavier backbones. Robustness evaluation under three types of image corruption further reveals that model confidence degrades faster than accuracy, providing a practical signal for human review. However, no XAI method is robust to corruption, with explanation reliability degrading at noise levels plausible in clinical practice, even when predictions remain accurate. These findings support the deployment of lightweight architectures for malaria diagnosis in resource-constrained settings, while highlighting the vulnerability of post-hoc explanations as an important consideration for responsible clinical deployment.

cs.LG↗

arXiv2026

Soft-CAM: Making black box models self-explainable for medical image analysis

Convolutional neural networks (CNNs) are widely used for high-stakes applications like medicine, often surpassing human performance. However, most explanation methods rely on post-hoc attribution, approximating the decision-making process of already trained black-box models. These methods are often sensitive, unreliable, and fail to reflect true model reasoning, limiting their trustworthiness in critical applications. In this work, we introduce SoftCAM, a straightforward yet effective approach that makes standard CNN architectures inherently interpretable. By removing the global average pooling layer and replacing the fully connected classification layer with a convolution-based class evidence layer, SoftCAM preserves spatial information and produces explicit class activation maps that form the basis of the model's predictions. Evaluated on three medical datasets, SoftCAM maintains classification performance while significantly improving both the qualitative and quantitative explanation compared to existing post-hoc methods. Our results demonstrate that CNNs can be inherently interpretable without compromising performance, advancing the development of self-explainable deep learning for high-stakes decision-making. The code is available at https://github.com/kdjoumessi/SoftCAM

cs.LG↗

arXiv2025

A Hybrid Fully Convolutional CNN-Transformer Model for Inherently Interpretable Disease Detection from Retinal Fundus Images

In many medical imaging tasks, convolutional neural networks (CNNs) efficiently extract local features hierarchically. More recently, vision transformers (ViTs) have gained popularity, using self-attention mechanisms to capture global dependencies, but lacking the inherent spatial localization of convolutions. Therefore, hybrid models combining CNNs and ViTs have been developed to combine the strengths of both architectures. However, such hybrid models are difficult to interpret, which hinders their application in medical imaging. In this work, we introduce an interpretable-by-design hybrid fully convolutional CNN-Transformer architecture for retinal disease detection. Unlike widely used post-hoc saliency methods for ViTs, our approach generates faithful and localized evidence maps that directly reflect the mode's decision process. We evaluated our method on two medical tasks focused on disease detection using color fundus images. Our model achieves state-of-the-art predictive performance compared to black-box and interpretable models and provides class-specific sparse evidence maps in a single forward pass. The code is available at: https://github.com/kdjoumessi/Self-Explainable-CNN-Transformer.

cs.CV↗

arXiv2025

Prototype-Guided and Lightweight Adapters for Inherent Interpretation and Generalisation in Federated Learning

Federated learning (FL) provides a promising paradigm for collaboratively training machine learning models across distributed data sources while maintaining privacy. Nevertheless, real-world FL often faces major challenges including communication overhead during the transfer of large model parameters and statistical heterogeneity, arising from non-identical independent data distributions across clients. In this work, we propose an FL framework that 1) provides inherent interpretations using prototypes, and 2) tackles statistical heterogeneity by utilising lightweight adapter modules to act as compressed surrogates of local models and guide clients to achieve generalisation despite varying client distribution. Each client locally refines its model by aligning class embeddings toward prototype representations and simultaneously adjust the lightweight adapter. Our approach replaces the need to communicate entire model weights with prototypes and lightweight adapters. This design ensures that each client's model aligns with a globally shared structure while minimising communication load and providing inherent interpretations. Moreover, we conducted our experiments on a real-world retinal fundus image dataset, which provides clinical-site information. We demonstrate inherent interpretable capabilities and perform a classification task, which shows improvements in accuracy over baseline algorithms.

cs.LG↗

arXiv2024

This actually looks like that: Proto-BagNets for local and global interpretability-by-design

Interpretability is a key requirement for the use of machine learning models in high-stakes applications, including medical diagnosis. Explaining black-box models mostly relies on post-hoc methods that do not faithfully reflect the model's behavior. As a remedy, prototype-based networks have been proposed, but their interpretability is limited as they have been shown to provide coarse, unreliable, and imprecise explanations. In this work, we introduce Proto-BagNets, an interpretable-by-design prototype-based model that combines the advantages of bag-of-local feature models and prototype learning to provide meaningful, coherent, and relevant prototypical parts needed for accurate and interpretable image classification tasks. We evaluated the Proto-BagNet for drusen detection on publicly available retinal OCT data. The Proto-BagNet performed comparably to the state-of-the-art interpretable and non-interpretable models while providing faithful, accurate, and clinically meaningful local and global explanations. The code is available at https://github.com/kdjoumessi/Proto-BagNets.

cs.AI↗