Cited by 125Artificial Intelligence in Healthcare and EducationExplainable Artificial Intelligence (XAI)Multimodal Machine Learning Applications

Transparent medical image AI via an image–text foundation model grounded in medical literature

Open access
Kim, Chanwoo, Gadgil, Soham U., DeGrave, Alex J., Omiye, Jesutofunmi A., Cai, Zhuo Ran, Daneshjou, Roxana, Lee, Su-In·2024·Nature Medicine

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Abstract

Abstract Building trustworthy and transparent image-based medical AI systems requires the ability to interrogate data and models at all stages of the development pipeline: from training models to post-deployment monitoring. Ideally, the data and associated AI systems could be described using terms already familiar to physicians, but this requires medical datasets densely annotated with semantically meaningful concepts. Here, we present a foundation model approach, named MONET ( M edical c ON cept r ET riever), which learns how to connect medical images with text and generates dense concept annotations to enable tasks in AI transparency from model auditing to model interpretation. Dermatology provides a demanding use case for the versatility of MONET, due to the heterogeneity in diseases, skin tones, and imaging modalities. We trained MONET on the basis of 105,550 dermatological images paired with natural language descriptions from a large collection of medical literature. MONET can accurately annotate concepts across dermatology images as verified by board-certified dermatologists, outperforming supervised models built on previously concept-annotated dermatology datasets. We demonstrate how MONET enables AI transparency across the entire AI development pipeline from dataset auditing to model auditing to building inherently interpretable models.

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  • PanDerm surpassed vision-language models such as CLIP, MONET and BiomedCLIP in benchmark evaluations.

    “Furthermore, PanDerm also surpassed vision-language models such as CLIP36, MONET39 and biomedical-specific CLIP (BiomedCLIP)40 in benchmark evaluations (Supplementary Table 1)”
  • CLIP-large outperformed biomedical-specific and dermatology-specific CLIP models.

    “CLIP-large outperformed biomedical-specific and dermatology-specific CLIP models”

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Authors
Kim, C., Gadgil, S. U., DeGrave, A. J., Omiye, J. A., Cai, Z. R., Daneshjou, R., & Lee, S.-I.
Affiliations
  • University of Washington (US)
  • Stanford Medicine (US)
  • Stanford University (US)
Corresponding author
  • Daneshjou, Roxana
  • Lee, Su-In
Venue
Nature Medicine
Published
2024-04
Volume
30
Issue
4
Pages
1154-1165
ISSN
  • 1078-8956 (ISSN-L)
  • 1546-170X
OpenAlex
W4394832225
Cited by
125
References
72
Citations by year
2026: 48 · 2025: 50 · 2024: 25 · 2023: 2
FWCI
11.52
Type
journal article
Language
en
Open access
Locations
  • Nature Medicine (publishedVersion, cc-by)
  • medRxiv (acceptedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • PubMed Central (submittedVersion, cc-by-nc)
Funders
  • National Science Foundation (DBI-1552309, DBI-1759487)
  • U.S. Department of Health & Human Services | National Institutes of Health (R01 AG061132, R35 GM 128638, 5T32 AR007422-38, AR007422-38)
Topics
  • Health Sciences › Medicine › Health Informatics › Artificial Intelligence in Healthcare and Education
  • Physical Sciences › Computer Science › Artificial Intelligence › Explainable Artificial Intelligence (XAI)
  • Physical Sciences › Computer Science › Computer Vision and Pattern Recognition › Multimodal Machine Learning Applications
Keywords
vision-language models, medical literature, dermatological images, model auditing, data auditing, model interpretability, AI transparency, self-supervised learning

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