Explainable classifier for improving the accountability in decision-making for colorectal cancer diagnosis from histopathological images

Pathologists are responsible for cancer type diagnoses from histopathological cancer tissues. However, it is known that microscopic examination is tedious and time-consuming. In recent years, a long list of machine learning approaches to image classification and whole-slide segmentation has been developed to support pathologists. Although many showed exceptional performances, the majority of them are not able to rationalize their decisions. In this study, we developed an explainable classifier to support decision making for medical diagnoses. The proposed model does not provide an explanation about the causality between the input and the decisions, but offers a human-friendly explanation about the plausibility of the decision. Cumulative Fuzzy Class Membership Criterion (CFCMC) explains its decisions in three ways: through a semantical explanation about the possibilities of misclassification, showing the training sample responsible for a certain prediction and showing training samples from conflicting classes. In this paper, we explain about the mathematical structure of the classifier, which is not designed to be used as a fully automated diagnosis tool but as a support system for medical experts. We also report on the accuracy of the classifier against real world histopathological data for colorectal cancer. We also tested the acceptability of the system through clinical trials by 14 pathologists. We show that the proposed classifier is comparable to state of the art neural networks in accuracy, but more importantly it is more acceptable to be used by human experts as a diagnosis tool in the medical domain.