Midhat Urooj

Midhat Urooj, Ayan Banerjee, Farhat Shaikh et al.

Accurate and interpretable image-based diagnosis remains a fundamental challenge in medical AI, particularly un- der domain shifts and rare-class conditions. Deep learning mod- els often struggle with real-world distribution changes, exhibit bias against infrequent pathologies, and lack the transparency required for deployment in safety-critical clinical environments. We introduce MedXAI (An Explainable Framework for Med- ical Imaging Classification), a unified expert knowledge based framework that integrates deep vision models with clinician- derived expert knowledge to improve generalization, reduce rare- class bias, and provide human-understandable explanations by localizing the relevant diagnostic features rather than relying on technical post-hoc methods (e.g., Saliency Maps, LIME). We evaluate MedXAI across heterogeneous modalities on two challenging tasks: (i) Seizure Onset Zone localization from resting-state fMRI, and (ii) Diabetic Retinopathy grading. Ex periments on ten multicenter datasets show consistent gains, including a 3% improvement in cross-domain generalization and a 10% improvmnet in F1 score of rare class, substantially outperforming strong deep learning baselines. Ablations confirm that the symbolic components act as effective clinical priors and regularizers, improving robustness under distribution shift. MedXAI delivers clinically aligned explanations while achieving superior in-domain and cross-domain performance, particularly for rare diseases in multimodal medical AI.

Midhat Urooj, Ayan Banerjee, Sandeep Gupta

Explainability domain generalization and rare class reliability are critical challenges in medical AI where deep models often fail under real world distribution shifts and exhibit bias against infrequent clinical conditions This paper introduces XAIMeD an explainable medical AI framework that integrates clinically accurate expert knowledge into deep learning through a unified neuro symbolic architecture XAIMeD is designed to improve robustness under distribution shift enhance rare class sensitivity and deliver transparent clinically aligned interpretations The framework encodes clinical expertise as logical connectives over atomic medical propositions transforming them into machine checkable class specific rules Their diagnostic utility is quantified through weighted feature satisfaction scores enabling a symbolic reasoning branch that complements neural predictions A confidence weighted fusion integrates symbolic and deep outputs while a Hunt inspired adaptive routing mechanism guided by Entropy Imbalance Gain EIG and Rare Class Gini mitigates class imbalance high intra class variability and uncertainty We evaluate XAIMeD across diverse modalities on four challenging tasks i Seizure Onset Zone SOZ localization from rs fMRI ii Diabetic Retinopathy grading across 6 multicenter datasets demonstrate substantial performance improvements including 6 percent gains in cross domain generalization and a 10 percent improved rare class F1 score far outperforming state of the art deep learning baselines Ablation studies confirm that the clinically grounded symbolic components act as effective regularizers ensuring robustness to distribution shifts XAIMeD thus provides a principled clinically faithful and interpretable approach to multimodal medical AI.

Bin Xu, Ayan Banerjee, Midhat Urooj et al.

Digital twins (DTs) can enable precision healthcare by continually learning a mathematical representation of patient-specific dynamics. However, mission critical healthcare applications require fast, resource-efficient DT learning, which is often infeasible with existing model recovery (MR) techniques due to their reliance on iterative solvers and high compute/memory demands. In this paper, we present a general DT learning framework that is amenable to acceleration on reconfigurable hardware such as FPGAs, enabling substantial speedup and energy efficiency. We compare our FPGA-based implementation with a multi-processing implementation in mobile GPU, which is a popular choice for AI in edge devices. Further, we compare both edge AI implementations with cloud GPU baseline. Specifically, our FPGA implementation achieves an 8.8x improvement in \text{performance-per-watt} for the MR task, a 28.5x reduction in DRAM footprint, and a 1.67x runtime speedup compared to cloud GPU baselines. On the other hand, mobile GPU achieves 2x better performance per watts but has 2x increase in runtime and 10x more DRAM footprint than FPGA. We show the usage of this technique in DT guided synthetic data generation for Type 1 Diabetes and proactive coronary artery disease detection.

Midhat Urooj, Ayan Banerjee, Farhat Shaikh et al.

Domain generalization remains a critical challenge in medical imaging, where models trained on single sources often fail under real-world distribution shifts. We propose KG-DG, a neuro-symbolic framework for diabetic retinopathy (DR) classification that integrates vision transformers with expert-guided symbolic reasoning to enable robust generalization across unseen domains. Our approach leverages clinical lesion ontologies through structured, rule-based features and retinal vessel segmentation, fusing them with deep visual representations via a confidence-weighted integration strategy. The framework addresses both single-domain generalization (SDG) and multi-domain generalization (MDG) by minimizing the KL divergence between domain embeddings, thereby enforcing alignment of high-level clinical semantics. Extensive experiments across four public datasets (APTOS, EyePACS, Messidor-1, Messidor-2) demonstrate significant improvements: up to a 5.2% accuracy gain in cross-domain settings and a 6% improvement over baseline ViT models. Notably, our symbolic-only model achieves a 63.67% average accuracy in MDG, while the complete neuro-symbolic integration achieves the highest accuracy compared to existing published baselines and benchmarks in challenging SDG scenarios. Ablation studies reveal that lesion-based features (84.65% accuracy) substantially outperform purely neural approaches, confirming that symbolic components act as effective regularizers beyond merely enhancing interpretability. Our findings establish neuro-symbolic integration as a promising paradigm for building clinically robust, and domain-invariant medical AI systems.