Anne-Christin Hauschild

Theresa Bender, Jacqueline Michelle Beinecke, Dagmar Krefting et al.

Despite their remarkable performance, deep neural networks remain unadopted in clinical practice, which is considered to be partially due to their lack in explainability. In this work, we apply attribution methods to a pre-trained deep neural network (DNN) for 12-lead electrocardiography classification to open this "black box" and understand the relationship between model prediction and learned features. We classify data from a public data set and the attribution methods assign a "relevance score" to each sample of the classified signals. This allows analyzing what the network learned during training, for which we propose quantitative methods: average relevance scores over a) classes, b) leads, and c) average beats. The analyses of relevance scores for atrial fibrillation (AF) and left bundle branch block (LBBB) compared to healthy controls show that their mean values a) increase with higher classification probability and correspond to false classifications when around zero, and b) correspond to clinical recommendations regarding which lead to consider. Furthermore, c) visible P-waves and concordant T-waves result in clearly negative relevance scores in AF and LBBB classification, respectively. In summary, our analysis suggests that the DNN learned features similar to cardiology textbook knowledge.

Maryam Moradpour, Jonas Harriehausen, Amirreza Aleyasin et al.

Multi-center survival prediction can improve robustness and generalizability, yet privacy regulations and institutional governance often prevent pooling patient-level clinical and genomic data across institutions. In practice, deployment is further complicated by feature-space heterogeneity, in which sites collect different covariates or use different sequencing panels, resulting in only partially overlapping feature sets. We present FederatedRSF, a Python package that implements federated random survival forests, aggregating locally trained survival trees and redistributing only feature-compatible trees to each site, enabling inference with partial overlap without sharing raw data. We evaluate FederatedRSF on the GBSG2 breast cancer cohort distributed with the scikit-survival package, simulating feature heterogeneity across clients by withholding subsets of features, and assessing discrimination using Harrell's concordance index (C-Index) under repeated cross-validation and site-splits. The results demonstrated that the federated model can achieve performance comparable to that of the centralized training setting.

Anh-Tien Nguyen, Duy Minh Ho Nguyen, Nghiem Tuong Diep et al.

Whole slide pathology image classification presents challenges due to gigapixel image sizes and limited annotation labels, hindering model generalization. This paper introduces a prompt learning method to adapt large vision-language models for few-shot pathology classification. We first extend the Prov-GigaPath vision foundation model, pre-trained on 1.3 billion pathology image tiles, into a vision-language model by adding adaptors and aligning it with medical text encoders via contrastive learning on 923K image-text pairs. The model is then used to extract visual features and text embeddings from few-shot annotations and fine-tunes with learnable prompt embeddings. Unlike prior methods that combine prompts with frozen features using prefix embeddings or self-attention, we propose multi-granular attention that compares interactions between learnable prompts with individual image patches and groups of them. This approach improves the model's ability to capture both fine-grained details and broader context, enhancing its recognition of complex patterns across sub-regions. To further improve accuracy, we leverage (unbalanced) optimal transport-based visual-text distance to secure model robustness by mitigating perturbations that might occur during the data augmentation process. Empirical experiments on lung, kidney, and breast pathology modalities validate the effectiveness of our approach; thereby, we surpass several of the latest competitors and consistently improve performance across diverse architectures, including CLIP, PLIP, and Prov-GigaPath integrated PLIP.

Khai Le-Duc, Duy M. H. Nguyen, Phuong T. H. Trinh et al.

Faithful reasoning in medical vision-language models (VLMs) requires not only accurate predictions but also transparent alignment between textual rationales and visual evidence. While Chain-of-Thought (CoT) prompting has shown promise in medical visual question answering (VQA), no large-scale expert-level dataset has captured stepwise reasoning with precise visual grounding. We introduce S-Chain, the first large-scale dataset of 12,000 expert-annotated medical images with bounding boxes and structured visual CoT (SV-CoT), explicitly linking visual regions to reasoning steps. The dataset further supports 16 languages, totaling over 700k VQA pairs for broad multilingual applicability. Using S-Chain, we benchmark state-of-the-art medical VLMs (ExGra-Med, LLaVA-Med) and general-purpose VLMs (Qwen2.5-VL, InternVL2.5), showing that SV-CoT supervision significantly improves interpretability, grounding fidelity, and robustness. Beyond benchmarking, we study its synergy with retrieval-augmented generation, revealing how domain knowledge and visual grounding interact during autoregressive reasoning. Finally, we propose a new mechanism that strengthens the alignment between visual evidence and reasoning, improving both reliability and efficiency. S-Chain establishes a new benchmark for grounded medical reasoning and paves the way toward more trustworthy and explainable medical VLMs.

Julian Matschinske, Julian Späth, Reza Nasirigerdeh et al.

Machine Learning (ML) and Artificial Intelligence (AI) have shown promising results in many areas and are driven by the increasing amount of available data. However, this data is often distributed across different institutions and cannot be shared due to privacy concerns. Privacy-preserving methods, such as Federated Learning (FL), allow for training ML models without sharing sensitive data, but their implementation is time-consuming and requires advanced programming skills. Here, we present the FeatureCloud AI Store for FL as an all-in-one platform for biomedical research and other applications. It removes large parts of this complexity for developers and end-users by providing an extensible AI Store with a collection of ready-to-use apps. We show that the federated apps produce similar results to centralized ML, scale well for a typical number of collaborators and can be combined with Secure Multiparty Computation (SMPC), thereby making FL algorithms safely and easily applicable in biomedical and clinical environments.