Deep learning has demonstrated expert-level performance in melanoma classification, positioning it as a powerful tool in clinical dermatology. However, model opacity and the lack of interpretability remain critical barriers to clinical adoption, as clinicians often struggle to trust the decision-making processes of black-box models. To address this gap, we present a Cross-modal Explainable Framework for Melanoma (CEFM) that leverages contrastive learning as the core mechanism for achieving interpretability. Specifically, CEFM maps clinical criteria for melanoma diagnosis-namely Asymmetry, Border, and Color (ABC)-into the Vision Transformer embedding space using dual projection heads, thereby aligning clinical semantics with visual features. The aligned representations are subsequently translated into structured textual explanations via natural language generation, creating a transparent link between raw image data and clinical interpretation. Experiments on public datasets demonstrate 92.79% accuracy and an AUC of 0.961, along with significant improvements across multiple interpretability metrics. Qualitative analyses further show that the spatial arrangement of the learned embeddings aligns with clinicians' application of the ABC rule, effectively bridging the gap between high-performance classification and clinical trust.

Accurate and timely diagnosis of multi-class skin lesions is hampered by subjective methods, inherent data imbalance in datasets like HAM10000, and the "black box" nature of Deep Learning (DL) models. This study proposes a trustworthy and highly accurate Computer-Aided Diagnosis (CAD) system to overcome these limitations. The approach utilizes Deep Convolutional Generative Adversarial Networks (DCGANs) for per class data augmentation to resolve the critical class imbalance problem. A fine-tuned ResNet-50 classifier is then trained on the augmented dataset to classify seven skin disease categories. Crucially, LIME and SHAP Explainable AI (XAI) techniques are integrated to provide transparency by confirming that predictions are based on clinically relevant features like irregular morphology. The system achieved a high overall Accuracy of 92.50 % and a Macro-AUC of 98.82 %, successfully outperforming various prior benchmarked architectures. This work successfully validates a verifiable framework that combines high performance with the essential clinical interpretability required for safe diagnostic deployment. Future research should prioritize enhancing discrimination for critical categories, such as Melanoma NOS (F1-Score is 0.8602).

We propose a Bayesian decision making framework for control of Markov Decision Processes (MDPs) with unknown dynamics and large, possibly continuous, state, action, and parameter spaces in data-poor environments. Most of the existing adaptive controllers for MDPs with unknown dynamics are based on the reinforcement learning framework and rely on large data sets acquired by sustained direct interaction with the system or via a simulator. This is not feasible in many applications, due to ethical, economic, and physical constraints. The proposed framework addresses the data poverty issue by decomposing the problem into an offline planning stage that does not rely on sustained direct interaction with the system or simulator and an online execution stage. In the offline process, parallel Gaussian process temporal difference (GPTD) learning techniques are employed for near-optimal Bayesian approximation of the expected discounted reward over a sample drawn from the prior distribution of unknown parameters. In the online stage, the action with the maximum expected return with respect to the posterior distribution of the parameters is selected. This is achieved by an approximation of the posterior distribution using a Markov Chain Monte Carlo (MCMC) algorithm, followed by constructing multiple Gaussian processes over the parameter space for efficient prediction of the means of the expected return at the MCMC sample. The effectiveness of the proposed framework is demonstrated using a simple dynamical system model with continuous state and action spaces, as well as a more complex model for a metastatic melanoma gene regulatory network observed through noisy synthetic gene expression data.

We propose a Bayesian decision making framework for control of Markov Decision Processes (MDPs) with unknown dynamics and large, possibly continuous, state, action, and parameter spaces in data-poor environments. Most of the existing adaptive controllers for MDPs with unknown dynamics are based on the reinforcement learning framework and rely on large data sets acquired by sustained direct interaction with the system or via a simulator. This is not feasible in many applications, due to ethical, economic, and physical constraints. The proposed framework addresses the data poverty issue by decomposing the problem into an offline planning stage that does not rely on sustained direct interaction with the system or simulator and an online execution stage. In the offline process, parallel Gaussian process temporal difference (GPTD) learning techniques are employed for near-optimal Bayesian approximation of the expected discounted reward over a sample drawn from the prior distribution of unknown parameters. In the online stage, the action with the maximum expected return with respect to the posterior distribution of the parameters is selected. This is achieved by an approximation of the posterior distribution using a Markov Chain Monte Carlo (MCMC) algorithm, followed by constructing multiple Gaussian processes over the parameter space for efficient prediction of the means of the expected return at the MCMC sample. The effectiveness of the proposed framework is demonstrated using a simple dynamical system model with continuous state and action spaces, as well as a more complex model for a metastatic melanoma gene regulatory network observed through noisy synthetic gene expression data.

Artificial Intelligence (AI) models have demonstrated expert-level performance in melanoma detection, yet their clinical adoption is hindered by performance disparities across demographic subgroups such as gender, race, and age. Previous efforts to benchmark the performance of AI models have primarily focused on assessing model performance using group fairness metrics that rely on the Area Under the Receiver Operating Characteristic curve (AUROC), which does not provide insights into a model's ability to provide accurate estimates. In line with clinical assessments, this paper addresses this gap by incorporating calibration as a complementary benchmarking metric to AUROC-based fairness metrics. Calibration evaluates the alignment between predicted probabilities and observed event rates, offering deeper insights into subgroup biases. We assess the performance of the leading skin cancer detection algorithm of the ISIC 2020 Challenge on the ISIC 2020 Challenge dataset and the PROVE-AI dataset, and compare it with the second and third place models, focusing on subgroups defined by sex, race (Fitzpatrick Skin Tone), and age. Our findings reveal that while existing models enhance discriminative accuracy, they often over-diagnose risk and exhibit calibration issues when applied to new datasets. This study underscores the necessity for comprehensive model auditing strategies and extensive metadata collection to achieve equitable AI-driven healthcare solutions. All code is publicly available at https://github.com/bdominique/testing_strong_calibration.

As machine learning systems become increasingly integrated into human-centered domains such as healthcare, ensuring fairness while maintaining high predictive performance is critical. Existing bias mitigation techniques often impose a trade-off between fairness and accuracy, inadvertently degrading performance for certain demographic groups. In high-stakes domains like clinical diagnosis, such trade-offs are ethically and practically unacceptable. In this study, we propose a fairness-without-harm approach by learning distinct representations for different demographic groups and selectively applying demographic experts consisting of group-specific representations and personalized classifiers through a no-harm constrained selection. We evaluate our approach on three real-world medical datasets -- covering eye disease, skin cancer, and X-ray diagnosis -- as well as two face datasets. Extensive empirical results demonstrate the effectiveness of our approach in achieving fairness without harm.

The skin is the largest organ in the human body, and approximately a third of the total number of cancer cases are represented by skin cancers. Melanoma is the deadliest form of skin cancer, which is responsible for an overwhelming majority of skin cancer deaths. The number of melanoma deaths is expected to increase by 4.4% in 2023. Although the mortality is significant, when detected e arly, the 5-year survival rate for melanoma is over 99% (American Cancer Society, 2022). Currently, the most accurate way to diagnose melanoma is a biopsy. This is a penetrative surgical procedure that involves higher costs but also incorporates risks of developing various infectious diseases (Lakhtakia et al., 2009). Thus, the usual clinical practice of melanoma diagnosis is visual inspection using Dermoscopy by dermatologists or specially trained clinicians. This approach presents challenges, primarily due to its resource-intensive nature in terms of time and cost. This method's accuracy of melanoma diagnosis is approximately

Innate resistance to anti-PD-1 immunotherapy remains a major clinical challenge in metastatic melanoma, with the underlying molecular networks being poorly understood. To address this, we constructed a dynamic Probabilistic Boolean Network model using transcriptomic data from patient tumor biopsies to elucidate the regulatory logic governing therapy response. We then employed a reinforcement learning agent to systematically discover optimal, multi-step therapeutic interventions and used explainable artificial intelligence to mechanistically interpret the agent's control policy. The analysis revealed that a precisely timed, 4-step temporary inhibition of the lysyl oxidase like 2 protein (LOXL2) was the most effective strategy. Our explainable analysis showed that this ''hit-and-run" intervention is sufficient to erase the molecular signature driving resistance, allowing the network to self-correct without requiring sustained intervention. This study presents a novel, time-dependent therapeutic hypothesis for overcoming immunotherapy resistance and provides a powerful computational framework for identifying non-obvious intervention protocols in complex biological systems.

Skin cancer is a life-threatening disease where early detection significantly improves patient outcomes. Automated diagnosis from dermoscopic images is challenging due to high intra-class variability and subtle inter-class differences. Many deep learning models operate as "black boxes," limiting clinical trust. In this work, we propose a dual-encoder attention-based framework that leverages both segmented lesions and clinical metadata to enhance skin lesion classification in terms of both accuracy and interpretability. A novel Deep-UNet architecture with Dual Attention Gates (DAG) and Atrous Spatial Pyramid Pooling (ASPP) is first employed to segment lesions. The classification stage uses two DenseNet201 encoders-one on the original image and another on the segmented lesion whose features are fused via multi-head cross-attention. This dual-input design guides the model to focus on salient pathological regions. In addition, a transformer-based module incorporates patient metadata (age, sex, lesion site) into the prediction. We evaluate our approach on the HAM10000 dataset and the ISIC 2018 and 2019 challenges. The proposed method achieves state-of-the-art segmentation performance and significantly improves classification accuracy and average AUC compared to baseline models. To validate our model's reliability, we use Gradient-weighted Class Activation Mapping (Grad-CAM) to generate heatmaps. These visualizations confirm that our model's predictions are based on the lesion area, unlike models that rely on spurious background features. These results demonstrate that integrating precise lesion segmentation and clinical data with attention-based fusion leads to a more accurate and interpretable skin cancer classification model.

Early detection of melanoma has grown to be essential because it significantly improves survival rates, but automated analysis of skin lesions still remains challenging. ABCDE, which stands for Asymmetry, Border irregularity, Color variation, Diameter, and Evolving, is a well-known classification method for skin lesions, but most deep learning mechanisms treat it as a black box, as most of the human interpretable features are not explained. In this work, we propose a deep learning framework that both classifies skin lesions into categories and also quantifies scores for each ABCD feature. It simulates the evolution of these features over time in order to represent the E aspect, opening more windows for future exploration. The A, B, C, and D values are quantified particularly within this work. Moreover, this framework also visualizes ABCD feature trajectories in latent space as skin lesions evolve from benign nevuses to malignant melanoma. The experiments are conducted using the HAM10000 dataset that contains around ten thousand images of skin lesions of varying stages. In summary, the classification worked with an accuracy of around 89 percent, with melanoma AUC being 0.96, while the feature evaluation performed well in predicting asymmetry, color variation, and diameter, though border irregularity remains more difficult to model. Overall, this work provides a deep learning framework that will allow doctors to link ML diagnoses to clinically relevant criteria, thus improving our understanding of skin cancer progression. Introduction Melanoma, an aggressive form of skin cancer, is one of the leading causes of death due to skin cancer [6]. Early diagnosis is important because the 5-year survival rate exceeds 90% for early-stage melanoma, but drops below 20% for advanced stages [6]. In order to differentiate between harmful and harmless lesions, dermatologists utilize the ABCDE method. "A" stands for "asymmetry," as malignant skin lesions often appear to be uneven; "B" stands for "border irregularity," as scientists search for jagged or notched edges; "C" If a lesion displays two or more of the attributes described above, the lesion is most likely harmful melanoma.