Saliency maps have been widely used to interpret deep learning classifiers for Alzheimer's disease (AD). However, since AD is heterogeneous and has multiple subtypes, the pathological mechanism of AD remains not fully understood and may vary from patient to patient. Due to the lack of such understanding, it is difficult to comprehensively and effectively assess the saliency map of AD classifier. In this paper, we utilize the anatomical segmentation to allocate saliency values into different brain regions. By plotting the distributions of saliency maps corresponding to AD and NC (Normal Control), we can gain a comprehensive view of the model's decisions process. In order to leverage the fact that the brain volume shrinkage happens in AD patients during disease progression, we define a new evaluation metric, brain volume change score (VCS), by computing the average Pearson correlation of the brain volume changes and the saliency values of a model in different brain regions for each patient. Thus, the VCS metric can help us gain some knowledge of how saliency maps resulting from different models relate to the changes of the volumes across different regions in the whole brain. We trained candidate models on the ADNI dataset and tested on three different datasets. Our results indicate: (i) models with higher VCSs tend to demonstrate saliency maps with more details relevant to the AD pathology, (ii) using gradient-based adversarial training strategies such as FGSM and stochastic masking can improve the VCSs of the models.

Motivation: Disease diagnosis oriented dialogue system models the interactive consultation procedure as Markov Decision Process and reinforcement learning algorithms are used to solve the problem. Existing approaches usually employ a flat policy structure that treat all symptoms and diseases equally for action making. This strategy works well in the simple scenario when the action space is small, however, its efficiency will be challenged in the real environment. Inspired by the offline consultation process, we propose to integrate a hierarchical policy structure of two levels into the dialogue systemfor policy learning. The high-level policy consists of amastermodel that is responsible for triggering a low-levelmodel, the lowlevel policy consists of several symptom checkers and a disease classifier. The proposed policy structure is capable to deal with diagnosis problem including large number of diseases and symptoms. Results: Experimental results on three real-world datasets and a synthetic dataset demonstrate that our hierarchical framework achieves higher accuracy and symptom recall in disease diagnosis compared with existing systems. We construct a benchmark including datasets and implementation of existing algorithms to encourage follow-up researches. Availability: The code and data is available from https://github.com/FudanDISC/DISCOpen-MedBox-DialoDiagnosis Contact: 21210980124@m.fudan.edu.cn Supplementary information: Supplementary data are available at Bioinformatics online.