Evidence map›Paper›PMID 41350577›Full record

ArticleNPJ digital medicine2025

The cost of explainability in artificial intelligence-enhanced electrocardiogram models.

Konstantinos Patlatzoglou, Libor Pastika, Joseph Barker, Ewa Sieliwonczyk, Gul Rukh Khattak, Boroumand Zeidaabadi, Antônio H Ribeiro, James S Ware, Nicholas S Peters, Antonio Luiz P Ribeiro and 4 more

Abstract read
In one paragraph

Article in NPJ digital medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Review
  3. A lesson from the past and the future of artificial intelligence in medical decision-making.Journal of perinatology : official journal of the California Perinatal Association · 2026
    Review
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Konstantinos PatlatzoglouNational Heart and Lung Institute, Imperial College London, London, UK.
Libor PastikaNational Heart and Lung Institute, Imperial College London, London, UK.
Joseph BarkerNational Heart and Lung Institute, Imperial College London, London, UK.
Ewa SieliwonczykNational Heart and Lung Institute, Imperial College London, London, UK.
Gul Rukh KhattakNational Heart and Lung Institute, Imperial College London, London, UK.
Boroumand ZeidaabadiNational Heart and Lung Institute, Imperial College London, London, UK.
Antônio H RibeiroDepartment of Information Technology, Uppsala University, Uppsala, Sweden.
James S WareNational Heart and Lung Institute, Imperial College London, London, UK.
Nicholas S PetersNational Heart and Lung Institute, Imperial College London, London, UK.
Antonio Luiz P RibeiroDepartment of Internal Medicine, Faculdade de Medicina, and Telehealth Center and Cardiology Service, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
Daniel B KramerRichard A. and Susan F. Smith Center for Outcomes Research in Cardiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Jonathan W WaksHarvard-Thorndike Electrophysiology Institute, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Arunashis SauNational Heart and Lung Institute, Imperial College London, London, UK.
Fu Siong NgNational Heart and Lung Institute, Imperial College London, London, UK. f.ng@imperial.ac.uk.

Funding

British Heart Foundation RG/F/22/110078
6 · The paper itself

Abstract

Artificial intelligence-enhanced electrocardiogram (AI-ECG) models have shown outstanding performance in diagnostic and prognostic tasks, yet their black-box nature hampers clinical adoption. Meanwhile, a growing demand for explainable AI in medicine underscores the need for transparent, trustworthy decision-making. Moving beyond post-hoc explainability techniques that have shown unreliable results, we focus on explicit representation learning using variational autoencoders (VAE) to capture inherently interpretable ECG features. While VAEs have demonstrated potential for ECG interpretability, the presumed performance-explainability trade-off remains underexplored, with many studies relying on complex, non-linear methods that obscure the morphological information of the features. In this work, we present a novel framework (VAE-SCAN) to model bi-directional, interpretable associations between ECG features and clinical factors. We also investigate how different representations affect ECG decoding performance across models with varying levels of explainability. Our findings demonstrate the cost introduced by intrinsic ECG interpretability, based on which we discuss potential implications and directions.

Identifiers

PMID41350577
PMCPMC12680752

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.