SoftCAM: Making black box models self-explainable for medical image analysis

Published: 14 Feb 2026, Last Modified: 23 Apr 2026MIDL 2026 PosterEveryoneRevisionsBibTeXCC BY 4.0
Keywords: ElasticNet, Self-explainable models, Convolutional Neural Networks, Class Activation Maps, Attribution maps
TL;DR: we introduce SoftCAM, a straightforward yet effective approach that makes standard CNN architectures inherently interpretable.
Abstract: Convolutional neural networks (CNNs) are widely used for high-stakes applications like medicine, often surpassing human performance. However, most explanation methods rely on post-hoc attribution, approximating the decision-making process of already trained black-box models. These methods are often sensitive, unreliable, and fail to reflect true model reasoning, limiting their trustworthiness in critical applications. In this work, we introduce SoftCAM, a straightforward yet effective approach that makes standard CNN architectures inherently interpretable. By removing the global average pooling layer and replacing the fully connected classification layer with a convolution-based class evidence layer, SoftCAM preserves spatial information and produces explicit class activation maps that form the basis of the model's predictions. Evaluated on three medical datasets spanning three imaging modalities, SoftCAM maintains classification performance while significantly improving both the qualitative and quantitative explanation compared to existing post-hoc methods. The code is available at \url{https://github.com/kdjoumessi/SoftCAM}.
Primary Subject Area: Interpretability and Explainable AI
Secondary Subject Area: Detection and Diagnosis
Registration Requirement: Yes
Reproducibility: https://github.com/kdjoumessi/SoftCAM
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Originality Policy: Yes
Single-blind & Not Under Review Elsewhere: Yes
LLM Policy: Yes
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