Uncertainty-Aware Medical Image Explanation Cards: LLM-Generated Visual Explanations for AI-Assisted Radiology Interfaces

Authors

  • Ziliang Samuel Zhong New York University, NY, USA
  • Qiyou Wu Artificial Intelligence, Northeastern University, MA, USA
  • Gaotian Mi Biomedical Engineering, Johns Hopkins University, MD, USA

DOI:

https://doi.org/10.51903/ijgd.v3i2.3616

Keywords:

radiology interface design, explainable artificial intelligence, Grad-CAM, uncertainty visualization, LLM microcopy, PneumoniaMNIST, visual hierarchy, UI/UX, medical image communication

Abstract

This study investigates how visual hierarchy, calibrated probability, uncertainty cues, Grad-CAM heatmaps, and role-specific language generation can be integrated into compact explanation cards for AI-assisted radiology interfaces. The empirical task was a reproducible PneumoniaMNIST-compatible normal-versus-pneumonia chest X-ray classification problem that preserves the MedMNIST label schema, split sizes, and NPZ data structure. All reported performance values were computed by the included scripts on the packaged dataset; every result table contains measured values from saved experimental artifacts. Six model variants were evaluated with accuracy, AUC, F1, sensitivity, specificity, negative log-likelihood, Brier score, and expected calibration error. The selected Spatial-CNN with temperature scaling achieved AUC = 0.868, accuracy = 0.763, F1 = 0.778, specificity = 0.923, Brier score = 0.155, and ECE = 0.021 on the 624-image test split. A warning rule using confidence, entropy, and MC-dropout variance flagged 310 test cases and captured 113 of 148 model errors. Grad-CAM stability was audited on a 200-case stratified subset, and role-specific microcopy was generated for clinician-facing, patient-facing, and uncertainty-warning cards. Patient-facing text achieved a mean Flesch Reading Ease of 74.6 and FK grade of 5.4, while clinician text preserved concise technical language. The contribution is a visual communication system for AI diagnostic cards that connects empirical model behavior with user-centered explanation design rather than treating explainability as an isolated algorithmic overlay.

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Published

2025-10-29

How to Cite

Uncertainty-Aware Medical Image Explanation Cards: LLM-Generated Visual Explanations for AI-Assisted Radiology Interfaces. (2025). International Journal of Graphic Design, 3(2), 415-436. https://doi.org/10.51903/ijgd.v3i2.3616