arXiv Machine Learning By Lalit Kumar

Pathology Transport: Optimal-Transport Explanations for Clinical Data, and When Their Heatmaps (Fail to) Localize Disease

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The paper presents an optimal‑transport based generative model that learns the distributional differences between healthy and diseased patients, producing per‑patient counterfactuals and label‑free attribution heatmaps. On tabular breast cancer data the model achieves high malignancy scoring (AUROC ≈ 0.91) and its attributions correlate moderately with a supervised classifier, yet it does not surpass logistic regression. In chest X‑ray experiments the transport heatmaps capture population‑level signals but fail to localize real lesions, revealing a synthetic‑to‑real gap that challenges the reliability of label‑free explanations.

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