ProConMV: Provenance-Enabled Conceptual Framework for Interpretable Multi-View Diabetic Retinopathy Diagnosis

Existing deep learning models have demonstrated potential in Diabetic retinopathy (DR) diagnosis, but they still suffer from three key challenges: reliance on single-source inputs, opaque and untraceable reasoning processes, and the absence of a mechanism for result verification. Thus, we propose a provenance-enabled concept-based framework for multi-view DR diagnostic (ProConMV), which integrates DR lesion masks, clinical text and multi-view data, utilizing multimodal prompt analysis and visual-text concept interaction to learn the interpretable multi-source input. During the reasoning stage, the proposed framework introduces lesion concepts for causal reasoning chains combining clinical guidelines, and adds doctor intervention for human-machine collaboration. For dynamic fusion decision and verification in multi-view DR diagnosis, we derive via generalization theory that incorporating each view’s lesion concept uncertainty and grading uncertainty reduces the generalization error upper bound. Accordingly, we design a dual uncertainty-aware module to enable provenance-based verification, ultimately enabling verifiable analysis of DR diagnostic results. Extensive experiments conducted on two public multi-view DR datasets demonstrate the effectiveness of our method.