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In addition, we aimed to determine whether XAI helps to increase the acceptance of artificial intelligence (AI) and recommend a particular method for this use case. The evaluation was conducted on a tool developed in\u2010house with different visualization approaches to the AI\u2010generated Gleason grade and the corresponding XAI explanations on top of the original slide. The study was a heuristic evaluation of five XAI methods. The participants were 15 pathologists from the University Hospital of Augsburg with a wide range of experience in Gleason grading and AI. The evaluation consisted of a user information form, short questionnaires on each XAI method, a ranking of the methods, and a general questionnaire to evaluate the performance and usefulness of the AI. There were significant differences between the ratings of the methods, with Grad\u2010CAM++ performing best. Both AI decision support and XAI explanations were seen as helpful by the majority of participants. In conclusion, our pilot study suggests that the evaluated XAI methods can indeed improve the usefulness and acceptance of AI. The results obtained are a good indicator, but further studies involving larger sample sizes are warranted to draw more definitive conclusions.<\/jats:p>","DOI":"10.1002\/2056-4538.70023","type":"journal-article","created":{"date-parts":[[2025,3,13]],"date-time":"2025-03-13T07:25:06Z","timestamp":1741850706000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Do explainable <scp>AI<\/scp> (<scp>XAI<\/scp>) methods improve the acceptance of <scp>AI<\/scp> in clinical practice? An evaluation of <scp>XAI<\/scp> methods on Gleason grading"],"prefix":"10.1002","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-5339-6091","authenticated-orcid":false,"given":"Robin","family":"Manz","sequence":"first","affiliation":[{"name":"Digital Medicine University Hospital of Augsburg  Augsburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonas","family":"B\u00e4cker","sequence":"additional","affiliation":[{"name":"Digital Medicine University Hospital of Augsburg  Augsburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samantha","family":"Cramer","sequence":"additional","affiliation":[{"name":"Digital Medicine University Hospital of Augsburg  Augsburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip","family":"Meyer","sequence":"additional","affiliation":[{"name":"Digital Medicine University Hospital of Augsburg  Augsburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0838-9885","authenticated-orcid":false,"given":"Dominik","family":"M\u00fcller","sequence":"additional","affiliation":[{"name":"Digital Medicine University Hospital of Augsburg  Augsburg Germany"},{"name":"IT\u2010Infrastructure for Translational Medical Research University of Augsburg  Augsburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4441-8006","authenticated-orcid":false,"given":"Anna","family":"Muzalyova","sequence":"additional","affiliation":[{"name":"Digital Medicine University Hospital of Augsburg  Augsburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7260-0177","authenticated-orcid":false,"given":"Lukas","family":"Rentschler","sequence":"additional","affiliation":[{"name":"Institute for Pathology and Molecular Diagnostics University Hospital of Augsburg  Augsburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Wengenmayr","sequence":"additional","affiliation":[{"name":"Digital Medicine University Hospital of Augsburg  Augsburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ludwig Christian","family":"Hinske","sequence":"additional","affiliation":[{"name":"Digital Medicine University Hospital of Augsburg  Augsburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6447-9300","authenticated-orcid":false,"given":"Ralf","family":"Huss","sequence":"additional","affiliation":[{"name":"Institute for Pathology and Molecular Diagnostics University Hospital of Augsburg  Augsburg Germany"},{"name":"BioM Biotech Cluster Development GmbH  Planegg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2495-4020","authenticated-orcid":false,"given":"Johannes","family":"Raffler","sequence":"additional","affiliation":[{"name":"Digital Medicine University Hospital of Augsburg  Augsburg Germany"},{"name":"Bavarian Cancer Research Center (BZKF)  Augsburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3061-5818","authenticated-orcid":false,"given":"I\u00f1aki","family":"Soto\u2010Rey","sequence":"additional","affiliation":[{"name":"Digital Medicine University Hospital of Augsburg  Augsburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,3,13]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41746-019-0112-2"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(19)30739-9"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/s43856-021-00005-3"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-021-01620-2"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1515\/9783839467664-009"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2022.1016366"},{"key":"e_1_2_11_8_1","unstructured":"EUR\u2010Lex \u2013 32017R0745 \u2013 EN \u2013 EUR\u2010Lex. 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