Beyond Black-Box AI: Interpretable Hybrid Systems for Dementia Care

The recent boom of large language models (LLMs) has re-ignited the hope that artificial intelligence (AI) systems could aid medical diagnosis. Yet despite dazzling benchmark scores, LLM assistants have yet to deliver measurable improvements at the bedside. This scoping review aims to highlight the areas where AI is limited to make practical contributions in the clinical setting, specifically in dementia diagnosis and care. Standalone machine-learning models excel at pattern recognition but seldom provide actionable, interpretable guidance, eroding clinician trust. Adjacent use of LLMs by physicians did not result in better diagnostic accuracy or speed. Key limitations trace to the data-driven paradigm: black-box outputs which lack transparency, vulnerability to hallucinations, and weak causal reasoning. Hybrid approaches that combine statistical learning with expert rule-based knowledge, and involve clinicians throughout the process help bring back interpretability. They also fit better with existing clinical workflows, as seen in examples like PEIRS and ATHENA-CDS. Future decision-support should prioritise explanatory coherence by linking predictions to clinically meaningful causes. This can be done through neuro-symbolic or hybrid AI that combines the language ability of LLMs with human causal expertise. AI researchers have addressed this direction, with explainable AI and neuro-symbolic AI being the next logical steps in further advancement in AI. However, they are still based on data-driven knowledge integration instead of human-in-the-loop approaches. Future research should measure success not only by accuracy but by improvements in clinician understanding, workflow fit, and patient outcomes. A better understanding of what helps improve human-computer interactions is greatly needed for AI systems to become part of clinical practice.

Proceedings of the Pacific Knowledge Acquisition Workshop 2004

Artificial intelligence (AI) research has evolved over the last few decades and knowledge acquisition research is at the core of AI research. PKAW-04 is one of three international knowledge acquisition workshops held in the Pacific-Rim, Canada and Europe over the last two decades. PKAW-04 has a strong emphasis on incremental knowledge acquisition, machine learning, neural nets and active mining. The proceedings contain 19 papers that were selected by the program committee among 24 submitted papers. All papers were peer reviewed by at least two reviewers. The papers in these proceedings cover the methods and tools as well as the applications related to develop expert systems or knowledge based systems.