Ensemble approach of transfer learning and vision transformer leveraging explainable AI for disease diagnosis: An advancement towards smart healthcare 5.0

Smart healthcare has advanced the medical industry with the integration of data-driven approaches. Artificial intelligence and machine learning provided remarkable progress, but there is a lack of transparency and interpretability in such applications. To overcome such limitations, explainable AI (EXAI) provided a promising result. This paper applied the EXAI for disease diagnosis in the advancement of smart healthcare. The paper combined the approach of transfer learning, vision transformer, and explainable AI and designed an ensemble approach for prediction of disease and its severity. The result is evaluated on a dataset of Alzheimer's disease. The result analysis compared the performance of transfer learning models with the ensemble model of transfer learning and vision transformer. For training, InceptionV3, VGG19, Resnet50, and Densenet121 transfer learning models were selected for ensembling with vision transformer. The result compares the performance of two models: a transfer learning (TL) model and an ensemble transfer learning (Ensemble TL) model combined with vision transformer (ViT) on ADNI dataset. For the TL model, the accuracy is 58 %, precision is 52 %, recall is 42 %, and the F1-score is 44 %. Whereas, the Ensemble TL model with ViT shows significantly improved performance i.e., 96 % of accuracy, 94 % of precision, 90 % of recall and 92 % of F1-score on ADNI dataset. This shows the efficacy of the ensemble model over transfer learning models. •Comparison of transfer learning algorithms for Alzheimer's disease severity prediction from brain MRI images.•Implementation of an ensemble model that combines vision transformer models with the mentioned transfer learning algorithms.•Comprehensive comparative analysis between single transfer learning models and ensemble models.•Demonstrated superior performance of the ensemble model over other CNN-based transfer learning algorithms.•Implementation of the GradCAM model for improved model explainability, providing insights into predictions from MRI images.