Detecting anomalies in longitudinal clinical profiles is clinically important but difficult: abnormal evidence is often sparse, patient histories have unequal length, and expert explanations are costly. We propose INCLAIR, a framework that scores each observation against multiple historical contexts, aggregates evidence at the profile level, and generates grounded natural-language explanations under limited expert supervision. Under stated within-profile exchangeability assumptions, the complete mean subsequence score takes an order-l U-statistic form, yielding a variance decomposition and an incomplete-subset approximation that controls combinatorial inference cost independently of profile length. The same analysis shows that mean aggregation attenuates localized anomalies by a factor set by the anomaly support and profile length, motivating validation-selected top-k pooling. Across three clinical datasets, INCLAIR consistently outperforms state-of-the-art baselines. We further validate practical relevance through a case study on longitudinal steroid profiles, comparing INCLAIR's predictions and explanations against domain-expert assessments supported by DNA analysis. The results show that INCLAIR enables clinically actionable anomaly detection under limited expert supervision.
Artificial Intelligence (AI)-based prospective anomaly detection methods are increasingly deployed in high-dimensional and nonlinear settings. Among these approaches, AI-based statistical process monitoring (SPM) is widely used, providing a structured framework for prospective monitoring. Once an anomaly is detected, a diagnosis method is needed to identify the features driving the flagged observation away from normal behaviour. Traditional SPM diagnosis methods are typically designed for specific detection models and cannot be directly applied to AI-based methods. Model-agnostic explainable AI (XAI) offers a general framework for feature relevance explanation. However, existing methods suffer from scalability limitations or assign relevance to noise features, reducing diagnosis accuracy. We propose a scalable, baseline-referenced diagnosis method that uses both the anomalous observation and normal baseline information. We provide mathematical guarantees that under a mean-shift anomaly setting, the proposed method achieves higher faithfulness in detecting the features causing the anomaly compared to LIME. Simulation studies and a real-world case study validate the effectiveness of the proposed method and show that it generates more faithful and accurate diagnosis results for AI-based prospective anomaly detection methods.
Anomaly detection in physiological sensor data from Wireless Body Area Networks (WBANs) can be caused by sensor faults, network disruptions, or missing data, leading to false alarms. Hence, it demands both high predictive accuracy and clinically interpretable explanations. Existing approaches rely either on black-box models that achieve strong performance but offer no transparency, or on post-prediction explanation methods such as SHAP and LIME. In this paper, we propose the Distilled Explanation Model (DEM), a three-stage glass-box framework that distills the non-linear knowledge of a gradient boosting expert into an interpretable decision tree operating on residuals relative to a linear baseline, so that the explanation is not an approximation but the prediction itself. DEM introduces a novel distillation fidelity metric that quantifies how faithfully the explanation tree captures the expert model's non-linear contribution, providing a principled measure of explanation trustworthiness absent from prior interpretable models. Evaluated across four physiological datasets, including MIMIC-IV, WESAD, eICU, and an in-house SmartNet WBAN corpus, DEM achieves an AUC of 0.9964 on clinical contextual anomaly detection and 0.9047 on wearable stress detection while producing human-readable if-then rules at a controllable depth. Inference requires 0.17ms per 1000 samples, rendering DEM 1235x faster than SHAP-based post-hoc explanation and suitable for real-time physiological monitoring. Ablation studies confirm that the XGBoost distillation step provides measurable gains over naive residual fitting, and depth-sensitivity analysis demonstrates an explicit, user-controlled accuracy-interpretability trade-off unique to DEM among existing intrinsically interpretable models.
Unsupervised anomaly detection scores each point of an unlabelled, contaminated sample in a single pass, and increasingly must also explain why a point is flagged. Yet the dominant detectors give a score with no account of which features drive it, and explanations are bolted on post-hoc with SHAP or LIME, which re-query the detector thousands of times per point and only approximate it. We introduce WAND, an unsupervised tabular anomaly detector that is explainable by design. WAND organises its computation around directions on the unit sphere, scoring each point by how far its projection escapes a sub-Gaussian extreme-value baseline. The originality of our approach is that the witness directions that flag a point, being vectors in feature space, are its explanation, a per-feature attribution obtained at no cost over scoring and, since the score is differentiable, recoverable by gradients. Scoring is linear in the sample size, and a probe-efficiency bound guarantees every anomaly a witness, hence an explanation. Across 47 ADBench datasets WAND attains the best mean Friedman rank at ROC-AUC parity with 16 unsupervised baselines, so the gain is interpretability at no accuracy cost; its native explanations are more accurate and faithful than post-hoc SHAP/LIME and ECOD at a fraction of the query cost. WAND is thus a practical, interpretable solution for explainable anomaly detection.