Deep neural network predictions are notoriously difficult to interpret. Feature attribution methods aim to explain these predictions by identifying the contribution of each input feature. Faithfulness, often evaluated using the area over the perturbation curve (AOPC), reflects feature attributions’ accuracy in describing the internal mechanisms of deep neural networks. However, many studies rely on AOPC to compare faithfulness across different models, which we show can lead to false conclusions about models’ faithfulness. Specifically, we find that AOPC is sensitive to variations in the model, resulting in unreliable cross-model comparisons. Moreover, AOPC scores are difficult to interpret in isolation without knowing the model-specific lower and upper limits. To address these issues, we propose a normalization approach, Normalized AOPC (NAOPC), enabling consistent cross-model evaluations and more meaningful interpretation of individual scores. Our experiments demonstrate that this normalization can radically change AOPC results, questioning the conclusions of earlier studies and offering a more robust framework for assessing feature attribution faithfulness. Our code is available at https://github.com/JoakimEdin/naopc.

In medical coding, experts map unstructured clinical notes to alphanumeric codes for diagnoses and procedures. We introduce ‘Code Like Humans’: a new agentic framework for medical coding with large language models. It implements official coding guidelines for human experts, and it is the first solution that can support the full ICD-10 coding system (+70K labels). It achieves the best performance to date on rare diagnosis codes. Fine-tuned discriminative classifiers retain an advantage for high-frequency codes, to which they are limited. Towards future work, we also contribute an analysis of system performance and identify its ‘blind spots’ (codes that are systematically undercoded).