Co-design for Trustworthy AI: An Interpretable and Explainable Tool for Type 2 Diabetes Prediction Using Genomic Polygenic Risk Scores

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Main Authors: Beuthan, Ralf, Coffee, Megan, Kim, Heejin, Kim, Na Yeon, Kringen, Pedro, Hildt, Elisabeth, Lee, Haekyung, Lee, Seunggeun, Mathez, Emilie Wiinblad, Maliphol, Sira, Pak, Vadim, Park, Yuna, Sonnenberg, Stephan, Tithi, Jesmin Jahan, Westerlund, Magnus, Zicari, Roberto V.
Format: Preprint
Published: 2026
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author Beuthan, Ralf
Coffee, Megan
Kim, Heejin
Kim, Na Yeon
Kringen, Pedro
Hildt, Elisabeth
Lee, Haekyung
Lee, Seunggeun
Mathez, Emilie Wiinblad
Maliphol, Sira
Pak, Vadim
Park, Yuna
Sonnenberg, Stephan
Tithi, Jesmin Jahan
Westerlund, Magnus
Zicari, Roberto V.
author_facet Beuthan, Ralf
Coffee, Megan
Kim, Heejin
Kim, Na Yeon
Kringen, Pedro
Hildt, Elisabeth
Lee, Haekyung
Lee, Seunggeun
Mathez, Emilie Wiinblad
Maliphol, Sira
Pak, Vadim
Park, Yuna
Sonnenberg, Stephan
Tithi, Jesmin Jahan
Westerlund, Magnus
Zicari, Roberto V.
contents The polygenic risk scores (PRS) have emerged as an important methodology for quantifying genetic predisposition to complex traits and clinical disease. Significant progress has been made in applying PRS to conditions such as obesity, cancer, and type 2 diabetes (T2DM). Studies have demonstrated that PRS can effectively identify individuals at high risk, thereby enabling early screening, personalized treatment, and targeted interventions for diseases with a genetic predisposition. One current limitation of PRS, however, is the lack of interpretability tools. To address this problem for T2DM, researchers at the Graduate School of Data Science at the Seoul National University introduced eXplainable PRS (XPRS). This visualization tool decomposes PRSs into gene-level and single-nucleotide polymorphism (SNP) contribution scores via Shapley Additive Explanations (SHAP), providing granular insights into the specific genetic factors driving an individual's risk profile. We used a co-design approach to assess XPRS trustworthiness by considering legal, medical, ethical, and technical robustness during early design and potential clinical use. For that, we used Z-inspection, an ethically aligned Trustworthy AI co-design methodology, and piloted the Council of Europe's Human Rights, Democracy, and the Rule of Law Impact Assessment for AI Systems (HUDERIA) (Council of Europe (CAI) 2025). The findings of this use-case comprise a comprehensive set of ethical, legal, and technical lessons learned. These insights, identified by a multidisciplinary team of experts (ethics, legal, human rights, computer science, and medical), serve as a framework for designers to navigate future challenges with this and other AI systems. The findings also provide a useful reference for researchers developing explainability frameworks for PRS in diverse clinical contexts.
format Preprint
id arxiv_https___arxiv_org_abs_2604_08217
institution arXiv
publishDate 2026
record_format arxiv
spellingShingle Co-design for Trustworthy AI: An Interpretable and Explainable Tool for Type 2 Diabetes Prediction Using Genomic Polygenic Risk Scores
Beuthan, Ralf
Coffee, Megan
Kim, Heejin
Kim, Na Yeon
Kringen, Pedro
Hildt, Elisabeth
Lee, Haekyung
Lee, Seunggeun
Mathez, Emilie Wiinblad
Maliphol, Sira
Pak, Vadim
Park, Yuna
Sonnenberg, Stephan
Tithi, Jesmin Jahan
Westerlund, Magnus
Zicari, Roberto V.
Computers and Society
K.4.1; J.3; I.2.0
The polygenic risk scores (PRS) have emerged as an important methodology for quantifying genetic predisposition to complex traits and clinical disease. Significant progress has been made in applying PRS to conditions such as obesity, cancer, and type 2 diabetes (T2DM). Studies have demonstrated that PRS can effectively identify individuals at high risk, thereby enabling early screening, personalized treatment, and targeted interventions for diseases with a genetic predisposition. One current limitation of PRS, however, is the lack of interpretability tools. To address this problem for T2DM, researchers at the Graduate School of Data Science at the Seoul National University introduced eXplainable PRS (XPRS). This visualization tool decomposes PRSs into gene-level and single-nucleotide polymorphism (SNP) contribution scores via Shapley Additive Explanations (SHAP), providing granular insights into the specific genetic factors driving an individual's risk profile. We used a co-design approach to assess XPRS trustworthiness by considering legal, medical, ethical, and technical robustness during early design and potential clinical use. For that, we used Z-inspection, an ethically aligned Trustworthy AI co-design methodology, and piloted the Council of Europe's Human Rights, Democracy, and the Rule of Law Impact Assessment for AI Systems (HUDERIA) (Council of Europe (CAI) 2025). The findings of this use-case comprise a comprehensive set of ethical, legal, and technical lessons learned. These insights, identified by a multidisciplinary team of experts (ethics, legal, human rights, computer science, and medical), serve as a framework for designers to navigate future challenges with this and other AI systems. The findings also provide a useful reference for researchers developing explainability frameworks for PRS in diverse clinical contexts.
title Co-design for Trustworthy AI: An Interpretable and Explainable Tool for Type 2 Diabetes Prediction Using Genomic Polygenic Risk Scores
topic Computers and Society
K.4.1; J.3; I.2.0
url https://arxiv.org/abs/2604.08217