Figure 4.

Gradient-weighted Class Activation Mapping (Grad-CAM) of the incorrectly predicted tympanic membrane images. (A) Otitis media with effusion was misdiagnosed as chronic otitis media because the machine learning model focused on the retracted part of the tympanic membrane and considered it as a perforation. (B) The machine learning model predicted a normal tympanic membrane by focusing on the pars tensa area of the tympanic membrane. The heat map image failed to highlight the small attic retraction and cholesteatoma materials.