Medicare fraud poses a substantial challenge to healthcare systems, resulting in significant financial losses and undermining the quality of care provided to legitimate beneficiaries. This study investigates the use of machine learning (ML) to enhance Medicare fraud detection, addressing key challenges such as class imbalance, high-dimensional data, and evolving fraud patterns. A dataset comprising inpatient claims, outpatient claims, and beneficiary details was used to train and evaluate five ML models: Random Forest, KNN, LDA, Decision Tree, and AdaBoost. Data preprocessing techniques included resampling SMOTE method to address the class imbalance, feature selection for dimensionality reduction, and aggregation of diagnostic and procedural codes. Random Forest emerged as the best-performing model, achieving a training accuracy of 99.2% and validation accuracy of 98.8%, and F1-score (98.4%). The Decision Tree also performed well, achieving a validation accuracy of 96.3%. KNN and AdaBoost demonstrated moderate performance, with validation accuracies of 79.2% and 81.1%, respectively, while LDA struggled with a validation accuracy of 63.3% and a low recall of 16.6%. The results highlight the importance of advanced resampling techniques, feature engineering, and adaptive learning in detecting Medicare fraud effectively. This study underscores the potential of machine learning in addressing the complexities of fraud detection. Future work should explore explainable AI and hybrid models to improve interpretability and performance, ensuring scalable and reliable fraud detection systems that protect healthcare resources and beneficiaries.

Policymakers often use Classification and Regression Trees (CART) to partition populations based on binary outcomes and target subpopulations whose probability of the binary event exceeds a threshold. However, classic CART and knowledge distillation method whose student model is a CART (referred to as KD-CART) do not minimize the misclassification risk associated with classifying the latent probabilities of these binary events. To reduce the misclassification risk, we propose two methods, Penalized Final Split (PFS) and Maximizing Distance Final Split (MDFS). PFS incorporates a tunable penalty into the standard CART splitting criterion function. MDFS maximizes a weighted sum of distances between node means and the threshold. It can point-identify the optimal split under the unique intersect latent probability assumption. In addition, we develop theoretical result for MDFS splitting rule estimation, which has zero asymptotic risk. Through extensive simulation studies, we demonstrate that these methods predominately outperform classic CART and KD-CART in terms of misclassification error. Furthermore, in our empirical evaluations, these methods provide deeper insights than the two baseline methods.

This paper proposes a financial fraud detection system based on improved Random Forest (RF) and Gradient Boosting Machine (GBM). Specifically, the system introduces a novel model architecture called GBM-SSRF (Gradient Boosting Machine with Simplified and Strengthened Random Forest), which cleverly combines the powerful optimization capabilities of the gradient boosting machine (GBM) with improved randomization. The computational efficiency and feature extraction capabilities of the Simplified and Strengthened Random Forest (SSRF) forest significantly improve the performance of financial fraud detection. Although the traditional random forest model has good classification capabilities, it has high computational complexity when faced with large-scale data and has certain limitations in feature selection. As a commonly used ensemble learning method, the GBM model has significant advantages in optimizing performance and handling nonlinear problems. However, GBM takes a long time to train and is prone to overfitting problems when data samples are unbalanced. In response to these limitations, this paper optimizes the random forest based on the structure, reducing the computational complexity and improving the feature selection ability through the structural simplification and enhancement of the random forest. In addition, the optimized random forest is embedded into the GBM framework, and the model can maintain efficiency and stability with the help of GBM's gradient optimization capability. Experiments show that the GBM-SSRF model not only has good performance, but also has good robustness and generalization capabilities, providing an efficient and reliable solution for financial fraud detection.

The Internet of Things generates massive data streams, with edge computing emerging as a key enabler for online IoT applications and 5G networks. Edge solutions facilitate real-time machine learning inference, but also require continuous adaptation to concept drifts. Ensemble-based solutions improve predictive performance, but incur higher resource consumption, latency, and memory demands. This paper presents DFDT: Dynamic Fast Decision Tree, a novel algorithm designed for energy-efficient memory-constrained data stream mining. DFDT improves hoeffding tree growth efficiency by dynamically adjusting grace periods, tie thresholds, and split evaluations based on incoming data. It incorporates stricter evaluation rules (based on entropy, information gain, and leaf instance count), adaptive expansion modes, and a leaf deactivation mechanism to manage memory, allowing more computation on frequently visited nodes while conserving energy on others. Experiments show that the proposed framework can achieve increased predictive performance (0.43 vs 0.29 ranking) with constrained memory and a fraction of the runtime of VFDT or SVFDT.

This study bridges the knowledge gap on how personal factors affect building occupants' responses in active shooter situations by applying interpretable machine learning methods to data from 107 participants. The personal factors studied are training methods, prior training experience, sense of direction, and gender. The response performance measurements consist of decisions (run, hide, multiple), vulnerability (corresponding to the time a participant is visible to a shooter), and pre-evacuation time. The results indicate that the propensity to run significantly determines overall response strategies, overshadowing vulnerability, and pre-evacuation time. The training method is a critical factor where VR-based training leads to better responses than video-based training. A better sense of direction and previous training experience are correlated with a greater propensity to run and less vulnerability. Gender slightly influences decisions and vulnerability but significantly impacts pre-evacuation time, with females evacuating slower, potentially due to higher risk perception. This study underscores the importance of personal factors in shaping responses to active shooter incidents.

The North Slope of Alaska is dominated by small waterbodies that provide critical ecosystem services for local population and wildlife. Detailed information on the depth of the waterbodies is scarce due to the challenges with collecting such information. In this work we have trained a machine learning (Random Forest Regressor) model to predict depth from multispectral Landsat data in waterbodies across the North Slope of Alaska. The greatest challenge is the scarcity of in situ data, which is expensive and difficult to obtain, to train the model. We overcame this challenge by using modeled depth predictions from a prior study as synthetic training data to provide a more diverse training data pool for the Random Forest. The final Random Forest model was more robust than models trained directly on the in situ data and when applied to 208 Landsat 8 scenes from 2016 to 2018 yielded a map with an overall $r^{2}$ value of 0.76 on validation. The final map has been made available through the Oak Ridge National Laboratory Distribute Active Archive Center (ORNL-DAAC). This map represents a first of its kind regional assessment of waterbody depth with per pixel estimates of depth for the entire North Slope of Alaska.

Random forests are widely used in regression. However, the decision trees used as base learners are poor approximators of linear relationships. To address this limitation we propose RaFFLE (Random Forest Featuring Linear Extensions), a novel framework that integrates the recently developed PILOT trees (Piecewise Linear Organic Trees) as base learners within a random forest ensemble. PILOT trees combine the computational efficiency of traditional decision trees with the flexibility of linear model trees. To ensure sufficient diversity of the individual trees, we introduce an adjustable regularization parameter and use node-level feature sampling. These modifications improve the accuracy of the forest. We establish theoretical guarantees for the consistency of RaFFLE under weak conditions, and its faster convergence when the data are generated by a linear model. Empirical evaluations on 136 regression datasets demonstrate that RaFFLE outperforms the classical CART and random forest methods, the regularized linear methods Lasso and Ridge, and the state-of-the-art XGBoost algorithm, across both linear and nonlinear datasets. By balancing predictive accuracy and computational efficiency, RaFFLE proves to be a versatile tool for tackling a wide variety of regression problems.

Machine learning models can inadvertently expose confidential properties of their training data, making them vulnerable to membership inference attacks (MIA). While numerous evaluation methods exist, many require computationally expensive processes, such as training multiple shadow models. This article presents two new complementary approaches for efficiently identifying vulnerable tree-based models: an ante-hoc analysis of hyperparameter choices and a post-hoc examination of trained model structure. While these new methods cannot certify whether a model is safe from MIA, they provide practitioners with a means to significantly reduce the number of models that need to undergo expensive MIA assessment through a hierarchical filtering approach. More specifically, it is shown that the rank order of disclosure risk for different hyperparameter combinations remains consistent across datasets, enabling the development of simple, human-interpretable rules for identifying relatively high-risk models before training. While this ante-hoc analysis cannot determine absolute safety since this also depends on the specific dataset, it allows the elimination of unnecessarily risky configurations during hyperparameter tuning. Additionally, computationally inexpensive structural metrics serve as indicators of MIA vulnerability, providing a second filtering stage to identify risky models after training but before conducting expensive attacks. Empirical results show that hyperparameter-based risk prediction rules can achieve high accuracy in predicting the most at risk combinations of hyperparameters across different tree-based model types, while requiring no model training. Moreover, target model accuracy is not seen to correlate with privacy risk, suggesting opportunities to optimise model configurations for both performance and privacy.

Audiology entities are using Machine Learning (ML) models to guide their screening towards people at risk. Feature Engineering (FE) focuses on optimizing data for ML models, with evolutionary methods being effective in feature selection and construction tasks. This work aims to benchmark an evolutionary FE wrapper, using models based on decision trees as proxies. The FEDORA framework is applied to a Hearing Loss (HL) dataset, being able to reduce data dimensionality and statistically maintain baseline performance. Compared to traditional methods, FEDORA demonstrates superior performance, with a maximum balanced accuracy of 76.2%, using 57 features. The framework also generated an individual that achieved 72.8% balanced accuracy using a single feature.

Deep distributed decision trees and tree ensembles have grown in importance due to the need to model increasingly large datasets. However, PLANET, the standard distributed tree learning algorithm implemented in systems such as \xgboost and Spark MLlib, scales poorly as data dimensionality and tree depths grow. We present Yggdrasil, a new distributed tree learning method that outperforms existing methods by up to 24x. Unlike PLANET, Yggdrasil is based on vertical partitioning of the data (i.e., partitioning by feature), along with a set of optimized data structures to reduce the CPU and communication costs of training. Yggdrasil (1) trains directly on compressed data for compressible features and labels; (2) introduces efficient data structures for training on uncompressed data; and (3) minimizes communication between nodes by using sparse bitvectors.