Inherently interpretable machine learning (IML) models provide valuable insights for clinical decision-making but face challenges when features have missing values. Classical solutions like imputation or excluding incomplete records are often unsuitable in applications where values are missing at test time. In this work, we conducted a survey with 71 clinicians from 29 trauma centers across France, including 20 complete responses to study the interaction between medical professionals and IML applied to data with missing values. This provided valuable insights into how missing data is interpreted in clinical machine learning. We used the prediction of hemorrhagic shock as a concrete example to gauge the willingness and readiness of the participants to adopt IML models from three classes of methods. Our findings show that, while clinicians value interpretability and are familiar with common IML methods, classical imputation techniques often misalign with their intuition, and that models that natively handle missing values are preferred. These results emphasize the need to integrate clinical intuition into future IML models for better human-computer interaction.

Despite the unprecedented performance of deep neural networks (DNNs) in computer vision, their practical application in the diagnosis and prognosis of cancer using medical imaging has been limited. One of the critical challenges for integrating diagnostic DNNs into radiological and oncological applications is their lack of interpretability, preventing clinicians from understanding the model predictions. Therefore, we study and propose the integration of expert-derived radiomics and DNN-predicted biomarkers in interpretable classifiers which we call ConRad, for computerized tomography (CT) scans of lung cancer. Importantly, the tumor biomarkers are predicted from a concept bottleneck model (CBM) such that once trained, our ConRad models do not require labor-intensive and time-consuming biomarkers. In our evaluation and practical application, the only input to ConRad is a segmented CT scan. The proposed model is compared to convolutional neural networks (CNNs) which act as a black box classifier. We further investigated and evaluated all combinations of radiomics, predicted biomarkers and CNN features in five different classifiers. We found the ConRad models using non-linear SVM and the logistic regression with the Lasso outperform others in five-fold cross-validation, although we highlight that interpretability of ConRad is its primary advantage. The Lasso is used for feature selection, which substantially reduces the number of non-zero weights while increasing the accuracy. Overall, the proposed ConRad model combines CBM-derived biomarkers and radiomics features in an interpretable ML model which perform excellently for the lung nodule malignancy classification.

Background: Elderly patients with MODS have high risk of death and poor prognosis. The performance of current scoring systems assessing the severity of MODS and its mortality remains unsatisfactory. This study aims to develop an interpretable and generalizable model for early mortality prediction in elderly patients with MODS. Methods: The MIMIC-III, eICU-CRD and PLAGH-S databases were employed for model generation and evaluation. We used the eXtreme Gradient Boosting model with the SHapley Additive exPlanations method to conduct early and interpretable predictions of patients' hospital outcome. Three types of data source combinations and five typical evaluation indexes were adopted to develop a generalizable model. Findings: The interpretable model, with optimal performance developed by using MIMIC-III and eICU-CRD datasets, was separately validated in MIMIC-III, eICU-CRD and PLAGH-S datasets (no overlapping with training set). The performances of the model in predicting hospital mortality as validated by the three datasets were: AUC of 0.858, sensitivity of 0.834 and specificity of 0.705; AUC of 0.849, sensitivity of 0.763 and specificity of 0.784; and AUC of 0.838, sensitivity of 0.882 and specificity of 0.691, respectively. Comparisons of AUC between this model and baseline models with MIMIC-III dataset validation showed superior performances of this model; In addition, comparisons in AUC between this model and commonly used clinical scores showed significantly better performance of this model. Interpretation: The interpretable machine learning model developed in this study using fused datasets with large sample sizes was robust and generalizable. This model outperformed the baseline models and several clinical scores for early prediction of mortality in elderly ICU patients. The interpretative nature of this model provided clinicians with the ranking of mortality risk features.

Can you interpret a deep neural network? Building a complex and dense machine learning model has the potential of reaching our desired accuracy, but does it make sense? Can you open up the black-box model and explain how it arrived at the final result? These are critical questions we need to answer as data scientists. A wide variety of businesses are relying on machine learning to drive their strategy and spruce up their bottomline. Building a model that we can explain to our clients and stakeholders is key.

With a mortality rate of 5.4 million lives worldwide every year and a healthcare cost of more than 16 billion dollars in the USA alone, sepsis is one of the leading causes of hospital mortality and an increasing concern in the ageing western world. Recently, medical and technological advances have helped re-define the illness criteria of this disease, which is otherwise poorly understood by the medical society. Together with the rise of widely accessible Electronic Health Records, the advances in data mining and complex nonlinear algorithms are a promising avenue for the early detection of sepsis. This work contributes to the research effort in the field of automated sepsis detection with an open-access labelling of the medical MIMIC-III data set. Moreover, we propose MGP-AttTCN: a joint multitask Gaussian Process and attention-based deep learning model to early predict the occurrence of sepsis in an interpretable manner. We show that our model outperforms the current state-of-the-art and present evidence that different labelling heuristics lead to discrepancies in task difficulty.

The Clock Drawing Test (CDT) is a rapid, inexpensive, and popular neuropsychological screening tool for cognitive conditions. The Digital Clock Drawing Test (dCDT) uses novel software to analyze data from a digitizing ballpoint pen that reports its position with considerable spatial and temporal precision, making possible the analysis of both the drawing process and final product. We developed methodology to analyze pen stroke data from these drawings, and computed a large collection of features which were then analyzed with a variety of machine learning techniques. The resulting scoring systems were designed to be more accurate than the systems currently used by clinicians, but just as interpretable and easy to use. The systems also allow us to quantify the tradeoff between accuracy and interpretability. We created automated versions of the CDT scoring systems currently used by clinicians, allowing us to benchmark our models, which indicated that our machine learning models substantially outperformed the existing scoring systems.