Explainable machine learning predictions to support personalized cardiology strategies

Abstract Aims A widely practiced intervention to modify cardiac health, the effect of physical activity on older adults is likely heterogeneous. While machine learning (ML) models that combine various systemic signals may aid in predictive modelling, the inability to rationalize predictions at a patient personalized level is a major shortcoming in the current field of ML. Methods and results We applied a novel methodology, SHapley Additive exPlanations (SHAP), on a dataset of older adults n = 86 (mean age 72 ± 4 years) whose physical activity levels were studied alongside changes in their left ventricular (LV) structure. SHAP was tested to provide intelligible visualization on the magnitude of the impact of the features in their physical activity levels on their LV structure. As proof of concept, using repeated K-cross-validation on the train set (n = 68), we found the Random Forest Regressor with the most optimal hyperparameters, which achieved the lowest mean squared error. With the trained model, we evaluated its performance by reporting its mean absolute error and plotting the correlation on the test set (n = 18). Based on collective force plot, individually numbered patients are indicated on the horizontal axis, and each bandwidth implies the magnitude (i.e. effect) of physical parameters (higher in red; lower in blue) towards prediction of their LV structure. Conclusions As a tool that identified specific features in physical activity that predicted cardiac structure on a per patient level, our findings support a role for explainable ML to be incorporated into personalized cardiology strategies.