Explainable Machine Learning System for Predicting Chronic Kidney Disease in High-Risk Cardiovascular Patients (2404.11148v1)
Abstract: As the global population ages, the incidence of Chronic Kidney Disease (CKD) is rising. CKD often remains asymptomatic until advanced stages, which significantly burdens both the healthcare system and patient quality of life. This research developed an explainable machine learning system for predicting CKD in patients with cardiovascular risks, utilizing medical history and laboratory data. The Random Forest model achieved the highest sensitivity of 88.2%. The study introduces a comprehensive explainability framework that extends beyond traditional feature importance methods, incorporating global and local interpretations, bias inspection, biomedical relevance, and safety assessments. Key predictive features identified in global interpretation were the use of diabetic and ACEI/ARB medications, and initial eGFR values. Local interpretation provided model insights through counterfactual explanations, which aligned with other system parts. After conducting a bias inspection, it was found that the initial eGFR values and CKD predictions exhibited some bias, but no significant gender bias was identified. The model's logic, extracted by scoped rules, was confirmed to align with existing medical literature. The safety assessment tested potentially dangerous cases and confirmed that the model behaved safely. This system enhances the explainability, reliability, and accountability of the model, promoting its potential integration into healthcare settings and compliance with upcoming regulatory standards, and showing promise for broader applications in healthcare machine learning.
- Csaba P. Kovesdy. Epidemiology of chronic kidney disease: an update 2022. Kidney International Supplements, 12(1):7–11, April 2022.
- World Health Organization: WHO. The top 10 causes of death, 2020.
- Chronic kidney disease in the united states, 2023, 2023.
- Chronic kidney disease in patients at high risk of cardiovascular disease in the united arab emirates: A population-based study. PLoS ONE, 13, 6 2018.
- Serg Masis. Interpretable Machine Learning with Python: Learn to build interpretable high-performance models with hands-on real-world examples. Packt Publishing, 3 2021.
- Prototype selection for interpretable classification. The Annals of Applied Statistics, 5, 12 2011.
- Christoph Molnar. Interpretable Machine Learning: A Guide for Making Black Box Models Explainable. independently published, second edition, 2 2022.
- A machine learning analysis of health records of patients with chronic kidney disease at risk of cardiovascular disease. IEEE Access, 9:165132–165144, 2021.
- Diabetes and ckd in the united states population, 2009–2014. Clinical Journal of the American Society of Nephrology, 12:1984–1990, 12 2017.
- Chronic kidney disease and diabetes. Maturitas, 71:94–103, 2 2012.
- Cardiovascular outcomes and all-cause mortality: Exploring the interaction between ckd and cardiovascular disease. American Journal of Kidney Diseases, 48:392–401, 9 2006.
- Hypertension in ckd: Core curriculum 2019. American Journal of Kidney Diseases, 74:120–131, 7 2019.
- Chronic kidney disease in older people: Physiology, pathology or both? Nephron Clinical Practice, 116:c19–c24, 5 2010.
- Association between prediabetes and risk of chronic kidney disease: a systematic review and meta-analysis. Diabetic Medicine, 33:1615–1624, 12 2016.
- 496-p: Risk factors for incident ckd in prediabetes. Diabetes, 69, 6 2020.
- Association between dyslipidemia and chronic kidney disease: a cross-sectional study in the middle-aged and elderly chinese population. Chinese medical journal, 126:1207–12, 4 2013.
- The association between dyslipidemia and the incidence of chronic kidney disease in the general zhejiang population: a retrospective study. BMC Nephrology, 21:252, 12 2020.
- Ace inhibitors and arbs: Managing potassium and renal function. Cleveland Clinic Journal of Medicine, 86:601–607, 9 2019.
- Nantika Nguycharoen (1 paper)