2015 · 1.6K citations · 7 references
ComputingComputer ScienceHealth InformaticsClinical Decision SupportData MiningMachine LearningDecision TreesEnsemble LearningEnsemble MethodsNeural NetworksPredictive Health ModelingProbabilistic Machine Learning30-Day ReadmissionAccuracyBoosted TreesLogistic RegressionMachine Learning For HealthcareMachine Learning Prediction ModelsRandom ForestsThirty-day Readmission
Machine learning models face a tradeoff between accuracy and intelligibility, a limitation that can hinder deployment in mission‑critical healthcare settings where model understanding is essential. The authors aim to demonstrate that generalized additive models with pairwise interactions (GA2Ms) can deliver high‑performance, intelligible models for real healthcare problems. They applied GA2Ms to pneumonia risk prediction and 30‑day hospital readmission, leveraging pairwise interactions to build modular, interpretable models. The pneumonia model revealed previously hidden patterns that could be corrected, while the readmission model scaled to large datasets and matched the accuracy of state‑of‑the‑art, unintelligible methods.
In machine learning often a tradeoff must be made between accuracy and intelligibility. More accurate models such as boosted trees, random forests, and neural nets usually are not intelligible, but more intelligible models such as logistic regression, naive-Bayes, and single decision trees often have significantly worse accuracy. This tradeoff sometimes limits the accuracy of models that can be applied in mission-critical applications such as healthcare where being able to understand, validate, edit, and trust a learned model is important. We present two case studies where high-performance generalized additive models with pairwise interactions (GA2Ms) are applied to real healthcare problems yielding intelligible models with state-of-the-art accuracy. In the pneumonia risk prediction case study, the intelligible model uncovers surprising patterns in the data that previously had prevented complex learned models from being fielded in this domain, but because it is intelligible and modular allows these patterns to be recognized and removed. In the 30-day hospital readmission case study, we show that the same methods scale to large datasets containing hundreds of thousands of patients and thousands of attributes while remaining intelligible and providing accuracy comparable to the best (unintelligible) machine learning methods.
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