A Clinical Decision Support System (CDSS) for Unbiased Prediction of Caesarean Section Based on Features Extraction and Optimized Classification

Abstract

Nowadays, caesarean section (CS) is given preference over vaginal birth and this trend is rapidly rising around the globe, although CS has serious complications such as pregnancy scar, scar dehiscence, and morbidly adherent placenta. Thus, CS should only be performed when it is absolutely necessary for mother and fetus. To avoid unnecessary CS, researchers have developed different machine-learning- (ML-) based clinical decision support systems (CDSS) for CS prediction using electronic health record of the pregnant women. However, previously proposed methods suffer from the problems of poor accuracy and biasedness in ML. To overcome these problems, we have designed a novel CDSS where random oversampling example (ROSE) technique has been used to eliminate the problem of minority classes in the dataset. Furthermore, principal component analysis has been employed for feature extraction from the dataset while, for classification purpose, random forest (RF) model is deployed. We have fine-tuned the hyperparameter of RF using a grid search algorithm for optimal classification performance. Thus, the newly proposed system is named ROSE-PCA-RF and it is trained and tested using an online CS dataset available on the UCI repository. In the first experiment, conventional RF model is trained and tested on the dataset while in the second experiment, the proposed model is tested. The proposed ROSE-PCA-RF model improved the performance of traditional RF by 4.5% with reduced time complexity, while only using two extracted features through the PCA. Moreover, the proposed model has obtained 96.29% accuracy on training data while improving the accuracy of 97.12% on testing data.