Machine learning (ML) utilizes artificial intelligence to generate predictive models efficiently and more effectively than conventional methods through detection of hidden patterns within large data sets. With this in mind, there are several areas within hepatology where these methods can be applied. In this review, we examine the literature pertaining to machine learning in hepatology and liver transplant medicine. We provide an overview of the strengths and limitations of ML tools and their potential applications to both clinical and molecular data in hepatology. ML has been applied to various types of data in liver disease research, including clinical, demographic, molecular, radiological, and pathological data. We anticipate that use of ML tools to generate predictive algorithms will change the face of clinical practice in hepatology and transplantation. This review will provide readers with the opportunity to learn about the ML tools available and potential applications to questions of interest in hepatology.

Background: Diabetes significantly impacts long-term survival after liver transplantation (LT). We aimed to identify survival factors for diabetic LT recipients to inform preventive care, using machine learning analysis. Methods: We analyzed risk factors for mortality in patients from across the U.S. using Scientific Registry of Transplant Recipients (SRTR). Patients had undergone LT from 1987-2019, with a follow-up of 6.47 years (SD: 5.95). Findings were validated on a cohort from

The recent increase in the deployment of machine learning models in critical domains such as healthcare, criminal justice, and finance has highlighted the need for trustworthy methods that can explain these models to stakeholders. Feature importance methods (e.g. gain and SHAP) are among the most popular explainability methods used to address this need. For any explainability technique to be trustworthy and meaningful, it has to provide an explanation that is accurate and stable. Although the stability of local feature importance methods (explaining individual predictions) has been studied before, there is yet a knowledge gap about the stability of global features importance methods (explanations for the whole model). Additionally, there is no study that evaluates and compares the accuracy of global feature importance methods with respect to feature ordering. In this paper, we evaluate the accuracy and stability of global feature importance methods through comprehensive experiments done on simulations as well as four real-world datasets. We focus on tree-based ensemble methods as they are used widely in industry and measure the accuracy and stability of explanations under two scenarios: 1. when inputs are perturbed 2. when models are perturbed. Our findings provide a comparison of these methods under a variety of settings and shed light on the limitations of global feature importance methods by indicating their lack of accuracy with and without noisy inputs, as well as their lack of stability with respect to: 1.

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