BackgroundHeadache disorders are an important health burden, having a large health-economic impact worldwide. Current treatment & follow-up processes are often archaic, creating opportunities for computer-aided and decision support systems to increase their efficiency. Existing systems are mostly completely data-driven, and the underlying models are a black-box, deteriorating interpretability and transparency, which are key factors in order to be deployed in a clinical setting.MethodsIn this paper, a decision support system is proposed, composed of three components: (i) a cross-platform mobile application to capture the required data from patients to formulate a diagnosis, (ii) an automated diagnosis support module that generates an interpretable decision tree, based on data semantically annotated with expert knowledge, in order to support physicians in formulating the correct diagnosis and (iii) a web application such that the physician can efficiently interpret captured data and learned insights by means of visualizations.ResultsWe show that decision tree induction techniques achieve competitive accuracy rates, compared to other black- and white-box techniques, on a publicly available dataset, referred to as migbase. Migbase contains aggregated information of headache attacks from 849 patients. Each sample is labeled with one of three possible primary headache disorders. We demonstrate that we are able to reduce the classification error, statistically significant (ρ≤0.05), with more than 10% by balancing the dataset using prior expert knowledge. Furthermore, we achieve high accuracy rates by using features extracted using the Weisfeiler-Lehman kernel, which is completely unsupervised. This makes it an ideal approach to solve a potential cold start problem.ConclusionDecision trees are the perfect candidate for the automated diagnosis support module. They achieve predictive performances competitive to other techniques on the migbase dataset and are, foremost, completely interpretable. Moreover, the incorporation of prior knowledge increases both predictive performance as well as transparency of the resulting predictive model on the studied dataset.
Abstract. Models obtained by decision tree induction techniques excel in being interpretable. However, they can be prone to overfitting, which results in a low predictive performance. Ensemble techniques provide a solution to this problem, and are hence able to achieve higher accuracies. However, this comes at a cost of losing the excellent interpretability of the resulting model, making ensemble techniques impractical in applications where decision support, instead of decision making, is crucial. To bridge this gap, we present the genesim algorithm that transforms an ensemble of decision trees into a single decision tree with an enhanced predictive performance while maintaining interpretability by using a genetic algorithm. We compared genesim to prevalent decision tree induction algorithms, ensemble techniques and a similar technique, called ism, using twelve publicly available data sets. The results show that genesim achieves better predictive performance on most of these data sets compared to decision tree induction techniques & ism. The results also show that genesim's predictive performance is in the same order of magnitude as the ensemble techniques. However, the resulting model of genesim outperforms the ensemble techniques regarding interpretability as it has a very low complexity.
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