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Updated: Jun 6, 2025

In Silico Clinical Trials for Cardiovascular Disease
Published on: May 27, 2022
Revolutionizing cardiovascular disease classification through machine learning and statistical methods
Tapan Kumar Behera1, Siddhartha Sathia2, Sibarama Panigrahi3
1Centre of Excellence in Natural Products and Therapeutics, Department of Biotechnology and Bioinformatics, Sambalpur University, Jyoti Vihar, Burla, Sambalpur, Odisha, India.
Insights
Machine learning (ML) models offer a cost-effective digital diagnosis for cardiovascular diseases (CVDs). The Extra Tree Classifier excels in accuracy and precision, while XGBoost leads in recall, kappa, and F1 scores for CVD classification.
Area of Science:
- Medical Informatics
- Computational Biology
- Artificial Intelligence
Background:
- Cardiovascular diseases (CVDs) encompass a range of heart and blood vessel conditions.
- Traditional CVD diagnosis relies on expensive and time-consuming expert clinical evaluation.
- Emerging machine learning (ML) and statistical techniques enable cost-effective digital CVD diagnosis.
Purpose of the Study:
- To classify cardiovascular diseases (CVDs) using 19 machine learning (ML) models.
- To evaluate and rank the performance of ML models for CVD classification.
- To assess the efficiency and reliability of ML models using benchmark datasets.
Main Methods:
- Utilized 19 ML models for CVD classification.
- Employed two benchmark CVD datasets from Kaggle and UCI repositories.
- Performed 50 simulations for each model and dataset, applying nonparametric statistical tests.
Main Results:
- Extra Tree Classifier demonstrated statistically superior accuracy and precision.
- Extreme Gradient Boost (XGBoost) classifier achieved statistically superior recall, kappa, and F1 scores.
- XGBRF classifier ranked second for recall performance.
Conclusions:
- ML models provide a viable alternative for CVD diagnosis.
- Specific ML models show distinct strengths in different performance metrics for CVD classification.
- Statistical testing confirms the significant performance differences among evaluated ML models.
Background:
Cardiovascular diseases (CVDs) include abnormal conditions of the heart, diseased blood vessels, structural problems of the heart, and blood clots. Traditionally, CVD has been diagnosed by clinical experts, physicians, and medical specialists, which is expensive, time-consuming, and requires expert intervention. On the other hand, cost-effective digital diagnosis of CVD is now possible because of the emergence of machine learning (ML) and statistical techniques.
Method:
In this research, extensive studies were carried out to classify CVD via 19 promising ML models. To evaluate the performance and rank the ML models for CVD classification, two benchmark CVD datasets are considered from well-known sources, such as Kaggle and the UCI repository. The results are analysed considering individual datasets and their combination to assess the efficiency and reliability of ML models on the basis of various performance measures, such as precision, kappa, accuracy, recall, and the F1 score. Since some of the ML models are stochastic, we repeated the simulation 50 times for each dataset using each model and applied nonparametric statistical tests to draw decisive conclusions.
Results:
The nonparametric Friedman - Nemenyi hypothesis test suggests that the Extra Tree Classifier provides statistically superior accuracy and precision compared with all other models. However, the Extreme Gradient Boost (XGBoost) classifier provides statistically superior recall, kappa, and F1 scores compared with those of all the other models. Additionally, the XGBRF classifier achieves a statistically second-best rank in terms of the recall measures.
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Homogeneity dictates that if an input x(t) is multiplied by a constant c, the output y(t) is multiplied by the same constant. Mathematically, this is expressed as: