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Updated: Sep 20, 2025

Evidence-based Knowledge Synthesis and Hypothesis Validation: Navigating Biomedical Knowledge Bases via Explainable AI and Agentic Systems
Published on: June 13, 2025
Predicting cardiovascular risk with hybrid ensemble learning and explainable AI
Pooja Shah1, Madhu Shukla2, Neel H Dholakia2
1Department of Computer Science and Engineering, Pandit Deendayal Energy University, Knowledge Corridor, Raisan Village, Gandhinagar, Gujarat, 382007, India.
Insights
This study introduces a hybrid ensemble learning framework for cardiovascular disease (CVD) risk prediction, combining machine learning and explainable AI. The model achieves strong predictive performance and interpretability, aiding in early risk assessment and targeted treatments.
Area of Science:
- Cardiology
- Artificial Intelligence
- Machine Learning
Background:
- Cardiovascular diseases (CVDs) remain a leading global cause of mortality.
- Accurate early risk prediction is crucial for effective prevention and treatment strategies.
- Existing models may lack the robustness and interpretability needed for clinical application.
Purpose of the Study:
- To develop an innovative hybrid ensemble learning framework for cardiovascular disease (CVD) risk prediction.
- To enhance model interpretability using explainable AI (XAI) techniques.
- To improve the accuracy and trustworthiness of AI in healthcare settings.
Main Methods:
- A stacked ensemble architecture combining Gradient Boosting, CatBoost, and Neural Networks was employed.
- Publicly accessible datasets were utilized for model training and validation.
- Explainable AI methods, including SHAP values, t-SNE, and PCA, were used for visualization and interpretation.
Main Results:
- The hybrid model achieved a high Area Under the Receiver Operating Characteristic Curve (AUC-ROC) score of 0.82.
- Classification metrics demonstrated strong performance: Precision 81%, Recall 83%, and F1-Score 82%.
- Visualizations revealed multidimensional relationships between risk factors (e.g., blood pressure, BMI, cholesterol-glucose ratio) and lifestyle parameters.
Conclusions:
- Ensemble learning offers a powerful approach for complex medical prediction tasks like CVD risk assessment.
- Model interpretability is essential for building trust in AI systems within clinical practice.
- The developed framework provides a promising tool for healthcare stakeholders to identify and manage CVD risk effectively.
Abstract:
Cardiovascular diseases (CVDs) are still one of the leading causes of death globally, underscoring the importance of early and right risk prediction for effective preventive measures and therapeutic approaches. This study proposes an innovative hybrid ensemble learning framework that combines state-of-the-art machine learning models and explainable AI approaches to risk prediction for cardiovascular disease. Using a range of publicly accessible datasets, the suggested structure incorporates Gradient Boosting, CatBoost, and Neural Networks using a stacked ensemble architecture, resulting in more robust predictive performance than the constituent models. This is particularly interesting when visualised through techniques such as SHAP values, t-SNE and PCA projections which allows the study to explore the multidimensional aspects of the relationships between key risk factors including systolic/diastolic blood pressure, BMI, cholesterol-glucose ratio, alongside various lifestyle parameters. They build further on model interpretability through explainable AI methods so that clinicians can observe the involvement of each feature in generating the predictions. The hybrid model demonstrated strong predictive performance with an AUC-ROC score of 0.82, and confusion matrices showing a well-balanced classification of both positive and negative cases - achieving Precision: 81%, Recall: 83%, and F1-Score: 82% on the test dataset. The results highlight the potential of ensemble learning for addressing complex medical prediction problems and the need for models to be interpretable to ensure the trustworthiness of AI systems in healthcare settings. These findings provide an exciting opportunity toward better models of CVD risk prediction, potentially providing healthcare stakeholders with interpretable means to target treatments.
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