E-TBI: explainable outcome prediction after traumatic brain injury using machine learning

Traumatic brain injury (TBI) is one of the most prevalent health conditions, with severity assessment serving as an initial step for management, prognosis, and targeted therapy. Existing studies on automated outcome prediction using machine learning (ML) often overlook the importance of TBI features in decision-making and the challenges posed by limited and imbalanced training data. Furthermore, many attempts have focused on quantitatively evaluating ML algorithms without explaining the decisions, making the outcomes difficult to interpret and apply for less-experienced doctors. This study presents a novel supportive tool, named E-TBI (explainable outcome prediction after TBI), designed with a user-friendly web-based interface to assist doctors in outcome prediction after TBI using machine learning. The tool is developed with the capability to visualize rules applied in the decision-making process. At the tool's core is a feature selection and classification module that receives multimodal data from TBI patients (demographic data, clinical data, laboratory test results, and CT findings). It then infers one of four TBI severity levels. This research investigates various machine learning models and feature selection techniques, ultimately identifying the optimal combination of gradient boosting machine and random forest for the task, which we refer to as GBMRF. This method enabled us to identify a small set of essential features, reducing patient testing costs by 35%, while achieving the highest accuracy rates of 88.82% and 89.78% on two datasets (a public TBI dataset and our self-collected dataset, TBI_MH103). Classification modules are available at https://github.com/auverngo110/Traumatic_Brain_Injury_103 .