Explainable AI-Enhanced Ensemble Protocol Using Gradient-Boosted Models for Zero-False-Alarm Seizure Detection from...

Epilepsy affects over 50 million people worldwide, yet automated seizure detection systems either achieve moderate sensitivity with excessive false alarms or rely on uninterpretable deep networks. This study presents a patient-independent EEG-based seizure detection framework that achieved zero false alarms in 24 h with 95% sensitivity in a retrospective evaluation on a CHB-MIT pediatric cohort (n = 6 seizure-positive patients). The pipeline extracts 27 time-, frequency-, and nonlinear-domain features from 5 s windows and trains five ensemble classifiers (XGBoost, CatBoost, LightGBM, Extra Trees, Random Forest) using strict leave-one-subject-out cross-validation. All models achieved segment-level AUC ≥ 0.99. Under zero-false-alarm constraints, XGBoost attained perfect specificity with 0.922 sensitivity. SHAP and LIME analyses suggested candidate EEG biomarkers that appear consistent with known ictal signatures, including temporo-parietal theta-band power, amplitude variability (IQR, RMS), and Hjorth activity. External validation on the Siena Scalp EEG Database (12 adult patients, 37 seizures) demonstrated cross-dataset generalization with 95% event-level sensitivity (Extra Trees) and AUC of 0.86 (Random Forest). Temporal lobe channels dominated feature importance in both datasets, confirming consistent biomarker identification across pediatric and adult populations. These findings demonstrate that calibrated gradient-boosted ensembles using interpretable EEG features achieve clinically safe seizure detection with cross-dataset generalizability.