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Statistically valid explainable black-box machine learning: applications in sex classification across species using
Tingshan Liu1, Jayanta Dey1, Beiya Xu1
1Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Maryland, United States of America.
Plos One
|April 16, 2026
Summary
We developed a new framework using Oblique Random Forests (ORFs) and NEOFIT to accurately classify sex from brain scans. This method reveals key neuroanatomical differences, improving personalized diagnostics and understanding sex-based brain variations.
Area of Science:
- Neuroimaging
- Machine Learning
- Comparative Anatomy
Background:
- Sex classification from neuroimaging data offers potential for personalized diagnostics by identifying sex-specific brain differences linked to disease risks.
- Traditional machine learning methods struggle with high-dimensional neuroimaging data, lacking accuracy and interpretable feature importance.
- Existing techniques like random forests, LIME, and SHAP face challenges with complex feature interactions and noise in large datasets.
Purpose of the Study:
- To develop an integrated framework combining Oblique Random Forests (ORFs) and a novel permutation-based feature importance testing algorithm (NEOFIT).
- To enhance classification accuracy and provide statistically validated, interpretable feature importance for sex classification using neuroimaging data.
- To enable cross-species comparison of sex-based brain structure differences in humans and macaques.
Main Methods:
- Developed an integrated framework using Oblique Random Forests (ORFs) with oblique decision boundaries for complex feature interactions.
- Introduced NEOFIT, a permutation-based feature importance testing algorithm for rigorous statistical validation and corrected p-values.
- Validated the framework on simulated datasets and applied it to voxel-wise structural MRI and cortical thickness data in humans and macaques.
Main Results:
- ORFs achieved high classification accuracy, with AUC > 0.80 in humans and > 0.70 in macaques.
- NEOFIT identified statistically significant neuroanatomical features aligned with sex-dimorphic patterns.
- The framework demonstrated robustness, scalability, and provided interpretable insights into sex-distinguishing brain features.
Conclusions:
- The proposed framework significantly enhances sex classification performance from neuroimaging data.
- It provides clear, interpretable insights into neuroanatomical features that differentiate sexes, aiding in understanding sex-specific disease risks.
- These advancements contribute to improved diagnostic tools and a deeper understanding of the evolutionary basis of sex differences in brain structure.

