Naïve Bayes is an interpretable and predictive machine learning algorithm in predicting osteoporotic hip fracture in-hospital mortality compared to other machine learning algorithms.

Osteoporotic hip fractures (HFs) in the elderly are a pertinent issue in healthcare, particularly in developed countries such as Australia. Estimating prognosis following admission remains a key challenge. Current predictive tools require numerous patient input features including those unavailable e...

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Main Author: Jo-Wai Douglas Wang
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2025-01-01
Series:PLOS Digital Health
Online Access:https://doi.org/10.1371/journal.pdig.0000529
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author Jo-Wai Douglas Wang
author_facet Jo-Wai Douglas Wang
author_sort Jo-Wai Douglas Wang
collection DOAJ
description Osteoporotic hip fractures (HFs) in the elderly are a pertinent issue in healthcare, particularly in developed countries such as Australia. Estimating prognosis following admission remains a key challenge. Current predictive tools require numerous patient input features including those unavailable early in admission. Moreover, attempts to explain machine learning [ML]-based predictions are lacking. Seven ML prognostication models were developed to predict in-hospital mortality following minimal trauma HF in those aged ≥ 65 years of age, requiring only sociodemographic and comorbidity data as input. Hyperparameter tuning was performed via fractional factorial design of experiments combined with grid search; models were evaluated with 5-fold cross-validation and area under the receiver operating characteristic curve (AUROC). For explainability, ML models were directly interpreted as well as analysed with SHAP values. Top performing models were random forests, naïve Bayes [NB], extreme gradient boosting, and logistic regression (AUROCs ranging 0.682-0.696, p>0.05). Interpretation of models found the most important features were chronic kidney disease, cardiovascular comorbidities and markers of bone metabolism; NB also offers direct intuitive interpretation. Overall, NB has much potential as an algorithm, due to its simplicity and interpretability whilst maintaining competitive predictive performance.
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spelling doaj-art-88e7c242db8746b38e04e54e8f4c3e832025-01-08T05:34:11ZengPublic Library of Science (PLoS)PLOS Digital Health2767-31702025-01-0141e000052910.1371/journal.pdig.0000529Naïve Bayes is an interpretable and predictive machine learning algorithm in predicting osteoporotic hip fracture in-hospital mortality compared to other machine learning algorithms.Jo-Wai Douglas WangOsteoporotic hip fractures (HFs) in the elderly are a pertinent issue in healthcare, particularly in developed countries such as Australia. Estimating prognosis following admission remains a key challenge. Current predictive tools require numerous patient input features including those unavailable early in admission. Moreover, attempts to explain machine learning [ML]-based predictions are lacking. Seven ML prognostication models were developed to predict in-hospital mortality following minimal trauma HF in those aged ≥ 65 years of age, requiring only sociodemographic and comorbidity data as input. Hyperparameter tuning was performed via fractional factorial design of experiments combined with grid search; models were evaluated with 5-fold cross-validation and area under the receiver operating characteristic curve (AUROC). For explainability, ML models were directly interpreted as well as analysed with SHAP values. Top performing models were random forests, naïve Bayes [NB], extreme gradient boosting, and logistic regression (AUROCs ranging 0.682-0.696, p>0.05). Interpretation of models found the most important features were chronic kidney disease, cardiovascular comorbidities and markers of bone metabolism; NB also offers direct intuitive interpretation. Overall, NB has much potential as an algorithm, due to its simplicity and interpretability whilst maintaining competitive predictive performance.https://doi.org/10.1371/journal.pdig.0000529
spellingShingle Jo-Wai Douglas Wang
Naïve Bayes is an interpretable and predictive machine learning algorithm in predicting osteoporotic hip fracture in-hospital mortality compared to other machine learning algorithms.
PLOS Digital Health
title Naïve Bayes is an interpretable and predictive machine learning algorithm in predicting osteoporotic hip fracture in-hospital mortality compared to other machine learning algorithms.
title_full Naïve Bayes is an interpretable and predictive machine learning algorithm in predicting osteoporotic hip fracture in-hospital mortality compared to other machine learning algorithms.
title_fullStr Naïve Bayes is an interpretable and predictive machine learning algorithm in predicting osteoporotic hip fracture in-hospital mortality compared to other machine learning algorithms.
title_full_unstemmed Naïve Bayes is an interpretable and predictive machine learning algorithm in predicting osteoporotic hip fracture in-hospital mortality compared to other machine learning algorithms.
title_short Naïve Bayes is an interpretable and predictive machine learning algorithm in predicting osteoporotic hip fracture in-hospital mortality compared to other machine learning algorithms.
title_sort naive bayes is an interpretable and predictive machine learning algorithm in predicting osteoporotic hip fracture in hospital mortality compared to other machine learning algorithms
url https://doi.org/10.1371/journal.pdig.0000529
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