Heart disease prediction with a feature-sensitized interpretable framework for the Internet of Medical Things sensors

Introduction Cardiovascular health is increasingly at risk due to modern lifestyle factors such as obesity, smoking, stress, hypertension, and sedentary behavior. Post-pandemic health practices and medication side effects have further contributed to rising cases of early heart failure, particularly among individuals aged 25–40 years. This highlights the need for an automated and interpretable framework to predict heart disease at an early stage. Methods In this study, body vitals acquired from a secondary dataset. Machine learning models including Support Vector Machine, Random Forest, Decision Tree, and Logistic Regression were employed for classification. Model performance was evaluated using accuracy, F1-score, and k-fold cross-validation. Results Among the tested models, the Random Forest classifier demonstrated superior performance with an accuracy and F1-score of 0.955. The interpretability is enhanced with model predictions were explained using Local Interpretable Model-Agnostic Explanations (LIME) for local surrogates and SHAP values for global surrogates. SHAP decision plots provided clear insights into classification behaviour and feature contributions. Discussion/Conclusion The proposed interpretable machine learning framework successfully predicts heart disease with high accuracy while maintaining transparency in decision-making. With the integration of sensor data with cloud-based analysis and explainable AI techniques, this study contributes to reducing the incidence of early heart failures and supports more reliable decision-making in healthcare applications.