A machine learning model using single-lead ECG achieved near-perfect classification for early detection of chemotherapy-induced cardiotoxicity (ROC–AUC > 0.99).
Does an explainable machine learning model using single-lead ECG signals accurately predict early chemo-induced cardiotoxicity patterns?
An explainable machine learning model using single-lead ECG signals can accurately predict early chemotherapy-induced cardiotoxicity patterns, offering a potential low-cost surveillance tool.
Absolute Event Rate: 0% vs 0%
Objectives: Chemotherapy-induced cardiotoxicity is still a major clinical problem, usually appearing subclinically before structural or symptomatic cardiac dysfunction appears. Standard surveillance methods use imaging and biomarkers, which are time-intensive and money-intensive and can only identify damage at more advanced levels. Electrocardiography (ECG) provides a low-cost, non-invasive method that can detect early electrophysiological changes but is not fully utilized in cardio-oncology. The present work was designed to build an explainable machine learning model for predicting chemo-like cardiotoxicity patterns at an early stage from single-lead ECG signals. Methods: A public ECG data set (n=4997 segments) underwent preprocessing and was converted to 18 temporal, morphologic, and spectral features. Two ensemble learning algorithms—Random Forest and XGBoost—were trained and validated with stratified splits. Model performance was assessed with ROC–AUC, PR–AUC, and F1-score with 1000 bootstrap resampling. Feature interpretability was evaluated through permutation importance and SHAP analysis. Results: Both models scored near-perfect classification (ROC–AUC and PR–AUC>0.99, F1-score ≈ 0.986). Spectral entropy, band3 (high-energy frequency), QT surrogate, and peak count were the top features ranking alongside early cardiotoxicity indicators like repolarization instability and autonomic imbalance. Conclusions: The feature-driven, interpretable ML architecture suggested here shows that single-lead ECG has the potential to be an affordable and clinically relevant tool for the early detection of chemotherapy-induced cardiotoxicity. The method provides a feasible route toward implementation in precision cardio-oncology, particularly in resource-poor or ambulatory environments.
Upreti et al. (Fri,) reported a other. A machine learning model using single-lead ECG achieved near-perfect classification for early detection of chemotherapy-induced cardiotoxicity (ROC–AUC > 0.99).