XGBoost, a novel explainable AI technique, in the prediction of myocardial infarction, a UK Biobank cohort study

Background and objective Myocardial infarction is common and associated with high morbidity and mortality. This study assessed if “Explainable AI” in the form of extreme gradient boosting (XGBoost) could outperform traditional logistic regression in predicting myocardial infarction (MI) in a large cohort. Methods We compared two machine learning methods, XGBoost and logistic regression in predicting risk of MI. The UK Biobank is a population-based prospective cohort including 502 506 volunteers with active consent, aged 40–69 years at recruitment from 2006 to 2010. These subjects were followed until end of 2019 and the primary outcome was myocardial infarction. Results Both models were trained using 90% of the cohort. The remaining 10% was used as a test set. Both models were equally precise, but the regression model classified more of the healthy class correctly. XGBoost was more accurate in identifying individuals who later suffered a myocardial infarction. Receiver operator characteristic (ROC) scores are class size invariant. In this metric XGBoost outperformed the logistic regression model, with ROC scores of 0.86 (accuracy 0.75; precision 0.99 and recall 0.75 for the healthy class; precision 0.07 and recall 0.81 for the MI-class) compared to 0.77 (accuracy 0.77; precision 0.99 and recall 0.77 for the healthy class; precision 0.07 and recall 0.78). Secondly, we demonstrate how SHAPley values can be used to visualize and interpret the predictions made by XGBoost models, both for the cohort test set and for individuals. Conclusions The XGBoost machine learning model shows very promising results in evaluating risk of MI in a large and diverse population. This model can be used, and visualized, both for individual assessments and in larger cohorts. The predictions made by the XGBoost models, points towards a future where “Explainable AI” may help to bridge the gap between medicine and data science.