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The aim of study was to develop an ensemble machine learning method for constructing interpretable predictive models and to validate it using the example of predicting in-hospital mortality (IHM) in patients with ST-segment elevation myocardial infarction (STEMI).

A retrospective cohort study was conducted using data from 5446 electronic medical records of STEMI patients who underwent percutaneous coronary intervention (PCI). Patients were divided into two groups: 335 (6.2%) patients who died during hospitalization and 5111 (93.8%) patients with a favourable in-hospital outcome. A pool of potential predictors was formed using statistical methods. Through multimetric categorization (minimizing p-values, maximizing the area under the ROC curve (AUC), and SHAP value analysis), decision trees, and multivariable logistic regression (MLR), predictors were transformed into risk factors for IHM. Predictive models for IHM were developed using MLR, Random Forest Risk Factors (RandFRF), Stochastic Gradient Boosting (XGboost), Random Forest (RF), Adaptive boosting, Gradient Boosting, Light Gradient-Boosting Machine, Categorical Boosting (CatBoost), Explainable Boosting Machine and Stacking methods.

Authors developed the RandFRF method, which integrates the predictive outcomes of modified decision trees, identifies risk factors and ranks them based on their contribution to the risk of adverse outcomes. RandFRF enables the development of predictive models with high discriminative performance (AUC 0.908), comparable to models based on CatBoost and Stacking (AUC 0.904 and 0.908, respectively). In turn, risk factors provide clinicians with information on the patient’s risk group classification and the extent of their impact on the probability of IHM. The risk factors identified by RandFRF can serve not only as rationale for the prediction results but also as a basis for developing more accurate models.

The article discusses the problem of the influence of the research goals on the structure of the multivariate model of regression analysis (in particular, on the implementation of the procedure for reducing the dimension of the model). It is shown how bringing the specification of the multiple regression model in line with the research objectives affects the choice of modeling methods. Two schemes for constructing a model are compared: the first does not allow taking into account the typology of primary predictors and the nature of their influence on the performance characteristics, the second scheme implies a stage of preliminary division of the initial predictors into groups, in accordance with the objectives of the study. Using the example of solving the problem of analyzing the causes of burnout of creative workers, the importance of the stage of qualitative analysis and systematization of a priori selected factors is shown, which is implemented not by computing means, but by attracting the knowledge and experience of specialists in the studied subject area. The presented example of the implementation of the approach to determining the specification of the regression model combines formalized mathematical and statistical procedures and the preceding stage of the classification of primary factors. The presence of this stage makes it possible to explain the scheme of managing (corrective) actions (softening the leadership style and increasing approval lead to a decrease in the manifestations of anxiety and stress, which, in turn, reduces the severity of the emotional exhaustion of the team members). Preclassification also allows avoiding the combination in one main component of controlled and uncontrolled, regulatory and controlled feature factors, which could worsen the interpretability of the synthesized predictors. On the example of a specific problem, it is shown that the selection of factors-regressors is a process that requires an individual solution. In the case under consideration, the following were consistently used: systematization of features, correlation analysis, principal component analysis, regression analysis. The first three methods made it possible to significantly reduce the dimension of the problem, which did not affect the achievement of the goal for which this task was posed: significant measures of controlling influence on the team were shown. allowing to reduce the degree of emotional burnout of its participants.