Interpretable prediction of stroke prognosis: SHAP for SVM and nomogram for logistic regression

BackgroundIschemic Stroke (IS) stands as a leading cause of mortality and disability globally, with an anticipated increase in IS-related fatalities by 2030. Despite therapeutic advancements, many patients still lack effective interventions, underscoring the need for improved prognostic assessment t...

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Main Authors: Kun Guo, Bo Zhu, Lei Zha, Yuan Shao, Zhiqin Liu, Naibing Gu, Kongbo Chen
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-03-01
Series:Frontiers in Neurology
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Online Access:https://www.frontiersin.org/articles/10.3389/fneur.2025.1522868/full
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author Kun Guo
Kun Guo
Bo Zhu
Lei Zha
Yuan Shao
Zhiqin Liu
Naibing Gu
Kongbo Chen
author_facet Kun Guo
Kun Guo
Bo Zhu
Lei Zha
Yuan Shao
Zhiqin Liu
Naibing Gu
Kongbo Chen
author_sort Kun Guo
collection DOAJ
description BackgroundIschemic Stroke (IS) stands as a leading cause of mortality and disability globally, with an anticipated increase in IS-related fatalities by 2030. Despite therapeutic advancements, many patients still lack effective interventions, underscoring the need for improved prognostic assessment tools. Machine Learning (ML) models have emerged as promising tools for predicting stroke prognosis, surpassing traditional methods in accuracy and speed.ObjectiveThe aim of this study was to develop and validate ML algorithms for predicting the 6-month prognosis of patients with Acute Cerebral Infarction, using clinical data from two medical centers in China, and to assess the feasibility of implementing Explainable ML in clinical settings.MethodsA retrospective observational cohort study was conducted involving 398 patients diagnosed with Acute Cerebral Infarction from January 2023 to February 2024. The dataset included demographic information, medical histories, clinical evaluations, and laboratory results. Six ML models were constructed: Logistic Regression, Naive Bayes, Support Vector Machine (SVM), Random Forest, XGBoost, and AdaBoost. Model performance was evaluated using the Area Under the Receiver Operating Characteristic curve (AUC), sensitivity, specificity, predictive values, and F1 score, with five-fold cross-validation to ensure robustness.ResultsThe training set, identified key variables associated with stroke prognosis, including hypertension, diabetes, and smoking history. The SVM model demonstrated exceptional performance, with an AUC of 0.9453 on the training set and 0.9213 on the validation set. A Nomogram based on Logistic Regression was developed for visualizing prognostic risk, incorporating factors such as the National Institutes of Health Stroke Scale (NIHSS) score, Barthel Index (BI), Watanabe Drinking Test (KWST) score, Platelet Distribution Width (PDW), and others. Our models showed high predictive accuracy and stability across both datasets.ConclusionThis study presents a robust ML approach for predicting stroke prognosis, with the SVM model and Nomogram providing valuable tools for clinical decision-making. By incorporating advanced ML techniques, we enhance the precision of prognostic assessments and offer a theoretical and practical framework for clinical application.
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spelling doaj-art-58d4743597b54ac6b7bd2f1c04aa34dd2025-08-20T02:46:25ZengFrontiers Media S.A.Frontiers in Neurology1664-22952025-03-011610.3389/fneur.2025.15228681522868Interpretable prediction of stroke prognosis: SHAP for SVM and nomogram for logistic regressionKun Guo0Kun Guo1Bo Zhu2Lei Zha3Yuan Shao4Zhiqin Liu5Naibing Gu6Kongbo Chen7Xi’an Central Hospital, Xi’an, ChinaTongchuan Mining Bureau Central Hospital, Tongchuan, ChinaXi’an Central Hospital, Xi’an, ChinaXi’an Central Hospital, Xi’an, ChinaTongchuan Mining Bureau Central Hospital, Tongchuan, ChinaXi’an Central Hospital, Xi’an, ChinaXi’an Central Hospital, Xi’an, ChinaTongchuan Mining Bureau Central Hospital, Tongchuan, ChinaBackgroundIschemic Stroke (IS) stands as a leading cause of mortality and disability globally, with an anticipated increase in IS-related fatalities by 2030. Despite therapeutic advancements, many patients still lack effective interventions, underscoring the need for improved prognostic assessment tools. Machine Learning (ML) models have emerged as promising tools for predicting stroke prognosis, surpassing traditional methods in accuracy and speed.ObjectiveThe aim of this study was to develop and validate ML algorithms for predicting the 6-month prognosis of patients with Acute Cerebral Infarction, using clinical data from two medical centers in China, and to assess the feasibility of implementing Explainable ML in clinical settings.MethodsA retrospective observational cohort study was conducted involving 398 patients diagnosed with Acute Cerebral Infarction from January 2023 to February 2024. The dataset included demographic information, medical histories, clinical evaluations, and laboratory results. Six ML models were constructed: Logistic Regression, Naive Bayes, Support Vector Machine (SVM), Random Forest, XGBoost, and AdaBoost. Model performance was evaluated using the Area Under the Receiver Operating Characteristic curve (AUC), sensitivity, specificity, predictive values, and F1 score, with five-fold cross-validation to ensure robustness.ResultsThe training set, identified key variables associated with stroke prognosis, including hypertension, diabetes, and smoking history. The SVM model demonstrated exceptional performance, with an AUC of 0.9453 on the training set and 0.9213 on the validation set. A Nomogram based on Logistic Regression was developed for visualizing prognostic risk, incorporating factors such as the National Institutes of Health Stroke Scale (NIHSS) score, Barthel Index (BI), Watanabe Drinking Test (KWST) score, Platelet Distribution Width (PDW), and others. Our models showed high predictive accuracy and stability across both datasets.ConclusionThis study presents a robust ML approach for predicting stroke prognosis, with the SVM model and Nomogram providing valuable tools for clinical decision-making. By incorporating advanced ML techniques, we enhance the precision of prognostic assessments and offer a theoretical and practical framework for clinical application.https://www.frontiersin.org/articles/10.3389/fneur.2025.1522868/fullischemic strokemachine learningprognosispredictive modelingclinical decision support
spellingShingle Kun Guo
Kun Guo
Bo Zhu
Lei Zha
Yuan Shao
Zhiqin Liu
Naibing Gu
Kongbo Chen
Interpretable prediction of stroke prognosis: SHAP for SVM and nomogram for logistic regression
Frontiers in Neurology
ischemic stroke
machine learning
prognosis
predictive modeling
clinical decision support
title Interpretable prediction of stroke prognosis: SHAP for SVM and nomogram for logistic regression
title_full Interpretable prediction of stroke prognosis: SHAP for SVM and nomogram for logistic regression
title_fullStr Interpretable prediction of stroke prognosis: SHAP for SVM and nomogram for logistic regression
title_full_unstemmed Interpretable prediction of stroke prognosis: SHAP for SVM and nomogram for logistic regression
title_short Interpretable prediction of stroke prognosis: SHAP for SVM and nomogram for logistic regression
title_sort interpretable prediction of stroke prognosis shap for svm and nomogram for logistic regression
topic ischemic stroke
machine learning
prognosis
predictive modeling
clinical decision support
url https://www.frontiersin.org/articles/10.3389/fneur.2025.1522868/full
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