Interpretable Predictive Models to Understand Risk Factors for Maternal and Fetal Outcomes
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41666_2023_151_ReferencePDF.pdf
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Author(s)
Bosschieter, Tomas M.
Xu, Zifei
Lan, Hui
Lengerich, Benjamin J.
Nori, Harsha
Painter, Ian
Souter, Vivienne
Caruana, Rich
Date Issued
October 13, 2023
Publisher
Springer International Publishing
Citation
Bosschieter, T.M., Xu, Z., Lan, H. et al. Interpretable Predictive Models to Understand Risk Factors for Maternal and Fetal Outcomes. J Healthc Inform Res 8, 65–87 (2024).
Version
Author's final manuscript
Abstract
Although most pregnancies result in a good outcome, complications are not uncommon and can be associated with serious implications for mothers and babies. Predictive modeling has the potential to improve outcomes through a better understanding of risk factors, heightened surveillance for high-risk patients, and more timely and appropriate interventions, thereby helping obstetricians deliver better care. We identify and study the most important risk factors for four types of pregnancy complications: (i) severe maternal morbidity, (ii) shoulder dystocia, (iii) preterm preeclampsia, and (iv) antepartum stillbirth. We use an Explainable Boosting Machine (EBM), a high-accuracy glass-box learning method, for the prediction and identification of important risk factors. We undertake external validation and perform an extensive robustness analysis of the EBM models. EBMs match the accuracy of other black-box ML methods, such as deep neural networks and random forests, and outperform logistic regression, while being more interpretable. EBMs prove to be robust. The interpretability of the EBM models reveal surprising insights into the features contributing to risk (e.g., maternal height is the second most important feature for shoulder dystocia) and may have potential for clinical application in the prediction and prevention of serious complications in pregnancy.
MIT Department
Massachusetts Institute of Technology. Computer Science and Artificial Intelligence Laboratory
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Article is made available in accordance with the publisher's policy and may be subject to US copyright law. Please refer to the publisher's site for terms of use.
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DOI of Published Version
https://doi.org/10.1007/s41666-023-00151-4
