用统计阈值法让医疗分类模型既透明又准确。
A Transportable Threshold-Based Framework for Interpretable Classification of Medical Data

- 基于卡方引导的二值化,自动找出连续变量的临床意义阈值。
- 在三个医疗数据集上AUC最高达0.984,且概率校准更可靠。
- 只需查表加算术就能复现结果,适合临床部署与监管审查。
黑箱模型因缺乏可解释性与可复现性,限制了人工智能在医学中的应用。本文提出一种基于统计学的可解释框架,采用伯努利朴素贝叶斯(BNB)模型实现规则化的临床分类。该方法通过监督式卡方引导的统计分箱,对连续变量进行二值化处理,识别出在训练数据中与临床结局关联最强的阈值。这一转换使BNB能有效处理连续医疗数据,同时保持其固有的透明性。在三个基准数据集上评估:孕妇糖尿病(Pima Indians Diabetes)、威斯康星乳腺癌(Wisconsin Breast Cancer)和心力衰竭预测(Heart Failure Prediction),AUC分别为0.800、0.984和0.919。除判别能力外,还通过泄漏安全的交叉验证校准分析(包含布莱尔分数、校准截距/斜率及事后贝塔校准)评估概率可靠性,显著提升各数据集的概率校准效果。结果表明,该统计可解释框架在性能上可媲美复杂模型,同时提供明确、临床有意义的决策规则与校准风险估计。为直观展示透明性,文中给出完整案例演示:仅需参考表与基础算术即可复现模型推理,无需软件或专有工具。本研究为真实医疗场景中可信、可推广的人工智能提供了实用路径。
原文摘要 · Abstract (English)
Black-box models limit the adoption of artificial intelligence in medicine due to their lack of interpretability and reproducibility. We introduce a statistically grounded framework that provides fully interpretable, rule-based clinical classification using the Bernoulli Naïve Bayes (BNB) model. The method applies supervised $χ^2$-guided statistical binarization to continuous variables, identifying thresholds that maximize association with clinical outcomes within the training data. This transformation allows BNB to operate effectively on continuous medical data without sacrificing its inherent transparency. The approach was evaluated on three benchmark datasets, Pima Indians Diabetes, Wisconsin Breast Cancer, and Heart Failure Prediction, achieving area-under-the-curve (AUC) scores of 0.800 for the Pima analysis, 0.984 for Wisconsin Breast Cancer, and 0.919 for Heart Failure Prediction. In addition to discrimination, probabilistic reliability was assessed using leakage-safe cross-validated calibration analysis including Brier score, calibration intercept/slope, and post-hoc beta calibration, which improved probability calibration across datasets. These results suggest that a statistically interpretable framework can achieve performance comparable to more complex models while providing explicit, clinically meaningful decision rules and calibrated risk estimates. To illustrate this transparency concretely, a complete worked example demonstrates that model inference can be reproduced using only a reference table and basic arithmetic, without access to software or proprietary tools. This work offers a practical approach to supporting trustworthy and generalizable AI in real-world healthcare settings.
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