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Nicora G, Catalano M, Bortolotto C, Achilli MF, Messana G, Lo Tito A, Consonni A, Cutti S, Comotto F, Stella GM, Corsico A, Perlini S, Bellazzi R, Bruno R, Preda L. Bayesian Networks in the Management of Hospital Admissions: A Comparison between Explainable AI and Black Box AI during the Pandemic. J Imaging 2024; 10:117. [PMID: 38786571 PMCID: PMC11122655 DOI: 10.3390/jimaging10050117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 04/24/2024] [Accepted: 05/06/2024] [Indexed: 05/25/2024] Open
Abstract
Artificial Intelligence (AI) and Machine Learning (ML) approaches that could learn from large data sources have been identified as useful tools to support clinicians in their decisional process; AI and ML implementations have had a rapid acceleration during the recent COVID-19 pandemic. However, many ML classifiers are "black box" to the final user, since their underlying reasoning process is often obscure. Additionally, the performance of such models suffers from poor generalization ability in the presence of dataset shifts. Here, we present a comparison between an explainable-by-design ("white box") model (Bayesian Network (BN)) versus a black box model (Random Forest), both studied with the aim of supporting clinicians of Policlinico San Matteo University Hospital in Pavia (Italy) during the triage of COVID-19 patients. Our aim is to evaluate whether the BN predictive performances are comparable with those of a widely used but less explainable ML model such as Random Forest and to test the generalization ability of the ML models across different waves of the pandemic.
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Affiliation(s)
- Giovanna Nicora
- Department of Electrical, Computer and Biomedical Engineering, University of Pavia, 27100 Pavia, Italy; (G.N.); (R.B.)
| | - Michele Catalano
- Diagnostic Imaging and Radiotherapy Unit, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy; (M.C.); (M.F.A.); (G.M.); (A.L.T.); (A.C.); (L.P.)
| | - Chandra Bortolotto
- Diagnostic Imaging and Radiotherapy Unit, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy; (M.C.); (M.F.A.); (G.M.); (A.L.T.); (A.C.); (L.P.)
- Radiology Institute, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
| | - Marina Francesca Achilli
- Diagnostic Imaging and Radiotherapy Unit, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy; (M.C.); (M.F.A.); (G.M.); (A.L.T.); (A.C.); (L.P.)
| | - Gaia Messana
- Diagnostic Imaging and Radiotherapy Unit, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy; (M.C.); (M.F.A.); (G.M.); (A.L.T.); (A.C.); (L.P.)
| | - Antonio Lo Tito
- Diagnostic Imaging and Radiotherapy Unit, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy; (M.C.); (M.F.A.); (G.M.); (A.L.T.); (A.C.); (L.P.)
| | - Alessio Consonni
- Diagnostic Imaging and Radiotherapy Unit, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy; (M.C.); (M.F.A.); (G.M.); (A.L.T.); (A.C.); (L.P.)
| | - Sara Cutti
- Medical Direction, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy;
| | | | - Giulia Maria Stella
- Department of Internal Medicine and Therapeutics, University of Pavia, 27100 Pavia, Italy; (G.M.S.); (A.C.); (S.P.)
- Unit of Respiratory Diseases, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
| | - Angelo Corsico
- Department of Internal Medicine and Therapeutics, University of Pavia, 27100 Pavia, Italy; (G.M.S.); (A.C.); (S.P.)
- Unit of Respiratory Diseases, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
| | - Stefano Perlini
- Department of Internal Medicine and Therapeutics, University of Pavia, 27100 Pavia, Italy; (G.M.S.); (A.C.); (S.P.)
- Department of Emergency, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
| | - Riccardo Bellazzi
- Department of Electrical, Computer and Biomedical Engineering, University of Pavia, 27100 Pavia, Italy; (G.N.); (R.B.)
| | - Raffaele Bruno
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy;
- Unit of Infectious Diseases, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
| | - Lorenzo Preda
- Diagnostic Imaging and Radiotherapy Unit, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy; (M.C.); (M.F.A.); (G.M.); (A.L.T.); (A.C.); (L.P.)
- Radiology Institute, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
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