Interpretable machine learning framework for congestive heart failure risk prediction

Abstract

Congestive heart failure (CHF) is a leading cause of morbidity and mortality worldwide and is influenced by multiple clinical risk factors, including age, sex, blood pressure, cholesterol levels, and electrocardiographic characteristics. This study employs publicly available heart disease datasets compiled from populations in Cleveland, Hungary, Switzerland, and Long Beach repositories (2015–2020) and analyzes 11 predictor attributes and one binary outcome using the cross-industry standard process for data mining (CRISP-DM) framework. Four supervised machine learning (ML) models—decision tree, random forest, gradient boosted trees, and naïve Bayes—were developed and evaluated using confusion matrix–based performance metrics, with results showing that the decision tree model offers balanced predictive performance and clear interpretability, making it suitable for heart failure risk prediction. The findings demonstrate the potential of ML approaches to support clinical risk assessment and enhance decision-making in heart failure management.