Interpretable Clinical Decision-Making Application for Etiological Diagnosis of Ventricular Tachycardia Based on Machine Learning

<b>Background:</b> Ventricular tachycardia (VT) can broadly be categorised into ischemic heart disease, non-ischemic structural heart disease, and idiopathic VT. There are few studies related to the application of machine learning for the etiological diagnosis of VT, and the interpretable methods are still in the exploratory stage for clinical decision-making applications. <b>Objectives:</b> The aim is to propose a machine learning model for the etiological diagnosis of VT. Interpretable results based on models are compared with expert knowledge, and interpretable evaluation protocols for clinical decision-making applications are developed. <b>Methods:</b> A total of 1305 VT patient data from 1 January 2013 to 1 September 2023 at the Arrhythmia Centre of Fuwai Hospital were included in the study. Clinical data collected during hospitalisation included demographics, medical history, vital signs, echocardiographic results, and laboratory test outcomes. <b>Results:</b> The XGBoost model demonstrated the best performance in VT etiological diagnosis (precision, recall, and F1 were 88.4%, 88.5%, and 88.4%, respectively). A total of four interpretable machine learning methods applicable to clinical decision-making were evaluated in terms of visualisation, clinical usability, clinical applicability, and efficiency with expert knowledge interpretation. <b>Conclusions:</b> The XGBoost model demonstrated superior performance in the etiological diagnosis of VT, and SHAP and decision tree interpretable methods are more favoured by clinicians for decision-making.