A Responsible Framework for Assessing, Selecting, and Explaining Machine Learning Models in Cardiovascular Disease Outcomes Among People With Type 2 Diabetes: Methodology and Validation Study

This study establishes a responsible framework for assessing, selecting, and explaining machine learning models, emphasizing accuracy-fairness trade-offs in predictive modeling. Key insights include: (1) simple models perform comparably to complex ensembles; (2) models with strong accuracy may harbor substantial differences in accuracy across demographic groups; and (3) explanation methods reveal the relationships between features and risk for MI and stroke. Our results underscore the need for holistic approaches that consider accuracy, fairness, and explainability in interpretable model design and selection, potentially enhancing health care technology adoption.