Assisting clinical practice with fuzzy probabilistic decision trees

Emma L. Ambag, Giulia Capitoli, Vincenzo L' Imperio, Michele Provenzano, Marco S. Nobile, Pietro Liò

The need for fully human-understandable models is increasingly being recognised as a central theme in AI research. The acceptance of AI models to assist in decision making in sensitive domains will grow when these models are interpretable, and this trend towards interpretable models will be amplified by upcoming regulations. One of the killer applications of interpretable AI is medical practice, which can benefit from accurate decision support methodologies that inherently generate trust. In this work, we propose FPT, (MedFP), a novel method that combines probabilistic trees and fuzzy logic to assist clinical practice. This approach is fully interpretable as it allows clinicians to generate, control and verify the entire diagnosis procedure; one of the methodology's strength is the capability to decrease the frequency of misdiagnoses by providing an estimate of uncertainties and counterfactuals. Our approach is applied as a proof-of-concept to two real medical scenarios: classifying malignant thyroid nodules and predicting the risk of progression in chronic kidney disease patients. Our results show that probabilistic fuzzy decision trees can provide interpretable support to clinicians, furthermore, introducing fuzzy variables into the probabilistic model brings significant nuances that are lost when using the crisp thresholds set by traditional probabilistic decision trees. We show that FPT and its predictions can assist clinical practice in an intuitive manner, with the use of a user-friendly interface specifically designed for this purpose. Moreover, we discuss the interpretability of the FPT model.

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