Appendicitis Diagnosis: Ensemble Machine Learning and Explainable Artificial Intelligence-Based Comprehensive Approach

Abstract

Appendicitis is a condition wherein the appendix becomes inflamed, and it can be difficult to diagnose accurately. The type of appendicitis can also be hard to determine, leading to misdiagnosis and difficulty in managing the condition. To avoid complications and reduce mortality, early diagnosis and treatment are crucial. While Alvarado’s clinical scoring system is not sufficient, ultrasound and computed tomography (CT) imaging are effective but have downsides such as operator-dependency and radiation exposure. This study proposes the use of machine learning methods and a locally collected reliable dataset to enhance the identification of acute appendicitis while detecting the differences between complicated and non-complicated appendicitis. Machine learning can help reduce diagnostic errors and improve treatment decisions. This study conducted four different experiments using various ML algorithms, including K-nearest neighbors (KNN), DT, bagging, and stacking. The experimental results showed that the stacking model had the highest training accuracy, test set accuracy, precision, and F1 score, which were 97.51%, 92.63%, 95.29%, and 92.04%, respectively. Feature importance and explainable AI (XAI) identified neutrophils, WBC_Count, Total_LOS, P_O_LOS, and Symptoms_Days as the principal features that significantly affected the performance of the model. Based on the outcomes and feedback from medical health professionals, the scheme is promising in terms of its effectiveness in diagnosing of acute appendicitis.