A feature-stable and explainable machine learning framework for trustworthy decision-making under incomplete clinical data

Machine learning models are increasingly applied to biomedical data, yet their adoption in high stakes domains remains limited by poor robustness, limited interpretability, and instability of learned features under realistic data perturbations, such as missingness. In particular, models that achieve high predictive performance may still fail to inspire trust if their key features fluctuate when data completeness changes, undermining reproducibility and downstream decision-making. Here, we present CACTUS (Comprehensive Abstraction and Classification Tool for Uncovering Structures), an explainable machine learning framework explicitly designed to address these challenges in small, heterogeneous, and incomplete clinical datasets. CACTUS integrates feature abstraction, interpretable classification, and systematic feature stability analysis to quantify how consistently informative features are preserved as data quality degrades. Using a real-world haematuria cohort comprising 568 patients evaluated for bladder cancer, we benchmark CACTUS against widely used machine learning approaches, including random forests and gradient boosting methods, under controlled levels of randomly introduced missing data. We demonstrate that CACTUS achieves competitive or superior predictive performance while maintaining markedly higher stability of top-ranked features as missingness increases, including in sex-stratified analyses. Our results show that feature stability provides information complementary to conventional performance metrics and is essential for assessing the trustworthiness of machine learning models applied to biomedical data. By explicitly quantifying robustness to missing data and prioritising interpretable, stable features, CACTUS offers a generalizable framework for trustworthy data-driven decision support.

Improving Noise Robustness through Abstractions and its Impact on Machine Learning

Noise is a fundamental problem in learning theory with huge effects in the application of Machine Learning (ML) methods, due to real world data tendency to be noisy. Additionally, introduction of malicious noise can make ML methods fail critically, as is the case with adversarial attacks. Thus, finding and developing alternatives to improve robustness to noise is a fundamental problem in ML. In this paper, we propose a method to deal with noise: mitigating its effect through the use of data abstractions. The goal is to reduce the effect of noise over the model's performance through the loss of information produced by the abstraction. However, this information loss comes with a cost: it can result in an accuracy reduction due to the missing information. First, we explored multiple methodologies to create abstractions, using the training dataset, for the specific case of numerical data and binary classification tasks. We also tested how these abstractions can affect robustness to noise with several experiments that explore the robustness of an Artificial Neural Network to noise when trained using raw data \emph{vs} when trained using abstracted data. The results clearly show that using abstractions is a viable approach for developing noise robust ML methods.

The Significance of Data Abstraction Methods in Machine Learning Classification Processes for Critical Decision-Making

The applicability of widely adopted machine learning (ML) methods to classification is circumscribed by the imperatives of explicability and uncertainty, particularly evident in domains such as healthcare, behavioural sciences, and finances, wherein accountability assumes priority. Recently, Small and Incomplete Dataset Analyser (SaNDA) has been proposed to enhance the ability to perform classification in such domains, by developing a data abstraction protocol using a ROC curve-based method. This paper focuses on column-wise data transformations called abstractions, which are crucial for SaNDA's classification process and explores alternative abstractions protocols, such as constant binning and quantiles. The best-performing methods have been compared against Random Forest as a baseline for explainable methods. The results suggests that SaNDA can be a viable substitute for Random Forest when data is incomplete, even with minimal missing values. It consistently maintains high accuracy even when half of the dataset is missing, unlike Random Forest which experiences a significant decline in accuracy under similar conditions.

CACTUS: a Comprehensive Abstraction and Classification Tool for Uncovering Structures

The availability of large data sets is providing an impetus for driving current artificial intelligent developments. There are, however, challenges for developing solutions with small data sets due to practical and cost-effective deployment and the opacity of deep learning models. The Comprehensive Abstraction and Classification Tool for Uncovering Structures called CACTUS is presented for improved secure analytics by effectively employing explainable artificial intelligence. It provides additional support for categorical attributes, preserving their original meaning, optimising memory usage, and speeding up the computation through parallelisation. It shows to the user the frequency of the attributes in each class and ranks them by their discriminative power. Its performance is assessed by application to the Wisconsin diagnostic breast cancer and Thyroid0387 data sets.