TY - JOUR AB - BACKGROUND: In data-sparse areas such as health care, computer scientists aim to leverage as much available information as possible to increase the accuracy of their machine learning models' outputs. As a standard, categorical data, such as patients' gender, socioeconomic status, or skin color, are used to train models in fusion with other data types, such as medical images and text-based medical information. However, the effects of including categorical data features for model training in such data-scarce areas are underexamined, particularly regarding models intended to serve individuals equitably in a diverse population. OBJECTIVE: This study aimed to explore categorical data's effects on machine learning model outputs, rooted the effects in the data collection and dataset publication processes, and proposed a mixed methods approach to examining datasets' data categories before using them for machine learning training. METHODS: Against the theoretical background of the social construction of categories, we suggest a mixed methods approach to assess categorical data's utility for machine learning model training. As an example, we applied our approach to a Brazilian dermatological dataset (Dermatological and Surgical Assistance Program at the Federal University of Espírito Santo [PAD-UFES] 20). We first present an exploratory, quantitative study that assesses the effects when including or excluding each of the unique categorical data features of the PAD-UFES 20 dataset for training a transformer-based model using a data fusion algorithm. We then pair our quantitative analysis with a qualitative examination of the data categories based on interviews with the dataset authors. RESULTS: Our quantitative study suggests scattered effects of including categorical data for machine learning model training across predictive classes. Our qualitative analysis gives insights into how the categorical data were collected and why they were published, explaining some of the quantitative effects that we observed. Our findings highlight the social constructedness of categorical data in publicly available datasets, meaning that the data in a category heavily depend on both how these categories are defined by the dataset creators and the sociomedico context in which the data are collected. This reveals relevant limitations of using publicly available datasets in contexts different from those of the collection of their data. CONCLUSIONS: We caution against using data features of publicly available datasets without reflection on the social construction and context dependency of their categorical data features, particularly in data-sparse areas. We conclude that social scientific, context-dependent analysis of available data features using both quantitative and qualitative methods is helpful in judging the utility of categorical data for the population for which a model is intended. AU - Willem, T. AU - Wollek, A.* AU - Cheslerean-Boghiu, T.* AU - Kenney, M.* AU - Buyx, A.* C1 - 73192 C2 - 56982 TI - The social construction of categorical data: Mixed methods approach to assessing data features in publicly available datasets. JO - JMIR Med. Inf. VL - 13 PY - 2025 SN - 2291-9694 ER - TY - JOUR AB - BACKGROUND: Acute kidney injury (AKI) is a common adverse outcome following nephrectomy. The progression from AKI to acute kidney disease (AKD) and subsequently to chronic kidney disease (CKD) remains a concern; yet, the predictive mechanisms for these transitions are not fully understood. Interpretable machine learning (ML) models offer insights into how clinical features influence long-term renal function outcomes after nephrectomy, providing a more precise framework for identifying patients at risk and supporting improved clinical decision-making processes. OBJECTIVE: This study aimed to (1) evaluate postnephrectomy rates of AKI, AKD, and CKD, analyzing long-term renal outcomes along different trajectories; (2) interpret AKD and CKD models using Shapley Additive Explanations values and Local Interpretable Model-Agnostic Explanations algorithm; and (3) develop a web-based tool for estimating AKD or CKD risk after nephrectomy. METHODS: We conducted a retrospective cohort study involving patients who underwent nephrectomy between July 2012 and June 2019. Patient data were randomly split into training, validation, and test sets, maintaining a ratio of 76.5:8.5:15. Eight ML algorithms were used to construct predictive models for postoperative AKD and CKD. The performance of the best-performing models was assessed using various metrics. We used various Shapley Additive Explanations plots and Local Interpretable Model-Agnostic Explanations bar plots to interpret the model and generated directed acyclic graphs to explore the potential causal relationships between features. Additionally, we developed a web-based prediction tool using the top 10 features for AKD prediction and the top 5 features for CKD prediction. RESULTS: The study cohort comprised 1559 patients. Incidence rates for AKI, AKD, and CKD were 21.7% (n=330), 15.3% (n=238), and 10.6% (n=165), respectively. Among the evaluated ML models, the Light Gradient-Boosting Machine (LightGBM) model demonstrated superior performance, with an area under the receiver operating characteristic curve of 0.97 for AKD prediction and 0.96 for CKD prediction. Performance metrics and plots highlighted the model's competence in discrimination, calibration, and clinical applicability. Operative duration, hemoglobin, blood loss, urine protein, and hematocrit were identified as the top 5 features associated with predicted AKD. Baseline estimated glomerular filtration rate, pathology, trajectories of renal function, age, and total bilirubin were the top 5 features associated with predicted CKD. Additionally, we developed a web application using the LightGBM model to estimate AKD and CKD risks. CONCLUSIONS: An interpretable ML model effectively elucidated its decision-making process in identifying patients at risk of AKD and CKD following nephrectomy by enumerating critical features. The web-based calculator, found on the LightGBM model, can assist in formulating more personalized and evidence-based clinical strategies. AU - Xu, L.* AU - Li, C.* AU - Gao, S.* AU - Zhao, L.* AU - Guan, C.* AU - Shen, X.* AU - Zhu, Z.* AU - Guo, C.* AU - Zhang, L. AU - Yang, C.* AU - Bu, Q.* AU - Zhou, B.* AU - Xu, Y.* C1 - 71775 C2 - 56428 TI - Personalized prediction of long-term renal function prognosis following nUsing interpretable machine learning algorithms: Case-control study. JO - JMIR Med. Inf. VL - 12 PY - 2024 SN - 2291-9694 ER -