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A Consensus-Driven Stacking Ensemble Framework for Interpretable Cardiovascular Risk Prediction and Clinical Deployment

Sozol, S. S.; Dev Nath, B. C.; Fahim, F. M. S.; Suzana, N. N.; Mirza, J. F.; Ahmmed, S.; Zohra, F.-T.; Zafr, A. H. A.; Uddin, M. N.; Mondal, M. R. H.; Hoque, A. S. M. L.

2026-05-26 health informatics
10.64898/2026.05.18.26352989 medRxiv
Show abstract

Machine learning (ML) is being considered to help diagnose cardiovascular diseases (CVD). Still, challenges like inconsistent and limited datasets, limited infrastructure, and global inequalities lead to the need for a reliable and practicable ML solution. This paper presents an ML-driven framework for predicting CVD risk scores and classifying status. Several data preprocessing techniques, including multiple imputation by chained equations (MICE), outlier removal, are considered. In addition, hyperparameter tuning is performed with the GridSearchCV tuning technique. Moreover, a consensus-driven five-feature selection method is applied to identify optimal predictors. The dataset used in this study contains healthcare records related to future CVD risk scores, comprising 1,529 patient records with 22 features. The optimized stacked ensemble model is applied to the dataset and achieves a cross-validated coefficient of determination value of 98.13% for CVD risk score regression. Comparative evaluation with other ML models confirmed improved accuracy, efficiency, and interpretability. The explainable AI technique SHAP is applied to interpret predictions and highlight key risk factors. Moreover, a deployment-ready web platform with multi-role access has been developed that demonstrates clinical applicability. The proposed framework offers a reliable and interpretable tool for early detection of CVD and personalized risk assessment. In the future, this work can be extended to integrate longitudinal data, medical imaging, and deep learning to improve generalizability and strengthen real-world impact.

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