Interpretable Machine Learning for Stroke Recovery: Predicting Discharge and 3-Month Functional Outcomes.

Introduction: Stroke is a leading cause of disability worldwide. This study uses Machine Learning models to investigate factors influencing modified Rankin Scale scores at discharge and three months post-discharge. Methods: Data from 116 stroke patients were analyzed using four predictive models: Lo...

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Publicado en:NeuroRehabilitation Vol. 58; no. 3; pp. 453 - 463
Autores principales: Augusto, Inês Carvalho Martins, Antonio, Nuno, Marreiros, Ana, Ramalhete, Sara Ventura, Nzwalo, Hipólito
Formato: research tables/charts Journal Article
Publicado: Sage Publications Inc. May2026
Acceso en línea:Ver este registro en EBSCOhost
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      dt: May2026
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        atl: Interpretable Machine Learning for Stroke Recovery: Predicting Discharge and 3-Month Functional Outcomes.
      aug:
        au:
          Augusto, Inês Carvalho Martins
          Antonio, Nuno
          Marreiros, Ana
          Ramalhete, Sara Ventura
          Nzwalo, Hipólito
        affil: NOVA Information Management School (NOVA IMS), Universidade Nova de Lisboa, Lisbon, Portugal
      sug:
        subj:
          Stroke Rehabilitation
          Machine Learning Utilization
          Prediction Models Utilization
          Recovery
          Patient Discharge
          Treatment Outcomes
          Human
          Male
          Female
          Adult
          Middle Age
          Aged
          Aged, 80 and Over
          Funding Source
          Portugal
          Stroke Patients
          Inpatients
          Retrospective Design
          Record Review
          Logistic Regression
          Support Vector Machine
          Random Forest
          Boosting Machine Learning Algorithms
          Kruskal-Wallis Test
          Post Hoc Analysis
          ROC Curve
          Correlational Studies
          Sociodemographic Factors
          Comorbidity
          Head Injuries
          Cerebrovascular Disorders
          Rehabilitation, Driver
          Data Analysis Software
          Descriptive Statistics
          Scales
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Aged: 65+ years
          Aged, 80 & over
          Male
          Female
      ab: Introduction: Stroke is a leading cause of disability worldwide. This study uses Machine Learning models to investigate factors influencing modified Rankin Scale scores at discharge and three months post-discharge. Methods: Data from 116 stroke patients were analyzed using four predictive models: Logistic Regression, Support Vector Machine, Random Forest, and Extreme Gradient Boosting (XGB). Shapley Additive Explanations (SHAP) were also employed to interpret factor significance. Results and discussion: The XGB model achieved an Area Under the Curve of 79% at discharge and 87% three months post-discharge. SHAP analysis revealed changing factor significance over time. The National Institutes of Health Stroke Scale was most critical at discharge, while post-discharge destination became more significant at three months. Age, time metrics, thrombolysis therapy, and management of long-term health issues also proved influential. Conclusions: Findings highlight the complex, evolving nature of stroke recovery. The shift in factor importance from clinical interventions to broader health management issues emphasizes the need for time-sensitive, multifaceted approaches to stroke care. This study contributes to understanding stroke recovery by identifying key influencing factors and demonstrating the value of SHAP for model interpretation. The insights gained have practical implications for rehabilitation practices. By identifying evolving predictors of recovery, the proposed framework may support early stratification of rehabilitation needs, assist clinicians in tailoring rehabilitation intensity and modality, and inform discharge destination decisions.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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