# Explainable Artificial Intelligence Techniques for Irregular Temporal Classification of Multidrug Resistance Acquisition in Intensive Care Unit Patients

arXiv: https://arxiv.org/abs/2407.17165 · HTML: https://mlsanity.com/paper/2407.17165/

## Key facts

- Cited by 1 papers in the map (data through 14 Oct 2026).
- Builds on 10 of its 53 references that are in the map.
- First posted on arXiv 24 Jul 2024.

## Builds on (most cited first, 10 of 10)

- [A Unified Approach to Interpreting Model Predictions](https://mlsanity.com/paper/1705.07874/) (2017)
- [Explainable Artificial Intelligence (XAI): Concepts, Taxonomies, Opportunities and Challenges toward Responsible AI](https://mlsanity.com/paper/1910.10045/) (2019)
- [A Comprehensive Taxonomy for Explainable Artificial Intelligence: A Systematic Survey of Surveys on Methods and Concepts](https://mlsanity.com/paper/2105.07190/) (2021)
- [Quasi-Recurrent Neural Networks](https://mlsanity.com/paper/1611.01576/) (2016)
- [Unbox the Black-box for the Medical Explainable AI via Multi-modal and Multi-centre Data Fusion: A Mini-Review, Two Showcases and Beyond](https://mlsanity.com/paper/2102.01998/) (2021)
- [TimeSHAP: Explaining Recurrent Models through Sequence Perturbations](https://mlsanity.com/paper/2012.00073/) (2020)
- [Deep learning for temporal data representation in electronic health records: A systematic review of challenges and methodologies](https://mlsanity.com/paper/2107.09951/) (2021)
- [Attention Mechanism in Neural Networks: Where it Comes and Where it Goes](https://mlsanity.com/paper/2204.13154/) (2022)
- [A Comprehensive Overview and Comparative Analysis on Deep Learning Models: CNN, RNN, LSTM, GRU](https://mlsanity.com/paper/2305.17473/) (2023)
- [A survey on attention mechanisms for medical applications: are we moving towards better algorithms?](https://mlsanity.com/paper/2204.12406/) (2022)

## Built on by (most cited first, 1 of 1)

- [Explainable Spatio-Temporal GCNNs for Irregular Multivariate Time Series: Architecture and Application to ICU Patient Data](https://mlsanity.com/paper/2411.01070/) (2024)

## Abstract (arXiv)

Antimicrobial Resistance represents a significant challenge in the Intensive Care Unit (ICU), where patients are at heightened risk of Multidrug-Resistant (MDR) infections-pathogens resistant to multiple antimicrobial agents. This study introduces a novel methodology that integrates Gated Recurrent Units (GRUs) with advanced intrinsic and post-hoc interpretability techniques for detecting the onset of MDR in patients across time. Within interpretability methods, we propose Explainable Artificial Intelligence (XAI) approaches to handle irregular Multivariate Time Series (MTS), introducing Irregular Time Shapley Additive Explanations (IT-SHAP), a modification of Shapley Additive Explanations designed for irregular MTS with Recurrent Neural Networks focused on temporal outputs. Our methodology aims to identify specific risk factors associated with MDR in ICU patients. GRU with Hadamard's attention demonstrated high initial specificity and increasing sensitivity over time, correlating with increased nosocomial infection risks during prolonged ICU stays. XAI analysis, enhanced by Hadamard attention and IT-SHAP, identified critical factors such as previous non-resistant cultures, specific antibiotic usage patterns, and hospital environment dynamics. These insights suggest that early detection of at-risk patients can inform interventions such as preventive isolation and customized treatments, significantly improving clinical outcomes. The proposed GRU model for temporal classification achieved an average Receiver Operating Characteristic Area Under the Curve of 78.27 +- 1.26 over time, indicating strong predictive performance. In summary, this study highlights the clinical utility of our methodology, which combines predictive accuracy with interpretability, thereby facilitating more effective healthcare interventions by professionals.