Cardiomyopathy diagnosis model from endomyocardial biopsy specimens: Appropriate feature space and class boundary in small sample size data

As the number of patients with heart failure increases, machine learning (ML) has garnered attention in cardiomyopathy diagnosis, driven by the shortage of pathologists. However, endomyocardial biopsy specimens are often limited in sample size and require techniques such as feature extraction and dimensionality reduction. This study investigated the effectiveness of texture features in the context of feature extraction for the pathological diagnosis of cardiomyopathy. Furthermore, model designs that contributed to improving generalization performance were examined by applying feature selection (FS) and dimensional compression (DC) to several ML models. The obtained results were verified by visualizing the inter-class distribution differences and conducting statistical hypothesis testing based on texture features. Additionally, they were evaluated using predictive performance across different model designs with varying combinations of FS and DC (applied or not) and decision boundaries. The obtained results confirmed that texture features may be effective for the pathological diagnosis of cardiomyopathy. Moreover, when the ratio of features to the sample size is high, a multi-step process involving FS and DC improved the generalization performance, with the linear kernel support vector machine achieving the best results. This process was demonstrated to be potentially effective for models with reduced complexity, regardless of whether the decision boundaries were linear, curved, perpendicular, or parallel to the axes. These findings are expected to facilitate the development of an effective cardiomyopathy diagnostic model for its rapid adoption in medical practice.