Diagnosing Coronary Artery Disease on the Basis of Hard Ensemble Voting Optimization.

Background and Objectives: Recently, many studies have focused on the early diagnosis of coronary artery disease (CAD), which is one of the leading causes of cardiac-associated death worldwide. The effectiveness of the most important features influencing disease diagnosis determines the performance of machine learning systems that can allow for timely and accurate treatment. We performed a Hybrid ML framework based on hard ensemble voting optimization (HEVO) to classify patients with CAD using the Z-Alizadeh Sani dataset. All categorical features were converted to numerical forms, the synthetic minority oversampling technique (SMOTE) was employed to overcome imbalanced distribution between two classes in the dataset, and then, recursive feature elimination (RFE) with random forest (RF) was used to obtain the best subset of features. Materials and Methods: After solving the biased distribution in the CAD data set using the SMOTE method and finding the high correlation features that affected the classification of CAD patients. The performance of the proposed model was evaluated using grid search optimization, and the best hyperparameters were identified for developing four applications, namely, RF, AdaBoost, gradient-boosting, and extra trees based on an HEV classifier. Results: Five fold cross-validation experiments with the HEV classifier showed excellent prediction performance results with the 10 best balanced features obtained using SMOTE and feature selection. All evaluation metrics results reached > 98% with the HEV classifier, and the gradient-boosting model was the second best classification model with accuracy = 97% and F1-score = 98%. Conclusions: When compared to modern methods, the proposed method perform well in diagnosing coronary artery disease, and therefore, the proposed method can be used by medical personnel for supplementary therapy for timely, accurate, and efficient identification of CAD cases in suspected patients.