Optimizing hepatitis C diagnosis through reinforcement learning feature selection and multi-model machine learning evaluation.

Hepatitis C virus (HCV) infection remains a leading cause of liver cirrhosis and hepatocellular carcinoma globally, affecting approximately 50 million people with chronic infection worldwide. Traditional diagnostic approaches often rely on extensive biomarker panels, resulting in increased healthcare costs and clinical complexity without corresponding improvements in diagnostic accuracy. This study presents a novel multi-agent reinforcement learning (MARL) framework for optimizing HCV diagnosis through intelligent feature selection, aiming to identify minimal yet highly effective biomarker subsets while maintaining superior classification performance. We developed a four-agent MARL system comprising Greedy Q-learning, Exploratory Q-Learning, Parsimonious Deep Q-Network (DQN), and Random agents to dynamically select optimal feature subsets from clinical data. The framework was validated using a real-world dataset of 1,004 patients with 14 clinical features from Government Medical College, Bakshi Nagar, Jammu, India. Selected features were evaluated across four machine learning classifiers: Logistic Regression, Decision Tree, Random Forest, and XGBoost. The MARL framework successfully identified compact feature subsets (3-4 features) achieving exceptional diagnostic performance (accuracy: 0.98-0.99, F1-score: 0.98-0.99). The Parsimonious DQN agent consistently outperformed other approaches across all classifiers. Notably, SGOT emerged as the most critical biomarkers for HCV detection. The framework demonstrated robust stability across six independent experimental runs, with ensemble methods (Random Forest and XGBoost) showing superior performance with RL-selected features. This study demonstrates that reinforcement learning-based adaptive feature selection significantly reduces diagnostic complexity and healthcare costs while maintaining or exceeding the performance of traditional full-feature approaches. The MARL framework offers a scalable, interpretable, and clinically viable solution for early HCV diagnosis, with potential applications across diverse healthcare analytics domains.