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routineHealthcare & BiomedicalXGBoost2606.29907

CW-B: Class Weighted Boosting Framework for Imbalance Resilient Multi Class Cardiac Phenotyping

Sijia Li, Xiaoyu Tan, Chen Zhan, Yuanji Ma, Haoyu Wang, Xihe Qiu

cs.LG cs.AI

Abstract

Cardiac discharge phenotyping informs post-discharge treatment and follow-up, but real-world records are often incomplete and class-imbalanced, increasing the risk of missed high-risk phenotypes. We propose CW-B, a clinical risk-aligned class-weighted XGBoost pipeline for five-class cardiac discharge phenotyping under real-world class imbalance and missingness. CW-B combines fold-specific class-balanced instance weighting, missingness-indicator augmentation, and classwise error auditing to improve recognition of clinically prioritized phenotypes while preserving interpretable and auditable decision logic. In five-fold stratified cross-validation, CW-B achieves the best Accuracy, Macro-F1, Balanced Accuracy, and Prioritized F1 among tree-based, ensemble, and neural baselines. Overall, CW-B provides a practical and deployment-oriented approach for more reliable cardiac discharge phenotyping in real-world clinical settings.

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Classified with taxonomy v2 on Wed, 2 Sept 2026.

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