Enhancing Framingham Cardiovascular Risk Score Transparency Through Logic-Based XAI

• Emannuel L. de A. Bezerra IFCE
• Luiz H. T. Viana IFCE
• Vinícius P. Chagas IFCE
• Diogo E. Rolim IFCE
• Thiago A. Rocha IFCE
• Carlos H. L. Cavalcante IFCE

Resumo

Cardiovascular disease (CVD) remains one of the leading global health challenges, accounting for more than 19 million deaths worldwide. To address this, several tools that aim to predict CVD risk and support clinical decision making have been developed. In particular, the Framingham Risk Score (FRS) is one of the most widely used and recommended worldwide. However, it does not explain why a patient was assigned to a particular risk category nor how it can be reduced. Due to this lack of transparency, our approach introduces a logical explainer for the FRS. Based on first-order logic and explainable artificial intelligence (XAI) fundaments, our method is capable of identifying the minimal set of patient attributes that are sufficient to explain a given risk classification (abduction). The explainer produces actionable scenarios that illustrate which modifiable variables would reduce a patient’s risk category (counterfactual). We evaluated all possible input combinations of the FRS (over 22,000 samples) and tested them with our solution, successfully identifying important risk factors and suggesting focused interventions for each case. The results improves clinician trust and facilitates the wider implementation of CVD risk assessment by converting opaque scores into transparent, prescriptive insights, particularly in areas with restricted access to specialists.