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This study examines the effect of feature extraction methods prior to automated pattern recognition based on magnetic resonance spectroscopy (MRS) for brain tumor diagnosis. Since individual inspection of spectra is time-consuming and requires specific spectroscopic expertise, the introduction of clinical decision support systems (DSSs) is expected to strongly promote the clinical use of MRS. This study focuses on the feature extraction step in the preprocessing protocol of MRS when using a DSS. On two independent data sets, encompassing single-voxel and multi-voxel data, it is observed that the use of the full spectra together with a kernel-based technique, handling high dimensional data, or using an automated pattern recognition method based on independent component analysis or Relief-F achieves accurate performances. In addition, these approaches have low cost and are easy to automate. When sophisticated quantification methods are used in a DSS, user interaction should be minimized. The computationally intensive quantification techniques do not tend to increase the performance in these circumstances. The results suggest to simplify the feature reduction step in the preprocessing protocol when using a DSS purely for classification purposes. This can greatly speed up the execution of classifiers and DSSs and may accelerate their introduction into clinical practice., ((c) 2008 Wiley-Liss, Inc.)