Machine learning-based prediction of Sasang constitution types using comprehensive clinical information and identification of key features for diagnosis

Background Despite the importance of accurate Sasang type diagnosis, a unique form of Korean medicine, there have been concerns about consistency among diagnoses. We investigate a data-driven integrative diagnostic model by applying machine learning to a multicenter clinical dataset with comprehensive features. Methods Extremely randomized trees (ERT), support vector machines, multinomial logistic regression, and K-nearest neighbor were applied, and performances were evaluated by cross-validation. The feature importance of the classifier was analyzed to understand which information is crucial in diagnosis. Results The ERT classifier showed the highest performance, with an overall f1 score of 0.60 ± 0.060. The feature classes of body measurement, personality, general information, and cold–heat were more decisive than others in classifying Sasang types. Costal angle was the most informative feature. In pairwise classification, we found Sasang type-dependent distinctions that body measurement features played a key role in TE-SE and TE-SY datasets, while personality and cold–heat features showed importance in SE-SY dataset. Conclusion Current study investigated a comprehensive diagnostic model for Sasang type using machine learning and achieved better performance than previous studies. This study helps data-driven decision making in clinics by revealing key features contributing to the Sasang type diagnosis.