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Explainable Machine Learning for Early Prediction of Unscheduled Hospital Readmissions: Integrating Global and Local Interpretability
At present, the majority of healthcare spending is driven by chronic patients who experience multiple readmissions due to their underlying conditions. Implementing individualized prevention frameworks could optimize the clinical management of this demographic. This study aimed to generate localized predictive models utilizing interpretable machine learning approaches to provide early identification of individual unscheduled hospital readmissions. To achieve this, a retrospective case-control investigation was performed, utilizing patient readmission data spanning 2018–2019. Following the cleaning and curation of the initial data repository (n = 76,210), the final sample size comprised n = 29,026 participants. A machine learning analysis evaluated multiple algorithms, employing unscheduled hospital readmission as the dependent variable, alongside local model-agnostic interpretability techniques.The results demonstrated a 13% rate of unscheduled hospital readmissions. Statistically significant variations were identified regarding patient age and length of hospital stay (p < 0.001 in both instances). A logistic regression framework highlighted chronic therapy (odds ratio: 3.75), a history of diabetes mellitus (odds ratio: 1.14), and length of stay (odds ratio: 1.02) as statistically meaningful predictors. Machine learning algorithms demonstrated superior performance concerning sensitivity and complementary evaluation metrics. Within this analytical framework, length of stay and patient age emerged as the primary determinants for forecasting unscheduled readmissions. Notably, other clinical indicators, such as documented allergies and histories of adverse drug reactions, also demonstrated predictive relevance. Individualized prognostic models exhibited high sensitivity. In conclusion, this investigation identified critical determinants governing unscheduled hospital readmissions, highlighting the prominence of age and hospitalization duration. A personalized risk assessment framework capable of predicting readmissions with high accuracy was established. Future investigations should incorporate a broader array of clinical parameters to further optimize the predictive capacity of this model.
Journal of Trustworthy and Explainable Intelligent Systems
Original Research | Open access | 15 March 2024 | Article: 49

Can Foundation Models Be Trusted? A Scoping Review of Interpretability, Hallucination, Uncertainty, Alignment, Evaluation, and Human Oversight
Foundation models have expanded the scope of artificial intelligence by supporting language generation, multimodal reasoning, knowledge-intensive assistance, decision support, and adaptable downstream applications. Their broad capabilities, however, do not establish that their outputs, explanations, internal processes, or deployment arrangements are trustworthy. This scoping review maps the research landscape concerning foundation-model trustworthiness across interpretability, explanation capabilities, hallucination, uncertainty, reliability, alignment, evaluation, and human oversight. The review uses structured search concepts, eligibility principles, evidence extraction, and dimension-based mapping to examine how peer-reviewed scholarship characterizes foundation models as general-purpose intelligent systems and how trustworthiness evidence is distributed across technical, human-centered, organizational, and governance domains. The synthesis indicates that interpretability methods can expose selected behavioral or representational features but do not independently demonstrate explanation fidelity, usefulness, or safety. Hallucination and factuality research identifies persistent risks involving fabrication, unsupported claims, weak grounding, and persuasive misinformation, while uncertainty methods remain constrained by calibration, context shift, and user-communication challenges. Alignment and post-training techniques may shape preferred behaviors but retain risks associated with proxy objectives, preference representation, and residual failure. Benchmarking, human evaluation, stress testing, and oversight provide partial evidence, yet their value depends on construct validity, domain relevance, intervention capacity, accountability, and lifecycle monitoring. The research landscape is therefore fragmented across disciplines and frequently model-centred rather than socio-technical. Key priorities include stronger foundation-model interpretability validation, consistent hallucination measurement, usable uncertainty communication, externally valid evaluation, meaningful oversight testing, multimodal analysis, and lifecycle governance. The review contributes an integrated evidence map while emphasizing that no single trustworthiness dimension certifies safety, reliability, accountability, or deployment readiness.
Journal of Trustworthy and Explainable Intelligent Systems
Review | Open access | 15 March 2026 | Article: 80