Explainable Artificial Intelligence Integrated Ensemble Learning Framework for Diabetes Prediction

Abstract

Accurate prediction of diabetes based on clinical and demographic indicators is essential, as early prediction of this chronic metabolic disorder plays a critical role in preventing long-term organ complications. However, existing research continues to face significant challenges, including pronounced class imbalance, the scarcity of large and diverse datasets, and limited integration of explainable artificial intelligence. This research compares several ensemble learning methods (Decision Tree, Random Forest, AdaBoost, Gradient Boosting, Histogram based Gradient Boosting, extremely randomized Trees, and XGBoost) on a large imbalanced dataset (87,664 negative vs. 8,482 positive samples). To mitigate imbalance, we evaluate six resampling approaches including (Random Over Sampling, Random Under Sampling, Synthetic Minority Over-sampling, Adaptive Synthetic Sampling, Tomek Links Removal Sampling and (Synthetic Minority Over-sampling with Edited Nearest Neighbors). We assess models using metrics robust to class imbalance (precision, recall, F1, AUC-ROC, and AUC-PR) and calibration measures.  The Extra Trees classifier achieved the highest measured accuracy (0.994); with Random Over Sampling for balancing dataset. also, these results were compared with several previous works and number of machine learning algorithms, and the results showed superiority. Explainability is performed at both global and local levels: permutation and SHAP for global feature importance, and (Local Interpretable Model-Agnostic Explanations) force plots for instance-level reasoning. however, we analyzed this result using sensitivity, specificity, PR-AUC and calibration, we report detailed experiments showing how resampling method, hyperparameter tuning, and stratified validation influence performance. Finally, we provide clinical-relevant insights from SHAP analyses and discuss limitations and future directions for deploying interpretable models in screening workflows.