Saram Abbas

Saram Abbas, Naeem Soomro, Rishad Shafik et al.

Non-muscle-invasive bladder cancer (NMIBC) is a relentless challenge in oncology, with recurrence rates soaring as high as 70-80%. Each recurrence triggers a cascade of invasive procedures, lifelong surveillance, and escalating healthcare costs - affecting 460,000 individuals worldwide. However, existing clinical prediction tools remain fundamentally flawed, often overestimating recurrence risk and failing to provide personalized insights for patient management. In this work, we propose an interpretable deep learning framework that integrates vector embeddings and attention mechanisms to improve NMIBC recurrence prediction performance. We incorporate vector embeddings for categorical variables such as smoking status and intravesical treatments, allowing the model to capture complex relationships between patient attributes and recurrence risk. These embeddings provide a richer representation of the data, enabling improved feature interactions and enhancing prediction performance. Our approach not only enhances performance but also provides clinicians with patient-specific insights by highlighting the most influential features contributing to recurrence risk for each patient. Our model achieves accuracy of 70% with tabular data, outperforming conventional statistical methods while providing clinician-friendly patient-level explanations through feature attention. Unlike previous studies, our approach identifies new important factors influencing recurrence, such as surgical duration and hospital stay, which had not been considered in existing NMIBC prediction models.

Saram Abbas, Rishad Shafik, Naeem Soomro et al.

Notorious for its 70-80% recurrence rate, Non-muscle-invasive Bladder Cancer (NMIBC) imposes a significant human burden and is one of the costliest cancers to manage. Current tools for predicting NMIBC recurrence rely on scoring systems that often overestimate risk and have poor accuracy. This is where Machine learning (ML)-based techniques have emerged as a promising approach for predicting NMIBC recurrence by leveraging molecular and clinical data. This comprehensive review paper critically analyses ML-based frameworks for predicting NMIBC recurrence, focusing on their statistical robustness and algorithmic efficacy. We meticulously examine the strengths and weaknesses of each study, by focusing on various prediction tasks, data modalities, and ML models, highlighting their remarkable performance alongside inherent limitations. A diverse array of ML algorithms that leverage multimodal data spanning radiomics, clinical, histopathological, and genomic data, exhibit significant promise in accurately predicting NMIBC recurrence. However, the path to widespread adoption faces challenges concerning the generalisability and interpretability of models, emphasising the need for collaborative efforts, robust datasets, and the incorporation of cost-effectiveness. Our detailed categorisation and in-depth analysis illuminate the nuances, complexities, and contexts that influence real-world advancement and adoption of these AI-based techniques. This rigorous analysis equips researchers with a deeper understanding of the intricacies of the ML algorithms employed. Researchers can use these insights to refine approaches, address limitations, and boost generalisability of their ML models, ultimately leading to reduced healthcare costs and improved patient outcomes.

Saram Abbas, Naeem Soomro, Rishad Shafik et al.

Bladder cancer claims one life every 3 minutes worldwide. Most patients are diagnosed with non-muscle-invasive bladder cancer (NMIBC), yet up to 70% recur after treatment, triggering a relentless cycle of surgeries, monitoring, and risk of progression. Clinical tools like the EORTC risk tables are outdated and unreliable - especially for intermediate-risk cases. We propose an interpretable AI model using the Tsetlin Machine (TM), a symbolic learner that outputs transparent, human-readable logic. Tested on the PHOTO trial dataset (n=330), TM achieved an F1-score of 0.80, outperforming XGBoost (0.78), Logistic Regression (0.60), and EORTC (0.42). TM reveals the exact clauses behind each prediction, grounded in clinical features like tumour count, surgeon experience, and hospital stay - offering accuracy and full transparency. This makes TM a powerful, trustworthy decision-support tool ready for real-world adoption.