Medical artificial intelligence toolbox (MAIT): an explainable machine learning framework for binary classification, survival modelling, and regression analyses

While machine learning offers diverse techniques suitable for exploring various medical research questions, a cohesive synergistic framework can facilitate the integration and understanding of new approaches within unified model development and interpretation. We therefore introduce the Medical Artificial Intelligence Toolbox (MAIT), an explainable, open-source Python pipeline for developing and evaluating binary classification, regression, and survival models on tabular datasets. MAIT addresses key challenges (e.g., high dimensionality, class imbalance, mixed variable types, and missingness) while promoting transparency in reporting (TRIPOD+AI compliant). Offering automated configurations for beginners and customizable source code for experts, MAIT streamlines two primary use cases: Discovery (feature importance via unified scoring, e.g., SHapley Additive exPlanations - SHAP) and Prediction (model development and deployment with optimized solutions). Moreover, MAIT proposes new techniques including fine-tuning of probability threshold in binary classification, translation of cumulative hazard curves to binary classification, enhanced visualizations for model interpretation for mixed data types, and handling censoring through semi-supervised learning, to adapt to a wide set of data constraints and study designs. We provide detailed tutorials on GitHub, using four open-access data sets, to demonstrate how MAIT can be used to improve implementation and interpretation of ML models in medical research.