Methodological Review of Classification Trees for Risk Stratification: An Application Example in the Obesity Paradox.

Journal: Nutrients
Published Date: May 31, 2025

Abstract

BACKGROUND: Classification trees (CTs) are widely used machine learning algorithms with growing applications in clinical research, especially for risk stratification. Their ability to generate interpretable decision rules makes them attractive to healthcare professionals. This review provides an accessible yet rigorous overview of CT methodology for clinicians, highlighting their utility through a case study addressing the "obesity paradox" in critically ill patients.

Authors

  • Javier Trujillano
    Servei de Medicina Intensiva, Hospital Universitari Arnau de Vilanova, Universitat de Lleida, IRBLleida, Avda Rovira Roure 80, 25198, Lleida, Spain. jtruji@cmb.udl.es.
  • Luis Serviá
    Servei de Medicina Intensiva, Hospital Universitari Arnau de Vilanova, Universitat de Lleida, IRBLleida, Avda Rovira Roure 80, 25198, Lleida, Spain.
  • Mariona Badia
    Servei de Medicina Intensiva, Hospital Universitari Arnau de Vilanova, Universitat de Lleida, IRBLleida, Avda Rovira Roure 80, 25198, Lleida, Spain.
  • José C E Serrano
    NUTREN-Nutrigenomics, Department of Experimental Medicine, University of Lleida, 25198 Lleida, Spain.
  • María Luisa Bordejé-Laguna
    Intensive Care Department, Hospital Universitario Germans Trias i Pujol, Carretera de Canyet, s/n, 08916 Badalona, Spain.
  • Carol Lorencio
    Intensive Care Department, Hospital Universitari Josep Trueta, Av. de França, s/n, 17007 Girona, Spain.
  • Clara Vaquerizo
    Intensive Care Department, Hospital Universitario de Fuenlabrada, Cam. del Molino, 2, 28942 Fuenlabrada, Spain.
  • José Luis Flordelis-Lasierra
    Intensive Care Department, Hospital Universitario 12 de Octubre, Av. de Córdoba s/n, 28041 Madrid, Spain.
  • Itziar Martínez de Lagrán
    Intensive Care Department, Hospital de Mataró, 08304 Mataró, Spain.
  • Esther Portugal-Rodríguez
    Intensive Care Department, Hospital Clínico Universitario de Valladolid, Av. Ramón y Cajal, 3, 47003 Valladolid, Spain.
  • Juan Carlos López-Delgado
    Area de Vigilancia Intensiva, Clinical Institute of Internal Medicine & Dermatology (ICMiD), Hospital Clínic de Barcelona, C/Villarroel, 170, 08036 Barcelona, Spain.

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