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1724403 Vol 10 · Issue 4 Download Paper

Explainable Artificial Intelligence for Heart Disease Prediction: A SHAP and LIME-Based Approach — A Review

Rutuja Pawar Dr. Brijendra Gupta

Subject area: Science,Engineering and Technology  ·  Area of research: Artificial Intelligence

DOI: 10.64388/IREV10I4-1724403

Abstract

Cardiovascular disease continues to be one of the leading causes of mortality worldwide, making early and accurate risk prediction essential for timely clinical intervention. Machine learning (ML) models such as Random Forest, Support Vector Machine and XGBoost have achieved high predictive accuracy for heart disease, yet their black-box nature limits clinician trust and hinders real-world adoption. This paper reviews recent research on Explainable Artificial Intelligence (XAI) applied to heart disease prediction, with a focus on two widely used model-agnostic interpretability techniques — SHAP (SHapley Additive exPlanations) and LIME (Local Interpretable Model-agnostic Explanations). It presents the theoretical foundations of both techniques, examines recent studies in terms of dataset, classifier, XAI method and reported performance, identifies open research gaps, and proposes an eight-phase methodology and system architecture for an XAI-based Clinical Decision Support System (CDSS) that predicts heart disease risk while generating transparent, feature-level explanations at both the global (population) and local (patient) level. Challenges, limitations and future research directions are also discussed. The review concludes that combining high-performing ensemble classifiers with SHAP and LIME can substantially improve the transparency, accountability and clinical usability of AI-assisted cardiovascular diagnosis.

Keywords

Explainable Artificial Intelligence (XAI); SHAP; LIME; Heart Disease Prediction; Machine Learning; Clinical Decision Support System; Shapley Values; Model Interpretability

References

[1] Explainable artificial intelligence for heart disease prediction: A SHAP and LIME-based approach. In: IEEE conference publication (IEEE Xplore). 2026.

[2] Rezk NG, Alshathri S, Sayed A, Hemdan EE, El-Behery H. XAI-Augmented Voting Ensemble Models for Heart Disease Prediction: A SHAP and LIME-Based Approach. Bioengineering. 2024;11(10):1016.

[3] A proposed technique for predicting heart disease using machine learning algorithms and an explainable AI method. Scientific Reports. 2024;14.

[4] Explainable soft-voting classifier for heart disease prediction using SHAP and LIME. Discover Computing. 2026.

[5] An explainable artificial intelligence framework for ischemic heart disease prediction using enhanced squirrel search feature selection. Scientific Reports. 2026.

[6] Developing a novel framework using optimized active stacking and explainable AI for heart disease prediction. ScienceDirect; 2025.

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[10] Which explanation can you trust? SHAP vs LIME on heart disease prediction [blog post]. Medium; June 2025.

[11] The role of explainable AI in revolutionizing human health monitoring: A review. arXiv:2409.07347 [Preprint]. 2024.

[12] Sathyan A, Weinberg AI, Cohen K. Interpretable AI for bio-medical applications. Complex Eng. Syst. 2022.

[13] Shapley LS. A Value for n-Person Games. In: Contributions to the Theory of Games II, Princeton Univ. Press. 1953. p. 307–317.

[14] Lundberg SM, Lee SI. A Unified Approach to Interpreting Model Predictions. In: Advances in Neural Information Processing Systems (NeurIPS). 2017.

[15] Molnar C. SHAP. In: Interpretable machine learning. 2022.

[16] Ribeiro MT, Singh S, Guestrin C. ‘Why Should I Trust You?’: Explaining the Predictions of Any Classifier. In: Proc. ACM SIGKDD Int. Conf. Knowledge Discovery and Data Mining. 2016. p. 1135–1144.

[17] Ng WY, Wang LR, Liu S, Fan X. Causal SHAP: Feature attribution with dependency awareness through causal discovery. arXiv:2509.00846 [Preprint]. 2025.

[18] Heart disease data set. UCI Machine Learning Repository / Kaggle.

How to cite this paper

Rutuja Pawar, Dr. Brijendra Gupta "Explainable Artificial Intelligence for Heart Disease Prediction: A SHAP and LIME-Based Approach — A Review" Iconic Research And Engineering Journals Volume 10 Issue 4 2026 Page 4317-4327 https://doi.org/10.64388/IREV10I4-1724403
Rutuja Pawar, Dr. Brijendra Gupta "Explainable Artificial Intelligence for Heart Disease Prediction: A SHAP and LIME-Based Approach — A Review" Iconic Research And Engineering Journals, vol. 10, no. 4, Oct. 2026, doi: https://doi.org/10.64388/IREV10I4-1724403
Rutuja Pawar, Dr. Brijendra Gupta (2026). Explainable Artificial Intelligence for Heart Disease Prediction: A SHAP and LIME-Based Approach — A Review. Iconic Research And Engineering Journals, 10(4). doi: https://doi.org/10.64388/IREV10I4-1724403
Rutuja Pawar, Dr. Brijendra Gupta "Explainable Artificial Intelligence for Heart Disease Prediction: A SHAP and LIME-Based Approach — A Review" Iconic Research And Engineering Journals, vol. 10, no. 4, Oct. 2026. Crossref, https://doi.org/10.64388/IREV10I4-1724403
@article{1724403,
      author = {Rutuja Pawar, Dr. Brijendra Gupta},
      title = {Explainable Artificial Intelligence for Heart Disease Prediction: A SHAP and LIME-Based Approach — A Review},
      journal = {Iconic Research And Engineering Journals},
      year = {2026},
      volume = {10},
      number = {4},
      pages = {4317-4327},
      issn = {2456-8880},
      url = {https://www.irejournals.com/formatedpaper/1724403.pdf},
      abstract = {Cardiovascular disease continues to be one of the leading causes of mortality worldwide, making early and accurate risk prediction essential for timely clinical intervention. Machine learning (ML) models such as Random Forest, Support Vector Machine and XGBoost have achieved high predictive accuracy for heart disease, yet their black-box nature limits clinician trust and hinders real-world adoption. This paper reviews recent research on Explainable Artificial Intelligence (XAI) applied to heart disease prediction, with a focus on two widely used model-agnostic interpretability techniques — SHAP (SHapley Additive exPlanations) and LIME (Local Interpretable Model-agnostic Explanations). It presents the theoretical foundations of both techniques, examines recent studies in terms of dataset, classifier, XAI method and reported performance, identifies open research gaps, and proposes an eight-phase methodology and system architecture for an XAI-based Clinical Decision Support System (CDSS) that predicts heart disease risk while generating transparent, feature-level explanations at both the global (population) and local (patient) level. Challenges, limitations and future research directions are also discussed. The review concludes that combining high-performing ensemble classifiers with SHAP and LIME can substantially improve the transparency, accountability and clinical usability of AI-assisted cardiovascular diagnosis.},
      keywords = {Explainable Artificial Intelligence (XAI); SHAP; LIME; Heart Disease Prediction; Machine Learning; Clinical Decision Support System; Shapley Values; Model Interpretability},
      month = {October},
      doi = {https://doi.org/10.64388/IREV10I4-1724403}
  }