Bridging Signal Intelligence and Clinical Insight: A Comprehensive Review of Feature Engineering, Model Interpretability, and Machine Learning in Biomedical Signal Analysis
Bibliographic record
Abstract
Biomedical signal analysis underpins modern healthcare by enabling accurate diagnosis, continuous physiological monitoring, and informed patient management. While deep learning excels at automated feature extraction and end-to-end modeling, classical ML remains essential for tasks requiring interpretability, data efficiency, and clinical transparency. This review synthesizes advances in ML methods including Support Vector Machines, Random Forests, and Decision Trees focusing on physiologically informed feature engineering, robust feature selection, and meaningful model interpretation. We provide guidelines for signal preprocessing, domain-specific feature extraction, and selection strategies across standard biomedical signals such as electrocardiograms (ECGs), electromyograms (EMGs), electroencephalograms (EEGs), Electrovestibulography (EVestG), and tracheal breathing sounds (TBSs). Reviewing TBS studies illustrates an end-to-end workflow highlighting common features and classifiers alongside practical challenges and solutions. Reported ML application performance ranges from 85 to 94% accuracy for EEG, ECG, and EMG, to 82% specificity for TBSs, emphasizing the trade-off between interpretability and predictive performance. Marginal accuracy gains alone do not constitute meaningful progress unless they enhance clinical insight, actionable decision-making, or model transparency. Finally, we compare ML with DL, discuss strengths and limitations, and provide recommendations and future directions for developing robust, interpretable, and clinically relevant biomedical ML.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.011 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.004 | 0.003 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.002 | 0.003 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".