Abstract
Although neuropsychiatric disorders have a well-established genetic background, their specific molecular foundations remain elusive. This has prompted many investigators to design studies that identify explanatory biomarkers, and then use these biomarkers to predict clinical outcomes. One approach involves using machine learning algorithms to classify patients based on blood mRNA expression from high-throughput transcriptomic assays. However, these endeavours typically fail to achieve the high level of performance, stability, and generalizability required for clinical translation. Moreover, these classifiers can lack interpretability because informative genes do not necessarily have relevance to researchers. For this study, we hypothesized that annotation-based classifiers can improve classification performance, stability, generalizability, and interpretability. To this end, we evaluated the performance of four classification algorithms on six neuropsychiatric data sets using four annotation databases. Our results suggest that the Gene Ontology Biological Process database can transform gene expression into an annotation-based feature space that improves the performance and stability of blood-based classifiers for neuropsychiatric conditions. We also show how annotation features can improve the interpretability of classifiers: since annotation databases are often used to assign biological importance to genes, annotation-based classifiers are easy to interpret because the biological importance of the features are the features themselves. We found that using annotations as features improves the performance and stability of classifiers. We also noted that the top ranked annotations tend contain the top ranked genes, suggesting that the most predictive annotations are a superset of the most predictive genes. Based on this, and the fact that annotations are used routinely to assign biological importance to genetic data, we recommend transforming gene-level expression into annotation-level expression prior to the classification of neuropsychiatric conditions.