<![CDATA[Heart failure is one of the leading causes of death worldwide and requires accurate and timely diagnosis to improve patient outcomes. However, early detection remains a significant challenge due to the complexity of clinical data, high dimensionality of features, and variability in patient conditions. Traditional clinical methods often fall short in identifying subtle patterns that indicate early stages of heart failure, motivating the need for intelligent computational techniques to support diagnostic decisions. This study aims to enhance predictive modeling for heart failure classification by comparing two supervised machine learning approaches: Extreme Learning Machine (ELM) and Hierarchical Extreme Learning Machine (HELM). The main contribution of this research is the empirical evaluation of HELM's performance improvements over conventional ELM using 10-fold cross-validation on a publicly available clinical dataset. Unlike traditional neural networks, ELM offers fast training by randomly assigning weights and analytically computing output connections, while HELM extends this with a multi-layer structure that allows for more complex feature representation and improved generalization. Both models were assessed based on classification accuracy and Area Under the Curve (AUC), two critical metrics in medical classification tasks. The ELM model achieved an accuracy of 73.95% ± 8.07 and an AUC of 0.7614 ± 0.093, whereas the HELM model obtained a comparable accuracy of 73.55% ± 7.85 but with a higher AUC of 0.7776 ± 0.085. In several validation folds, HELM outperformed ELM, notably reaching 90% accuracy and 0.9250 AUC in specific cases. In conclusion, HELM demonstrates improved robustness and discriminatory capability in identifying heart failure cases. These findings suggest that HELM is a promising candidate for implementation in clinical decision support systems. Future research may incorporate feature selection, hyperparameter optimization, and evaluation across multi-center datasets to improve generalizability and real-world applicability.]]>
