{"id":"https://openalex.org/W4406230663","doi":"https://doi.org/10.1186/s12911-024-02823-6","title":"Explainable unsupervised anomaly detection for healthcare insurance data","display_name":"Explainable unsupervised anomaly detection for healthcare insurance data","publication_year":2025,"publication_date":"2025-01-09","ids":{"openalex":"https://openalex.org/W4406230663","doi":"https://doi.org/10.1186/s12911-024-02823-6","pmid":"https://pubmed.ncbi.nlm.nih.gov/39789541"},"language":"en","primary_location":{"id":"doi:10.1186/s12911-024-02823-6","is_oa":true,"landing_page_url":"https://doi.org/10.1186/s12911-024-02823-6","pdf_url":"https://bmcmedinformdecismak.biomedcentral.com/counter/pdf/10.1186/s12911-024-02823-6","source":{"id":"https://openalex.org/S107516304","display_name":"BMC Medical Informatics and Decision Making","issn_l":"1472-6947","issn":["1472-6947"],"is_oa":true,"is_in_doaj":true,"is_core":true,"host_organization":"https://openalex.org/P4310320256","host_organization_name":"BioMed Central","host_organization_lineage":["https://openalex.org/P4310320256","https://openalex.org/P4310319965"],"host_organization_lineage_names":["BioMed Central","Springer Nature"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"BMC Medical Informatics and Decision Making","raw_type":"journal-article"},"type":"article","indexed_in":["crossref","doaj","pubmed"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://bmcmedinformdecismak.biomedcentral.com/counter/pdf/10.1186/s12911-024-02823-6","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5053252950","display_name":"Hannes De Meulemeester","orcid":"https://orcid.org/0000-0002-5938-2387"},"institutions":[{"id":"https://openalex.org/I99464096","display_name":"KU Leuven","ror":"https://ror.org/05f950310","country_code":"BE","type":"education","lineage":["https://openalex.org/I99464096"]}],"countries":["BE"],"is_corresponding":true,"raw_author_name":"Hannes De Meulemeester","raw_affiliation_strings":["Department of Electrical Engineering, ESAT-STADIUS, KU Leuven, Kasteelpark Arenberg 10, B-3001 Leuven, Belgium. hannes.demeulemeester@gmail.com","Department of Electrical Engineering, ESAT-STADIUS, KU Leuven, Kasteelpark Arenberg 10, B-3001 Leuven, Belgium"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Electrical Engineering, ESAT-STADIUS, KU Leuven, Kasteelpark Arenberg 10, B-3001 Leuven, Belgium. hannes.demeulemeester@gmail.com","institution_ids":["https://openalex.org/I99464096"]},{"raw_affiliation_string":"Department of Electrical Engineering, ESAT-STADIUS, KU Leuven, Kasteelpark Arenberg 10, B-3001 Leuven, Belgium","institution_ids":["https://openalex.org/I99464096"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5063725680","display_name":"Frank De Smet","orcid":"https://orcid.org/0000-0002-0656-5921"},"institutions":[{"id":"https://openalex.org/I99464096","display_name":"KU Leuven","ror":"https://ror.org/05f950310","country_code":"BE","type":"education","lineage":["https://openalex.org/I99464096"]}],"countries":["BE"],"is_corresponding":false,"raw_author_name":"Frank De Smet","raw_affiliation_strings":["Christian Health Insurance Fund, 1031 Brussels, Belgium","Department of Public Health and Primary Care, Environment and Health, KU Leuven, 3000 Leuven, Belgium"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Christian Health Insurance Fund, 1031 Brussels, Belgium","institution_ids":[]},{"raw_affiliation_string":"Department of Public Health and Primary Care, Environment and Health, KU Leuven, 3000 Leuven, Belgium","institution_ids":["https://openalex.org/I99464096"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5072412498","display_name":"Johanna Dorst","orcid":"https://orcid.org/0000-0002-2028-6291"},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Johan van Dorst","raw_affiliation_strings":["Christian Health Insurance Fund, 1031 Brussels, Belgium"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Christian Health Insurance Fund, 1031 Brussels, Belgium","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5115829548","display_name":"Elise Derroitte","orcid":null},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Elise Derroitte","raw_affiliation_strings":["Christian Health Insurance Fund, 1031 Brussels, Belgium"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Christian Health Insurance Fund, 1031 Brussels, Belgium","institution_ids":[]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5101526197","display_name":"Bart De Moor","orcid":"https://orcid.org/0000-0001-5836-2037"},"institutions":[{"id":"https://openalex.org/I99464096","display_name":"KU Leuven","ror":"https://ror.org/05f950310","country_code":"BE","type":"education","lineage":["https://openalex.org/I99464096"]}],"countries":["BE"],"is_corresponding":false,"raw_author_name":"Bart De Moor","raw_affiliation_strings":["Department of Electrical Engineering, ESAT-STADIUS, KU Leuven, Kasteelpark Arenberg 10, B-3001 Leuven, Belgium"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Electrical Engineering, ESAT-STADIUS, KU Leuven, Kasteelpark Arenberg 10, B-3001 Leuven, Belgium","institution_ids":["https://openalex.org/I99464096"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":["https://openalex.org/A5053252950"],"corresponding_institution_ids":["https://openalex.org/I99464096"],"apc_list":{"value":2690,"currency":"USD","value_usd":2690},"apc_paid":{"value":2690,"currency":"USD","value_usd":2690},"fwci":14.2964,"has_fulltext":true,"cited_by_count":12,"citation_normalized_percentile":{"value":0.98625912,"is_in_top_1_percent":false,"is_in_top_10_percent":true},"cited_by_percentile_year":{"min":98,"max":99},"biblio":{"volume":"25","issue":"1","first_page":"14","last_page":"14"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T11512","display_name":"Anomaly Detection Techniques and Applications","score":0.5008000135421753,"subfield":{"id":"https://openalex.org/subfields/1702","display_name":"Artificial Intelligence"},"field":{"id":"https://openalex.org/fields/17","display_name":"Computer Science"},"domain":{"id":"https://openalex.org/domains/3","display_name":"Physical Sciences"}},"topics":[{"id":"https://openalex.org/T11512","display_name":"Anomaly Detection Techniques and Applications","score":0.5008000135421753,"subfield":{"id":"https://openalex.org/subfields/1702","display_name":"Artificial Intelligence"},"field":{"id":"https://openalex.org/fields/17","display_name":"Computer Science"},"domain":{"id":"https://openalex.org/domains/3","display_name":"Physical Sciences"}},{"id":"https://openalex.org/T11652","display_name":"Imbalanced Data Classification Techniques","score":0.2207999974489212,"subfield":{"id":"https://openalex.org/subfields/1702","display_name":"Artificial Intelligence"},"field":{"id":"https://openalex.org/fields/17","display_name":"Computer Science"},"domain":{"id":"https://openalex.org/domains/3","display_name":"Physical Sciences"}},{"id":"https://openalex.org/T12026","display_name":"Explainable Artificial Intelligence (XAI)","score":0.14630000293254852,"subfield":{"id":"https://openalex.org/subfields/1702","display_name":"Artificial Intelligence"},"field":{"id":"https://openalex.org/fields/17","display_name":"Computer Science"},"domain":{"id":"https://openalex.org/domains/3","display_name":"Physical Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/workflow","display_name":"Workflow","score":0.7715909481048584},{"id":"https://openalex.org/keywords/categorical-variable","display_name":"Categorical variable","score":0.7649643421173096},{"id":"https://openalex.org/keywords/anomaly-detection","display_name":"Anomaly detection","score":0.7400466799736023},{"id":"https://openalex.org/keywords/computer-science","display_name":"Computer science","score":0.645139753818512},{"id":"https://openalex.org/keywords/context","display_name":"Context (archaeology)","score":0.6099889278411865},{"id":"https://openalex.org/keywords/health-care","display_name":"Health care","score":0.5244893431663513},{"id":"https://openalex.org/keywords/data-science","display_name":"Data science","score":0.44321465492248535},{"id":"https://openalex.org/keywords/cardinality","display_name":"Cardinality (data modeling)","score":0.43744727969169617},{"id":"https://openalex.org/keywords/unsupervised-learning","display_name":"Unsupervised learning","score":0.43535006046295166},{"id":"https://openalex.org/keywords/outlier","display_name":"Outlier","score":0.4254066050052643},{"id":"https://openalex.org/keywords/machine-learning","display_name":"Machine learning","score":0.41874033212661743},{"id":"https://openalex.org/keywords/data-mining","display_name":"Data mining","score":0.3930974006652832},{"id":"https://openalex.org/keywords/artificial-intelligence","display_name":"Artificial intelligence","score":0.3913114666938782},{"id":"https://openalex.org/keywords/database","display_name":"Database","score":0.18813148140907288}],"concepts":[{"id":"https://openalex.org/C177212765","wikidata":"https://www.wikidata.org/wiki/Q627335","display_name":"Workflow","level":2,"score":0.7715909481048584},{"id":"https://openalex.org/C5274069","wikidata":"https://www.wikidata.org/wiki/Q2285707","display_name":"Categorical variable","level":2,"score":0.7649643421173096},{"id":"https://openalex.org/C739882","wikidata":"https://www.wikidata.org/wiki/Q3560506","display_name":"Anomaly detection","level":2,"score":0.7400466799736023},{"id":"https://openalex.org/C41008148","wikidata":"https://www.wikidata.org/wiki/Q21198","display_name":"Computer science","level":0,"score":0.645139753818512},{"id":"https://openalex.org/C2779343474","wikidata":"https://www.wikidata.org/wiki/Q3109175","display_name":"Context (archaeology)","level":2,"score":0.6099889278411865},{"id":"https://openalex.org/C160735492","wikidata":"https://www.wikidata.org/wiki/Q31207","display_name":"Health care","level":2,"score":0.5244893431663513},{"id":"https://openalex.org/C2522767166","wikidata":"https://www.wikidata.org/wiki/Q2374463","display_name":"Data science","level":1,"score":0.44321465492248535},{"id":"https://openalex.org/C87117476","wikidata":"https://www.wikidata.org/wiki/Q362383","display_name":"Cardinality (data modeling)","level":2,"score":0.43744727969169617},{"id":"https://openalex.org/C8038995","wikidata":"https://www.wikidata.org/wiki/Q1152135","display_name":"Unsupervised learning","level":2,"score":0.43535006046295166},{"id":"https://openalex.org/C79337645","wikidata":"https://www.wikidata.org/wiki/Q779824","display_name":"Outlier","level":2,"score":0.4254066050052643},{"id":"https://openalex.org/C119857082","wikidata":"https://www.wikidata.org/wiki/Q2539","display_name":"Machine learning","level":1,"score":0.41874033212661743},{"id":"https://openalex.org/C124101348","wikidata":"https://www.wikidata.org/wiki/Q172491","display_name":"Data mining","level":1,"score":0.3930974006652832},{"id":"https://openalex.org/C154945302","wikidata":"https://www.wikidata.org/wiki/Q11660","display_name":"Artificial intelligence","level":1,"score":0.3913114666938782},{"id":"https://openalex.org/C77088390","wikidata":"https://www.wikidata.org/wiki/Q8513","display_name":"Database","level":1,"score":0.18813148140907288},{"id":"https://openalex.org/C162324750","wikidata":"https://www.wikidata.org/wiki/Q8134","display_name":"Economics","level":0,"score":0.0},{"id":"https://openalex.org/C86803240","wikidata":"https://www.wikidata.org/wiki/Q420","display_name":"Biology","level":0,"score":0.0},{"id":"https://openalex.org/C50522688","wikidata":"https://www.wikidata.org/wiki/Q189833","display_name":"Economic growth","level":1,"score":0.0},{"id":"https://openalex.org/C151730666","wikidata":"https://www.wikidata.org/wiki/Q7205","display_name":"Paleontology","level":1,"score":0.0}],"mesh":[{"descriptor_ui":"D000069558","descriptor_name":"Unsupervised Machine Learning","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D000069558","descriptor_name":"Unsupervised Machine Learning","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D000069558","descriptor_name":"Unsupervised Machine Learning","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D000069558","descriptor_name":"Unsupervised Machine Learning","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D000069558","descriptor_name":"Unsupervised Machine Learning","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D001530","descriptor_name":"Belgium","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D001530","descriptor_name":"Belgium","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D001530","descriptor_name":"Belgium","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D001530","descriptor_name":"Belgium","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D001530","descriptor_name":"Belgium","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D005607","descriptor_name":"Fraud","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D005607","descriptor_name":"Fraud","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D005607","descriptor_name":"Fraud","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D005607","descriptor_name":"Fraud","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D005607","descriptor_name":"Fraud","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D007348","descriptor_name":"Insurance, Health","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D007348","descriptor_name":"Insurance, Health","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D007348","descriptor_name":"Insurance, Health","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D007348","descriptor_name":"Insurance, Health","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D007348","descriptor_name":"Insurance, Health","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D057225","descriptor_name":"Data Mining","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D057225","descriptor_name":"Data Mining","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D057225","descriptor_name":"Data Mining","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D057225","descriptor_name":"Data Mining","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D057225","descriptor_name":"Data Mining","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false}],"locations_count":5,"locations":[{"id":"doi:10.1186/s12911-024-02823-6","is_oa":true,"landing_page_url":"https://doi.org/10.1186/s12911-024-02823-6","pdf_url":"https://bmcmedinformdecismak.biomedcentral.com/counter/pdf/10.1186/s12911-024-02823-6","source":{"id":"https://openalex.org/S107516304","display_name":"BMC Medical Informatics and Decision Making","issn_l":"1472-6947","issn":["1472-6947"],"is_oa":true,"is_in_doaj":true,"is_core":true,"host_organization":"https://openalex.org/P4310320256","host_organization_name":"BioMed Central","host_organization_lineage":["https://openalex.org/P4310320256","https://openalex.org/P4310319965"],"host_organization_lineage_names":["BioMed Central","Springer Nature"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"BMC Medical Informatics and Decision Making","raw_type":"journal-article"},{"id":"pmid:39789541","is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/39789541","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"BMC medical informatics and decision making","raw_type":null},{"id":"pmh:oai:lirias2repo.kuleuven.be:20.500.12942/757439","is_oa":true,"landing_page_url":"https://lirias.kuleuven.be/handle/20.500.12942/757439","pdf_url":"https://lirias.kuleuven.be/retrieve/65c10667-57a9-49ae-bd55-c46fa3f58bd9","source":{"id":"https://openalex.org/S7407055369","display_name":"Lirias","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"Bmc Medical Informatics And Decision Making, vol. 25 (1), Art.No. ARTN 14","raw_type":"info:eu-repo/semantics/article"},{"id":"pmh:oai:pubmedcentral.nih.gov:11720628","is_oa":true,"landing_page_url":"https://www.ncbi.nlm.nih.gov/pmc/articles/11720628","pdf_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC11720628/pdf/12911_2024_Article_2823.pdf","source":{"id":"https://openalex.org/S2764455111","display_name":"PubMed Central","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"BMC Med Inform Decis Mak","raw_type":"Text"},{"id":"pmh:oai:doaj.org/article:6cb8ec1b32a54b08ab227b7125670df8","is_oa":true,"landing_page_url":"https://doaj.org/article/6cb8ec1b32a54b08ab227b7125670df8","pdf_url":null,"source":{"id":"https://openalex.org/S4306401280","display_name":"DOAJ (DOAJ: Directory of Open Access Journals)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by-sa","license_id":"https://openalex.org/licenses/cc-by-sa","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"BMC Medical Informatics and Decision Making, Vol 25, Iss 1, Pp 1-11 (2025)","raw_type":"article"}],"best_oa_location":{"id":"doi:10.1186/s12911-024-02823-6","is_oa":true,"landing_page_url":"https://doi.org/10.1186/s12911-024-02823-6","pdf_url":"https://bmcmedinformdecismak.biomedcentral.com/counter/pdf/10.1186/s12911-024-02823-6","source":{"id":"https://openalex.org/S107516304","display_name":"BMC Medical Informatics and Decision Making","issn_l":"1472-6947","issn":["1472-6947"],"is_oa":true,"is_in_doaj":true,"is_core":true,"host_organization":"https://openalex.org/P4310320256","host_organization_name":"BioMed Central","host_organization_lineage":["https://openalex.org/P4310320256","https://openalex.org/P4310319965"],"host_organization_lineage_names":["BioMed Central","Springer Nature"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"BMC Medical Informatics and Decision Making","raw_type":"journal-article"},"sustainable_development_goals":[],"awards":[{"id":"https://openalex.org/G1214117848","display_name":null,"funder_award_id":"C24/18/022","funder_id":"https://openalex.org/F4320322308","funder_display_name":"KU Leuven"},{"id":"https://openalex.org/G1371775621","display_name":null,"funder_award_id":"C16/15/059","funder_id":"https://openalex.org/F4320322308","funder_display_name":"KU Leuven"},{"id":"https://openalex.org/G1661581078","display_name":null,"funder_award_id":"SBO project S005319N","funder_id":"https://openalex.org/F4320327336","funder_display_name":"Vlaamse regering"},{"id":"https://openalex.org/G2998977510","display_name":null,"funder_award_id":"C3I-21-00316)","funder_id":"https://openalex.org/F4320322308","funder_display_name":"KU Leuven"},{"id":"https://openalex.org/G4466228027","display_name":null,"funder_award_id":"C3/20/117","funder_id":"https://openalex.org/F4320322308","funder_display_name":"KU Leuven"},{"id":"https://openalex.org/G5103706795","display_name":null,"funder_award_id":"C3/19/053","funder_id":"https://openalex.org/F4320322308","funder_display_name":"KU Leuven"},{"id":"https://openalex.org/G5541109553","display_name":null,"funder_award_id":"TBM Project T001919N","funder_id":"https://openalex.org/F4320327336","funder_display_name":"Vlaamse regering"},{"id":"https://openalex.org/G6136023902","display_name":null,"funder_award_id":"VLAIO: CSBO (HBC.2021.0076) Baekeland PhD","funder_id":"https://openalex.org/F4320327336","funder_display_name":"Vlaamse regering"},{"id":"https://openalex.org/G6412682158","display_name":null,"funder_award_id":"Research Fund (projectsi BOF/23/064","funder_id":"https://openalex.org/F4320322308","funder_display_name":"KU Leuven"},{"id":"https://openalex.org/G6567379633","display_name":null,"funder_award_id":"FWO: EOS Project no G0F6718N (SeLMA), SBO project S005319N, Infrastructure project I013218N, TBM Project T001919N; PhD Grant (SB/1SA1319N), EWI: the Flanders AI Research Program, VLAIO: CSBO (HBC.2021.0076) Baekeland PhD (HBC.20192204)","funder_id":"https://openalex.org/F4320327336","funder_display_name":"Vlaamse regering"},{"id":"https://openalex.org/G795436546","display_name":null,"funder_award_id":"FWO: EOS Project no G0F6718N","funder_id":"https://openalex.org/F4320327336","funder_display_name":"Vlaamse regering"},{"id":"https://openalex.org/G8160680691","display_name":null,"funder_award_id":"Research Fund (projectsi BOF/23/064, C16/15/059, C3/19/053, C24/18/022, C3/20/117, C3I-21-00316), Industrial Research Fund (Fellowships 13-0260, IOFm/16/004) and several Leuven Research and Development bilateral industrial projects","funder_id":"https://openalex.org/F4320322308","funder_display_name":"KU Leuven"}],"funders":[{"id":"https://openalex.org/F4320322308","display_name":"KU Leuven","ror":"https://ror.org/05f950310"},{"id":"https://openalex.org/F4320327317","display_name":"Kom op tegen Kanker","ror":null},{"id":"https://openalex.org/F4320327336","display_name":"Vlaamse regering","ror":null},{"id":"https://openalex.org/F4320338453","display_name":"HORIZON EUROPE European Research Council","ror":null}],"has_content":{"pdf":true,"grobid_xml":false},"content_urls":{"pdf":"https://content.openalex.org/works/W4406230663.pdf"},"referenced_works_count":36,"referenced_works":["https://openalex.org/W199035648","https://openalex.org/W1242748811","https://openalex.org/W1660390307","https://openalex.org/W1968573882","https://openalex.org/W1986332411","https://openalex.org/W2083408233","https://openalex.org/W2084512860","https://openalex.org/W2102201073","https://openalex.org/W2129281431","https://openalex.org/W2132870739","https://openalex.org/W2144182447","https://openalex.org/W2147152072","https://openalex.org/W2152742003","https://openalex.org/W2295589360","https://openalex.org/W2296719434","https://openalex.org/W2345406336","https://openalex.org/W2345945023","https://openalex.org/W2487770199","https://openalex.org/W2577748110","https://openalex.org/W2584158425","https://openalex.org/W2618851150","https://openalex.org/W2646970574","https://openalex.org/W2783205364","https://openalex.org/W2887302654","https://openalex.org/W2892312135","https://openalex.org/W2969619127","https://openalex.org/W3089485643","https://openalex.org/W3128465814","https://openalex.org/W4226060502","https://openalex.org/W4246479655","https://openalex.org/W4281480382","https://openalex.org/W4283810514","https://openalex.org/W4386038752","https://openalex.org/W6637101025","https://openalex.org/W6675354045","https://openalex.org/W6751494907"],"related_works":["https://openalex.org/W2499612753","https://openalex.org/W4229333355","https://openalex.org/W3111802945","https://openalex.org/W2122407924","https://openalex.org/W2946096271","https://openalex.org/W2295423552","https://openalex.org/W1598471830","https://openalex.org/W3107369729","https://openalex.org/W4285233543","https://openalex.org/W4230838436"],"abstract_inverted_index":{"BACKGROUND:":[0],"Waste":[1],"and":[2,24,29,38,45,54,103,139,162,191,241],"fraud":[3,251],"are":[4,21],"important":[5],"problems":[6],"for":[7],"health":[8,171,256],"insurers":[9,20],"to":[10,33,47,76,98,125,136,144,188,217,233],"deal":[11,126],"with.":[12],"With":[13],"the":[14,116,146,164,169,193,210,255],"advent":[15],"of":[16,90,118,166,168],"big":[17],"data,":[18],"these":[19],"looking":[22],"more":[23,25,99],"towards":[26],"data":[27,42],"mining":[28],"machine":[30,71],"learning":[31,72],"methods":[32,190],"help":[34,165],"in":[35,70,85,96,115,174,245,254],"detecting":[36],"waste":[37,102],"fraud.":[39,104],"However,":[40],"labeled":[41],"is":[43,231],"costly":[44],"difficult":[46],"acquire":[48],"as":[49],"it":[50],"requires":[51],"expert":[52,243],"investigators":[53,84,244],"known":[55,159,235],"care":[56,236],"providers":[57,156,237],"with":[58,92,127,157,163,213,238],"atypical":[59,239],"behavior.":[60],"METHODS:":[61],"In":[62,206],"this":[63],"work":[64],"we":[65],"show":[66,179,200],"how":[67],"recent":[68],"advances":[69],"can":[73,82],"be":[74],"used":[75,114],"set":[77],"up":[78],"a":[79,158,184,207,219],"workflow":[80,212,230],"that":[81,180,192],"aid":[83],"discovering":[86],"practitioners":[87,91],"or":[88,252],"groups":[89],"unusual":[93],"resource":[94],"use":[95],"order":[97],"efficiently":[100],"combat":[101],"We":[105],"combine":[106],"three":[107],"different":[108],"techniques,":[109],"which":[110],"have":[111],"not":[112],"been":[113,153],"context":[117],"healthcare":[119],"insurance":[120,172,257],"anomaly":[121,133,196],"detection:":[122],"categorical":[123,129,181],"embeddings":[124,182],"high-cardinality":[128],"variables,":[130],"state-of-the-art":[131,194],"unsupervised":[132,195],"detection":[134,197],"techniques":[135,198],"detect":[137,218,234],"anomalies":[138],"Shapley":[140],"additive":[141],"explanations":[142],"(SHAP)":[143],"explain":[145],"model":[147],"output.":[148],"RESULTS:":[149],"The":[150,176,228],"method":[151],"has":[152],"evaluated":[154],"on":[155],"anomalous":[160,222],"profile":[161],"experts":[167],"largest":[170],"fund":[173],"Belgium.":[175],"quantitative":[177],"experiments":[178],"offer":[183],"significant":[185],"improvement":[186,202],"compared":[187],"standard":[189],"generally":[199],"an":[201],"over":[203],"traditional":[204],"methods.":[205],"practical":[208],"setting,":[209],"proposed":[211,229],"SHAP":[214],"was":[215],"able":[216,232],"previously":[220],"unknown,":[221],"trend":[223],"among":[224],"general":[225],"practitioners.":[226],"CONCLUSIONS:":[227],"behaviour":[240],"helps":[242],"making":[246],"informed":[247],"decisions":[248],"concerning":[249],"possible":[250],"overconsumption":[253],"field.":[258]},"counts_by_year":[{"year":2026,"cited_by_count":3},{"year":2025,"cited_by_count":9}],"updated_date":"2026-08-08T01:25:22.217667","created_date":"2025-10-10T00:00:00"}
