Target leakage, not model class, explains reported accuracy in survey-based cardiovascular screening: a leakage-tiered audit of glass-box and tabular foundation models

The study audited ten different classifiers—including linear, tree‑ensemble, neural, glass‑box, and tabular foundation models—on national health survey data to predict myocardial infarction. By systematically removing features that could cause target leakage, the authors found that all models’ AUROC scores collapsed into a narrow band, indicating that reported high accuracy in prior work was largely due to leakage rather than model sophistication. The glass‑box explainable boosting machine performed comparably to other models while being much faster, and the authors demonstrated that fairness, calibration, and uncertainty can be audited and repaired without sacrificing performance.