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Machine learning (ML), a form of artificial intelligence (AI), is being increasingly employed in neurology. Reported performance metrics often match or exceed the efficiency of average clinicians. The neurologist is easily baffled by the underlying concepts and terminologies associated with ML studies. The superlative performance metrics of ML algorithms often hide the opaque nature of its inner workings. Questions regarding ML model's interpretability and reproducibility of its results in real-world scenarios, need emphasis. Given an abundance of time and information, the expert clinician should be able to deliver comparable predictions to ML models, a useful benchmark while evaluating its performance. Predictive performance metrics of ML models should not be confused with causal inference between its input and output. ML and clinical gestalt should compete in a randomized controlled trial before they can complement each other for screening, triaging, providing second opinions and modifying treatment. [ABSTRACT FROM AUTHOR]

In this paper, we suggest basing the development of classification methods on traditional techniques but approximating them in whole or in part with artificial neural networks (ANNs). Compared to a direct ANN approach, the underlying traditional method is often easier to analyse. Classification failures can be better understood and corrected for, while at the same time faster execution can be obtained due to the parallel ANN structure. Furthermore, such a two‐step design philosophy partly eliminates the 'guesswork' associated with the design of ANNs. The expected gain is thus that the benefits from the traditional field, and the ANN field can be obtained by combining the best features from both fields. We illustrate our approach by working through an explicit example, namely, a Nearest Neighbour classifier applied to a subset of the MNIST database of handwritten digits. Two different approaches are discussed for how to translate the traditional method into an ANN. The first approach is based on a constructive implementation which directly reflects the original algorithm. The second approach uses ANNs to approximate the whole, or part of, the original method. An important part of the approach is to show how improvements can be introduced. In line with the presented philosophy, this is done by extending the traditional method in several ways followed by ANN approximation of the modified algorithms. The extensions are based on a windowed version of the nearest neighbour algorithm. We show that the improvements carry over to the ANN implementations. We further investigate the stability of the solutions by modifying the training set. It is shown that the errors do not change significantly. This also holds true for the ANN approximations providing confidence that the two‐step strategy is robust. [ABSTRACT FROM AUTHOR]