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LE affects individuals across various professions and causes daily problems. Methods: We analyzed signals from the forearm muscles of 14 healthy controls and 14 LE patients using high-density surface electromyography. We discerned significant differences between groups by employing phase\u2013amplitude coupling (PAC) features. Our study leveraged PAC, Daubechies wavelet with four vanishing moments (db4), and state-of-the-art techniques to train a neural network for the subject\u2019s label prediction. Results: Remarkably, PAC features achieved 100% specificity and sensitivity in predicting unseen subjects, while state-of-the-art features lagged with only 35.71% sensitivity and 28.57% specificity, and db4 with 78.57% sensitivity and 85.71 specificity. PAC significantly outperformed the state-of-the-art features (adj. p-value &lt; 0.001) with a large effect size. However, no significant difference was found between PAC and db4 (adj.\u00a0p-value = 0.147). Also, the Jeffries\u2013Matusita (JM) distance of the PAC was significantly higher than other features (adj. p-value &lt; 0.001), with a large effect size, suggesting PAC features as robust predictors of neuromuscular diseases, offering a profound understanding of disease pathology and new avenues for interpretation. We evaluated the generalization ability of the PAC model using 99.9% confidence intervals and Bayesian credible intervals to quantify prediction uncertainty across subjects. Both methods demonstrated high reliability, with an expected accuracy of 89% in larger, more diverse populations. Conclusions: This study\u2019s implications might extend beyond LE, paving the way for enhanced diagnostic tools and deeper insights into the complexities of neuromuscular disorders.<\/jats:p>","DOI":"10.3390\/diagnostics14202255","type":"journal-article","created":{"date-parts":[[2024,10,10]],"date-time":"2024-10-10T07:54:09Z","timestamp":1728546849000},"page":"2255","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["AML-DECODER: Advanced Machine Learning for HD-sEMG Signal Classification\u2014Decoding Lateral Epicondylitis in Forearm Muscles"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0938-6451","authenticated-orcid":false,"given":"Mehdi","family":"Shirzadi","sequence":"first","affiliation":[{"name":"Automatic Control Department (ESAII), Biomedical Engineering Research Centre (CREB), Universitat Polit\u00e8cnica de Catalunya-Barcelona Tech (UPC), 08028 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9971-3566","authenticated-orcid":false,"given":"M\u00f3nica Rojas","family":"Mart\u00ednez","sequence":"additional","affiliation":[{"name":"Automatic Control Department (ESAII), Biomedical Engineering Research Centre (CREB), Universitat Polit\u00e8cnica de Catalunya-Barcelona Tech (UPC), 08028 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2980-6716","authenticated-orcid":false,"given":"Joan Francesc","family":"Alonso","sequence":"additional","affiliation":[{"name":"Automatic Control Department (ESAII), Biomedical Engineering Research Centre (CREB), Universitat Polit\u00e8cnica de Catalunya-Barcelona Tech (UPC), 08028 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0374-4246","authenticated-orcid":false,"given":"Leidy Yanet","family":"Serna","sequence":"additional","affiliation":[{"name":"Automatic Control Department (ESAII), Biomedical Engineering Research Centre (CREB), Universitat Polit\u00e8cnica de Catalunya-Barcelona Tech (UPC), 08028 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joaquim","family":"Chaler","sequence":"additional","affiliation":[{"name":"EUSES-Bellvitge, Universitat de Girona, Universitat de Barcelona, ENTI, 08907 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9836-6083","authenticated-orcid":false,"given":"Miguel Angel","family":"Ma\u00f1anas","sequence":"additional","affiliation":[{"name":"Automatic Control Department (ESAII), Biomedical Engineering Research Centre (CREB), Universitat Polit\u00e8cnica de Catalunya-Barcelona Tech (UPC), 08028 Barcelona, Spain"},{"name":"CIBER de Bioingenier\u00eda, Biomateriales y Nanomedicina (CIBER-BBN), 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4408-2397","authenticated-orcid":false,"given":"Hamid Reza","family":"Marateb","sequence":"additional","affiliation":[{"name":"Automatic Control Department (ESAII), Biomedical Engineering Research Centre (CREB), Universitat Polit\u00e8cnica de Catalunya-Barcelona Tech (UPC), 08028 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,10,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1158","DOI":"10.1302\/0301-620X.95B9.29285","article-title":"Lateral epicondylitis","volume":"95","author":"Ahmad","year":"2013","journal-title":"Bone Jt. 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