从生物化学和临床数据开发可解释的机器学习模型,以预测心血管疾病和癌症共发病的全因和因特定死亡率:基于NHANESES的纵向研究
Lu Chai1, Xiwei Shi2, Xiaohui Wang2
1HunanNormal University Health Science Center, Changsha, Hunan 410013, China; Kiang Wu Nursing College of Macau, Macao, Macao SAR 999078, China.
International journal of cardiology
|December 12, 2025
概括
这项研究开发了可解释的机器学习模型,以预测心血管疾病和癌症的成年人死亡率. 随机生存森林 (RSF) 的表现优于传统模型,确定了更好的患者分层的关键风险因素.
科学领域:
- 生物医学数据科学是生物医学数据科学.
- 计算流行病学计算流行病学
- 精准医学是一门精准的医学.
背景情况:
- 心血管疾病 (CVD) 和癌症是导致死亡的主要原因,特别是在老年人群中.
- 同病症协同增加患者的风险,但准确的预测工具是有限的.
- 传统模型在生物化学标记物中与非线性相互作用作斗争.
研究的目的:
- 开发可解释的机器学习 (ML) 模型来预测全因,心血管疾病特异性和癌症特异性死亡率.
- 在美国成年患者中使用常规的生物化学概况,包括并发性心血管疾病和癌症.
- 加强复杂并发症患者的风险分层.
主要方法:
- 分析了10个国家健康和营养检查调查 (NHANES) 周期 (1999-2018).
- 使用随机生存森林 (RSF) 选了21种生化标志物和共变量.
- 将RSF与Cox PH,Cox Net,梯度提升和极端生存树 (EST) 进行比较,使用C指数,Brier分数和SHAP进行解释.
主要成果:
- 在预测死亡率方面,RSF始终优于其他模型 (C指数:所有原因0.729,心血管疾病0.731,癌症0.674).
- 无线电通信实现了优越的校准,并获得了最低的布赖尔分数.
- SHAP确定了年龄,红细胞分布宽度,肌素和白蛋白作为关键预测因素,表明炎症,功能障碍和代谢失调.
结论:
- 可解释的RSF模型有效捕捉非线性相互作用,优于传统方法.
- 这一框架为心血管疾病与癌症共患病的风险分层提供了改进.
- 强调了可解释的ML在复杂疾病的精密医学中的临床价值.
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