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在社区和临床人群中预测心脏病风险的可解释后勤回归:发展和外部验证研究
Peihua Tong1, Hui Hu1, Ling Tong1
1Huzhou Central Hospital, Affiliated Central Hospital of Huzhou University, 1558 Sanhuan North Road, Huzhou City, Zhejiang Province,313000, China, Huzhou, CN.
一个新的可解释后勤回归模型 (SHAP-LR) 显示出预测心脏病风险的前景,提供与复杂的机器学习模型相比的透明度. 对于常规临床使用,需要进一步验证.
科学领域:
- 心脏病学 心脏病学
- 医疗信息学 医疗信息学
- 机器学习 机器学习
背景情况:
- 心脏病仍然是全球主要的死亡原因.
- 复杂的机器学习模型的有限可解释性阻碍了它们的临床采用.
- 后勤回归提供了透明度,但通常被认为不那么准确.
研究的目的:
- 为心脏病风险预测开发一个可解释的物流回归模型 (SHAP-LR).
- 为了评估SHAP-LR的性能与机器学习模型和Framingham风险评分 (FRS) 对不同的数据集进行比较.
- 评估心脏病风险评估中的预测性表现和可解释性之间的平衡.
主要方法:
- 使用行为风险因素监测系统 (BRFSS) 数据集开发了SHAP-LR.
- 将SHAP-LR与UCI和Statlog心脏病数据集上的机器学习模型进行比较.
- 在UCI心脏病数据库上外部验证SHAP-LR并与FRS进行比较.
主要成果:
- 在数据集 (AUROCs ~0.73-0.80) 中,SHAP-LR表现出与树型模型相比或优于树型模型的性能.
- 在外部队列中,SHAP-LR显示了与FRS相似的歧视,在高流行率样本中,校准更有利.
- 在特定高危子组 (如糖尿病,高血压) 中,FRS的表现优于SHAP-LR.
结论:
- SHAP-LR为流行心脏病风险预测提供了一个透明和可解释的框架.
- 虽然SHAP-LR平衡了性能和透明度,但FRS在某些高风险群体中表现出色.
- 原始SHAP-LR概率需要重新校准以进行绝对风险估计,特别是在低患病率的人群中.
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