Feng Tong, Li PeiPei, Duan Ran, Jin Zhi
Department of Respiratory and Critical Care Medicine, Deyang People's Hospital, Affiliated Hospital of Chengdu College of Medicine, Deyang, China.
The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China.
BMC Psychiatry. 2025 Jul 3;25(1):506. doi: 10.1186/s12888-025-06913-1.
BACKGROUND: Chronic Obstructive Pulmonary Disease (COPD) is a prevalent respiratory condition often accompanied by depression, which exacerbates disease burden and impairs quality of life. Early identification of depression risk in COPD patients remains a clinical challenge. OBJECTIVE: This study aimed to develop a machine learning-based model to predict depression risk in COPD patients, utilizing interpretable features from clinical and demographic data to support early intervention. METHODS: Data were extracted from the National Health and Nutrition Examination Survey (NHANES), involving 1,638 COPD patients. Depression was assessed using the Patient Health Questionnaire-9 (PHQ-9) scale. Feature selection was performed with Boruta and least absolute shrinkage and selection operator (LASSO) algorithms, identifying key predictors from demographic, lifestyle, medical history, and laboratory variables. Nine machine learning models were trained and evaluated, with performance assessed via accuracy, area under the curve (AUC), calibration, and clinical utility metrics. RESULTS: Significant predictors of depression included sleep disturbances, age, poverty, hypertension, and comorbidities like cardiovascular disease. The Support Vector Machine (SVM) model achieved the highest performance, with an AUC of 0.890 in the validation set and 0.887 in the test set, demonstrating robust discriminative ability and clinical applicability. SHapley Additive exPlanations (SHAP) analysis enhanced model interpretability. Notably, sleep disturbances, younger age, and greater socioeconomic deprivation were associated with an elevated risk of depression. CONCLUSION: This study presents a reliable SVM-based model for predicting depression risk in COPD patients, leveraging NHANES data and interpretable features. It offers a valuable tool for early screening and personalized care, with potential to improve mental health outcomes in this population.
背景:慢性阻塞性肺疾病(COPD)是一种常见的呼吸系统疾病,常伴有抑郁症,这会加重疾病负担并损害生活质量。早期识别COPD患者的抑郁风险仍然是一项临床挑战。 目的:本研究旨在开发一种基于机器学习的模型,以预测COPD患者的抑郁风险,利用临床和人口统计学数据中的可解释特征来支持早期干预。 方法:数据取自国家健康与营养检查调查(NHANES),涉及1638名COPD患者。使用患者健康问卷-9(PHQ-9)量表评估抑郁情况。采用Boruta算法和最小绝对收缩和选择算子(LASSO)算法进行特征选择,从人口统计学、生活方式、病史和实验室变量中识别关键预测因素。训练并评估了九个机器学习模型,通过准确性、曲线下面积(AUC)、校准和临床效用指标评估性能。 结果:抑郁的显著预测因素包括睡眠障碍、年龄、贫困、高血压以及心血管疾病等合并症。支持向量机(SVM)模型表现最佳,在验证集中AUC为0.890,在测试集中为0.887,显示出强大的判别能力和临床适用性。SHapley加法解释(SHAP)分析增强了模型的可解释性。值得注意的是,睡眠障碍、年轻和社会经济剥夺程度较高与抑郁风险升高相关。 结论:本研究提出了一种基于SVM的可靠模型,用于预测COPD患者的抑郁风险,利用了NHANES数据和可解释特征。它为早期筛查和个性化护理提供了一个有价值的工具,有可能改善该人群的心理健康状况。
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