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A machine-learning-derived online prediction model for depression risk in COPD patients: A retrospective cohort study from CHARLS.

Xuanna Zhao, Yu-Nan Wang, Jiahua Li, Weiliang Liu, Yuting Yang, Youping Qiao, Jinyu Liao, Min Chen et al.

Journal of Affective Disorders, 2025

2,921 participants · 68 citations

Abstract

BACKGROUND

Depression associated with Chronic Obstructive Pulmonary Disease (COPD) is a detrimental complication that significantly impairs patients' quality of life. This study aims to develop an online predictive model to estimate the risk of depression in COPD patients.

METHODS

This study included 2921 COPD patients from the 2018 China Health and Retirement Longitudinal Study (CHARLS), analyzing 36 behavioral, health, psychological, and socio-demographic indicators. LASSO regression filtered predictive factors, and six machine learning models-Logistic Regression, Support Vector Machine, Multilayer Perceptron, LightGBM, XGBoost, and Random Forest-were applied to identify the best model for predicting depression risk in COPD patients. Temporal validation used 2013 CHARLS data. We developed a personalized, interpretable risk prediction platform using SHAP.

RESULTS

A total of 2921 patients with COPD were included in the analysis, of whom 1451 (49.7 %) presented with depressive symptoms. 11 variables were selected to develop 6 machine learning models. Among these, the XGBoost model exhibited exceptional predictive performance in terms of discrimination, calibration, and clinical applicability, with an AUROC range of 0.747-0.811. In validation sets encompassing diverse population characteristics, XGBoost achieved the highest accuracy (70.63 %), sensitivity (59.05 %), and F1 score (63.17 %).

LIMITATIONS

The target population for the model is COPD patients. And the clinical…

How strong is the evidence?

Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 2,921 participants or records.

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