基于机器学习与SHAP的社区老年人口腔衰弱风险预测模型构建
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男,本科在读,学生

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科研项目:国家级大学生创新训练计划项目(202410439015)


Construction of a risk prediction model for oral frailty in community-dwelling older adults using machine learning and SHAP analysis
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    摘要:

    目的 构建社区老年人口腔衰弱风险的动态可解释预测模型,为社区护理人员开展早期评估与干预提供参考。 方法 采用便利抽样法在安徽省选取1 457名社区老年人,由经过培训的调查人员运用口腔衰弱指标筛查-8进行口腔衰弱评估,并收集可能影响社区老年人口腔衰弱的相关资料作为模型候选预测变量。按7∶3比例随机分为训练集(1 020名)和验证集(437名),基于训练集筛选影响因素并构建包括logistic回归、随机森林、支持向量机、决策树、神经网络、极限梯度提升、朴素贝叶斯及K近邻8种机器学习模型;基于验证集评价模型性能;并采用夏普利加性解释(SHAP)对最优模型进行解释与可视化。 结果 64.4%的社区老年人存在口腔衰弱风险。支持向量机模型在验证集中预测性能最优,AUC为0.783,F1分数最高(0.659),Brier分数最小(0.180);慢性病、年龄、抑郁、吸烟、营养不良和躯体衰弱是社区老年人口腔衰弱的主要影响因素。SHAP结果显示,慢性病贡献度最高。 结论 支持向量机模型对社区老年人口腔衰弱风险具有良好的预测能力,基于SHAP识别的主要风险因素可为制订针对性护理干预措施提供依据。

    Abstract:

    Objective To construct a dynamic interpretable prediction model for oral frailty risk in community-dwelling older adults, and to provide a reference for community nurses to carry out early assessment and intervention. Methods Using convenience sampling, 1,457 community-dwelling older people in Anhui Province were recruited and assessed using the Oral Frailty Index-8 by trained investigators.The relevant influencing factors for oral frailty were collected as potential variables for the model.Participants were randomly divided into a training set (n=1,020) and a validation set (n=437) at a 7∶3 ratio.Based on the training set, inf-luencing factors were identified through 8 machine learning algorithms, including logistic regression, random forest, support vector machine, decision tree, neural network, extreme gradient boosting, naive Bayes, and K-nearest neighbors.Model performance was evaluated using the validation set.The optimal model was interpreted and visualized using SHapley Additive exPlanations (SHAP). Results The incidence of oral frailty risk was 64.4% in the community-dwelling older adults.The support vector machine model had the best predictive performance in the validation set, with an AUC of 0.783, F1 score of 0.659 (the highest), and Brier score of 0.180 (the lowest); chronic disease, age, depression, smoking, malnutrition, and physical frailty were the main influencing factors of oral frailty.SHAP results showed that chronic disease of the greatest contribution. Conclusion The support vector machine model has satisfactory predictive performance for the risk of oral frailty in community-dwelling older adults.The main risk factors identified based on SHAP can provide a basis for the development of targeted nursing interventions.

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刘庆伟,郭丽,刘欢,钱秋雨,闵佳慧,罗洋,侯乐栋,张铭.基于机器学习与SHAP的社区老年人口腔衰弱风险预测模型构建[J].护理学杂志,2026,41(7):107-112+123

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  • 收稿日期:2025-10-06
  • 最后修改日期:2025-12-13
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  • 在线发布日期: 2026-04-28