Evidence map›Paper›PMID 40469589›Full record

ArticleFrontiers in public health2025

Developing machine learning models for predicting cardiovascular disease survival based on heavy metal serum and urine levels.

Hui Jin, Ling Zhang, Yan Sun, Ya Xu, Man Luo

Abstract read
In one paragraph

Article in Frontiers in public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Review
  2. An Exploration of Machine Learning Methods in Human Biomonitoring.International journal of environmental research and public health · 2026
    Review
  3. Article
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Hui Jin *Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Ling Zhang *Huai'an No. 3 People's Hospital, Huaian Second Clinical College, Xuzhou Medical University, Huai'an, Jiangsu, China.
Yan Sun *Nanjing Jiangbei Hospital, Affiliated Nanjing Jiangbei Hospital of Xinglin College, Nantong University, Nanjing, Jiangsu, China.
Ya XuNanjing Jiangbei Hospital, Affiliated Nanjing Jiangbei Hospital of Xinglin College, Nantong University, Nanjing, Jiangsu, China.
Man LuoHuai'an TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Huai'an, Jiangsu, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Environmental exposure to heavy metals, such as arsenic, cadmium, and lead, is a known risk factor for cardiovascular diseases. Objective: We aim to examine the associations between heavy metal exposure and the mortality of patients with cardiovascular diseases. Methods: We analyzed data from the NHANES 2003-2018, including urine and blood metal concentrations from 4,924 participants. Five machine learning models-CoxPHSurvival, FastKernelSurvivalSVM, GradientBoostingSurvival, RandomSurvivalForest, and ExtraSurvivalTrees-were used to predict cardiovascular mortality. Model performance was assessed with the concordance index (C-index), integrated Brier score, time-dependent AUC, and calibration curves. SHAP analysis was conducted using a reduced background dataset created via K-means clustering. Results: GradientBoostingSurvival (GBS) showed the best performance for hypertension (C-index: 0.780, mean AUC: 0.798). RandomSurvivalForest (RSF) was the top model for coronary heart disease (C-index: 0.592, mean AUC: 0.626) and myocardial infarction (C-index: 0.705, mean AUC: 0.743), while CoxPHSurvival excelled for heart failure (C-index: 0.642, mean AUC: 0.672) and stroke (C-index: 0.658, mean AUC: 0.691). ExtraSurvivalTrees performed best in angina (C-index: 0.652, mean AUC: 0.669). Calibration curves confirmed the models' accuracy. SHAP analysis identified age as the most influential factor, with heavy metals like lead, cadmium, and thallium significantly contributing to risk. A user-friendly web calculator was developed for individualized survival predictions. Conclusion: Machine learning models, including GradientBoostingSurvival, RandomSurvivalForest, CoxPHSurvival, and ExtraSurvivalTrees, demonstrated strong performance in predicting mortality risk for various cardiovascular diseases. Key metals were identified as significant risk factors in cardiovascular risk assessment.

Indexed as

Cardiovascular DiseasesEnvironmental ExposureMachine LearningMetals, HeavyAdultAgedFemaleHumansMaleMiddle AgedNutrition SurveysRisk FactorsMetals, Heavycardiovascular diseaseheavy metalsinterpretable machine learningmortalitySHAP

Identifiers

PMID40469589
PMCPMC12134072

What Socratic holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.