Evidence map›Paper›PMID 42548658›Full record

ArticleFrontiers in endocrinology2026

Explainable machine learning for osteoporosis detection in patients with osteopenia: model development and validation using routine clinical data from an Asian cohort.

Xiuzhen Zhang, Li Zhao, Han Wu, Fengyi Yuan, Weiqing Wu, Yan Wu, Wei Wang

Abstract readValidation Study
In one paragraph

Article in Frontiers in endocrinology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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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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3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

7 authors.

Xiuzhen ZhangDepartment of Endocrinology and Metabolism, Shenzhen People's Hospital (The First Affiliated Hospital, Southern University of Science and Technology; The Second Clinical Medical College, Jinan University), Shenzhen, Guangdong, China.
Li ZhaoHealth Management Center, Shenzhen People's Hospital (The First Affiliated Hospital, Southern University of Science and Technology; The Second Clinical Medical College, Jinan University), Shenzhen, Guangdong, China.
Han WuDepartment of Endocrinology and Metabolism, Shenzhen People's Hospital (The First Affiliated Hospital, Southern University of Science and Technology; The Second Clinical Medical College, Jinan University), Shenzhen, Guangdong, China.
Fengyi YuanDepartment of Endocrinology and Metabolism, Shenzhen People's Hospital (The First Affiliated Hospital, Southern University of Science and Technology; The Second Clinical Medical College, Jinan University), Shenzhen, Guangdong, China.
Weiqing WuHealth Management Center, Shenzhen People's Hospital (The First Affiliated Hospital, Southern University of Science and Technology; The Second Clinical Medical College, Jinan University), Shenzhen, Guangdong, China.
Yan WuDepartment of Endocrinology and Metabolism, Shenzhen People's Hospital (The First Affiliated Hospital, Southern University of Science and Technology; The Second Clinical Medical College, Jinan University), Shenzhen, Guangdong, China.
Wei WangDepartment of Endocrinology and Metabolism, Shenzhen People's Hospital (The First Affiliated Hospital, Southern University of Science and Technology; The Second Clinical Medical College, Jinan University), Shenzhen, Guangdong, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Osteopenia is a critical precursor to osteoporosis (OP), yet accurately discriminating OP from osteopenia among individuals with low bone mass remains challenging. While dual-energy X-ray absorptiometry (DXA) provides definitive diagnosis, accessibility limitations necessitate alternative screening approaches. We therefore aimed to develop an algorithm based on readily available clinical data to discriminate between OP and osteopenia in this population. Methods: We conducted a retrospective diagnostic study to develop a model for discriminating osteoporosis from osteopenia within a cohort of 1,203 Asian adults with low bone mass. Eleven machine learning algorithms were trained and validated for this diagnostic task (case: osteoporosis [T-score ≤ -2.5]; control: osteopenia [T-score -2.5 to -1.0]).Performance was evaluated using area under the curve (AUC). The interpretability and clinical utility of the selected model were respectively enhanced and validated by SHAP analysis, nomogram calibration, and decision curve analysis (DCA). Findings: The Linear Discriminant Analysis model demonstrated superior and consistent performance. It achieved a mean cross-validated AUC of 0.738 (95% CI: 0.736-0.741) and showed excellent calibration (Hosmer-Lemeshow p = 0.266). On an independent validation set, the model maintained robust performance with an AUC of 0.710 (95% CI: 0.686-0.734). Key predictors included waist-to-height ratio, body weight, serum uric acid, age, and alkaline phosphatase. DCA indicated a positive net benefit across a wide range of risk thresholds. Interpretation: This study developed a practical and interpretable tool for discriminating osteoporosis from osteopenia among individuals with low bone mass, using only routinely available clinical data. This approach may serve as a preliminary screening tool to identify high-risk individuals within primary care populations for further definitive testing.

Indexed as

Bone Diseases, MetabolicMachine LearningOsteoporosisAbsorptiometry, PhotonAdultAgedAlgorithmsAsian PeopleBone DensityFemaleHumansMaleMiddle AgedPredictive Learning ModelsRetrospective StudiesDXA-independentmachine learningosteopeniaosteoporosisrisk stratification

Identifiers

PMID42548658
PMCPMC13429491

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.