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Enhancing osteoporosis risk prediction using machine learning: a holistic approach integrating biomarkers and clinical data

datacite.subject.sdg03:Saúde de Qualidade
datacite.subject.sdg09:Indústria, Inovação e Infraestruturas
datacite.subject.sdg10:Reduzir as Desigualdades
dc.contributor.authorPires de Carvalho, Filipe Ricardo
dc.contributor.authorGavaia, Paulo
dc.date.accessioned2026-04-21T09:32:33Z
dc.date.available2026-04-21T09:32:33Z
dc.date.issued2025-06
dc.description.abstractOsteoporosis (OP) affects approximately 18 % of the global population, with osteoporosis-associated fractures impacting up to 37 million people annually. While dual-energy X-ray absorptiometry (DXA) remains the gold standard for diagnosis, its limitations, including restricted availability and radiation exposure, highlight the need for alternative screening methods. We developed a machine learning model to predict OP risk using routinely collected clinical data, deliberately excluding DXA measurements to ensure broad accessibility. Using data from NHANES cycles 2007–2014, we analyzed 7924 participants aged 50 years and older, identifying 1636 OP cases (20.6 %) and 6288 normal cases (79.4 %) through comprehensive criteria incorporating both WHO densitometric standards (T-scores ≤ − 2.5) and anthropometric risk factors. We implemented a stacking ensemble model combining four specialized classifiers (Gradient Boosting, Random Forest, XGBoost, and LightGBM) with a logistic regression meta-classifier. The model achieved 93 % accuracy, an AUC of 0.94, and demonstrated robust performance through cross-validation (mean score: 0.929 ± 0.030). feature importance analysis revealed age (6.04 %), arm muscle circumference (5.61 %), and body weight (5.30 %) as the most influential predictors, followed by gender (3.28 %), BMI (2.71 %), and calcium intake (2.42 %). Additional significant predictors included folate (2.28 %), height (2.23 %), hand grip strength (2.21 %), and alkaline phosphatase (2.16 %). These biologically plausible relationships align with established clinical knowledge of OP risk factors. The model’s strong performance metrics and reliance on readily available clinical data suggest its potential as a practical screening tool, particularly in settings with limited DXA access. All code and implementation details are openly available on GitHub, facilitating integration into existing healthcare systems. This approach offers a promising pathway for enhancing early OP detection and risk assessment across diverse healthcare settings.eng
dc.identifier.doi10.1016/j.compbiomed.2025.110289
dc.identifier.issn0010-4825
dc.identifier.urihttp://hdl.handle.net/10400.1/28723
dc.language.isoeng
dc.peerreviewedyes
dc.publisherElsevier
dc.relationAlgarve Centre for Marine Sciences
dc.relationAlgarve Centre for Marine Sciences
dc.relationCentre for Marine and Environmental Research
dc.relation.ispartofComputers in Biology and Medicine
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.subjectMachine learning
dc.subjectOsteoporosis risk prediction
dc.subjectBiomarkers
dc.subjectNHANES
dc.subjectStacking ensemble
dc.subjectBone mineral density
dc.subjectPreventive medicine
dc.titleEnhancing osteoporosis risk prediction using machine learning: a holistic approach integrating biomarkers and clinical dataeng
dc.typejournal article
dspace.entity.typePublication
oaire.awardNumberUIDB/04326/2020
oaire.awardNumberUIDP/04326/2020
oaire.awardNumberLA/P/0101/2020
oaire.awardTitleAlgarve Centre for Marine Sciences
oaire.awardTitleAlgarve Centre for Marine Sciences
oaire.awardTitleCentre for Marine and Environmental Research
oaire.awardURIinfo:eu-repo/grantAgreement/FCT/6817 - DCRRNI ID/UIDB%2F04326%2F2020/PT
oaire.awardURIinfo:eu-repo/grantAgreement/FCT/6817 - DCRRNI ID/UIDP%2F04326%2F2020/PT
oaire.awardURIinfo:eu-repo/grantAgreement/FCT/6817 - DCRRNI ID/LA%2FP%2F0101%2F2020/PT
oaire.citation.startPage110289
oaire.citation.titleComputers in Biology and Medicine
oaire.citation.volume192
oaire.fundingStream6817 - DCRRNI ID
oaire.fundingStream6817 - DCRRNI ID
oaire.fundingStream6817 - DCRRNI ID
oaire.versionhttp://purl.org/coar/version/c_970fb48d4fbd8a85
person.familyNamePires de Carvalho
person.familyNameGavaia
person.givenNameFilipe Ricardo
person.givenNamePaulo
person.identifier.ciencia-id181A-A440-7D6E
person.identifier.ciencia-idB619-FC16-D007
person.identifier.orcid0000-0002-1468-0305
person.identifier.orcid0000-0002-9582-1957
person.identifier.ridA-6470-2011
person.identifier.scopus-author-id55115644400
person.identifier.scopus-author-id6507104377
project.funder.identifierhttp://doi.org/10.13039/501100001871
project.funder.identifierhttp://doi.org/10.13039/501100001871
project.funder.identifierhttp://doi.org/10.13039/501100001871
project.funder.nameFundação para a Ciência e a Tecnologia
project.funder.nameFundação para a Ciência e a Tecnologia
project.funder.nameFundação para a Ciência e a Tecnologia
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