临床荟萃 ›› 2026, Vol. 41 ›› Issue (9): 812-817.doi: 10.3969/j.issn.1004-583X.2026.09.005

• 论著 • 上一篇    下一篇

中老年人视力障碍的风险因素及预测模型构建与验证:基于CHARLS数据库

梅柏豪, 李颖, 杨星宇, 高照渝()   

  1. 牡丹江医科大学 护理学院, 黑龙江 牡丹江 157000
  • 收稿日期:2026-05-20 出版日期:2026-09-20 发布日期:2026-09-17
  • 通讯作者: 高照渝 E-mail:gzy721031@163.com

Risk factors and development and validation of a prediction model for vision impairment in middle-aged and older adults: A CHARLS database-based study

Mei Baihao, Li Ying, Yang Xingyu, Gao Zhaoyu()   

  1. School of Nursing, Mudanjiang Medical University, Mudanjiang 157000, China
  • Received:2026-05-20 Online:2026-09-20 Published:2026-09-17
  • Contact: Gao Zhaoyu E-mail:gzy721031@163.com

摘要:

目的 基于机器学习算法预测视力障碍(vision impairment,VI)并确定其风险因素。方法 选取中国健康与养老追踪调查(China Health and Retirement Longitudinal Study, CHARLS) 2016-2018年数据,筛选符合条件的参与者,经过数据清洗和预处理,最终纳入19 430名参与者,按8∶2比例将参与者随机分为训练集(15 544例)和验证集(3 886例),以是否患有VI为结局变量。采用随机森林(Random Forest, RF)、极端梯度提升(XGBoost, XGB)、类别梯度提升(CatBoost, CB)、梯度提升(Gradient Boosting, GB)和轻量级梯度提升(LightGBM, LGBM)算法构建预测模型,通过受试者工作特征曲线下面积、F1分数、精确率、准确率等指标评估模型性能,采用SHAP算法对最优模型进行解释性分析。 结果 19 430名参与者中5 026名参与者患有VI,患病率为25.9%。其中RF、XGB、CB、GB和LGBM的曲线下面积分别为0.748、0.771、0.773、0.778和0.779。综合各项指标相比较,基于GB算法构建的预测模型预测效能最佳。SHAP法分析发现听力障碍、出生地区、年龄、教育情况、认知能力、居住环境、子女支持等关键特征对预测结果具有显著影响。 结论 基于GB算法构建了中老年人群VI预测模型,并进行了网页端预测模型部署,该模型可以有效筛选出高危人群,以便早期制定有针对性的干预措施和健康宣教策略。

关键词: 视力障碍, 机器学习, 预测模型, CHARLS, SHAP, 老年人

Abstract:

Objective To predict vision impairment (VI) and identify its risk factors using machine learning algorithms. Methods Data from the 2016-2018 waves of the China Health and Retirement Longitudinal Study (CHARLS) were selected. Eligible participants were screened, and after data cleaning and preprocessing, 19 430 participants were ultimately included. Participants were randomly assigned in an 8:2 ratio to a training set (15 544 cases) and a validation set (3 886 cases), with VI as the outcome variable. Prediction models were constructed using Random Forest (RF), Extreme Gradient Boosting (XGBoost, XGB), CatBoost (CB), Gradient Boosting (GB), and Light Gradient Boosting Machine (LightGBM, LGBM). Model performance was evaluated using the area under the receiver operating characteristic (ROC) curve (AUC), F1 score, precision, accuracy, and other indicators. SHAP analysis was used to interpret the optimal model. Results Among the 19 430 participants, 5 026 had VI, yielding a prevalence of 25.9%. The AUC values of RF, XGB, CB, GB, and LGBM were 0.748, 0.771, 0.773, 0.778, and 0.779, respectively. Based on a comprehensive comparison of all indicators, the prediction model constructed using the GB algorithm showed the best predictive performance. SHAP analysis showed that key features such as hearing impairment, place of birth, age, education level, cognitive function, living environment, and offspring support had a significant impact on the prediction results. Conclusion A GB-based prediction model for VI in middle-aged and older adults was developed and deployed on a web platform. This model can effectively identify high-risk individuals, thereby facilitating early implementation of targeted intervention and health education strategies.

Key words: vision impairment, machine learning, prediction model, CHARLS, SHAP, older adults

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