Auxiliary identification of depression patients using interpretable machine learning models based on heart rate variability: a retrospective study

Abstract Objective Depression has emerged as a global public health concern with high incidence and disability rates, which are timely imperative to identify and intervene in clinical practice. The objective of this study was to explore the association between heart rate variability (HRV) and depres...

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Main Authors: Min Yang, Huiqin Zhang, Minglan Yu, Yunxuan Xu, Bo Xiang, Xiaopeng Yao
Format: Article
Language:English
Published: BMC 2024-12-01
Series:BMC Psychiatry
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Online Access:https://doi.org/10.1186/s12888-024-06384-w
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author Min Yang
Huiqin Zhang
Minglan Yu
Yunxuan Xu
Bo Xiang
Xiaopeng Yao
author_facet Min Yang
Huiqin Zhang
Minglan Yu
Yunxuan Xu
Bo Xiang
Xiaopeng Yao
author_sort Min Yang
collection DOAJ
description Abstract Objective Depression has emerged as a global public health concern with high incidence and disability rates, which are timely imperative to identify and intervene in clinical practice. The objective of this study was to explore the association between heart rate variability (HRV) and depression, with the aim of establishing and validating machine learning models for the auxiliary diagnosis of depression. Methods The data of 465 outpatients from the Affiliated Hospital of Southwest Medical University were selected for the study. The study population was then randomly divided into training and test sets in a 7:3 ratio. Logistic regression (LR), support vector machine (SVM), random forest (RF) and eXtreme gradient boosting (XGBoost) algorithm models were used to construct risk prediction models in the training set, and the model performance was verified in the test set. The four models were evaluated by the area under the receiver operating characteristic curve (ROC), calibration curve and the decision curve analysis (DCA). Furthermore, we employed the SHapley Additive exPlanations (SHAP) method to illustrate the effects of the features attributed to the model. Results There were 237 people in the depressed group and 228 in the non-depressed group. In the training set (n = 325) and test set (n = 140), the area under of the curve(AUC) values of the XGBoost model are 0.92 [95% confidence interval (CI) 0.888,0.95] and 0.82 (95% CI 0.754,0.892)] respectively, which are higher than the other three models. The XGBoost model has excellent predictive efficacy and clinical utility. The SHAP method was ranked according to the importance of the degree of influence on the model, with age, heart rate, Standard deviation of the NN intervals (SDNN), two nonlinear parameters of HRV and sex considered to be the top 6 predictors. Conclusion We provided a feasibility study of HRV as a potential biomarker for depression. The proposed model based on HRV provides clinicians with a quantitative auxiliary diagnostic tool, which is assist to improving the accuracy and efficiency of depression diagnosis, and can also be utilized for the monitoring and prevention of depression.
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spelling doaj-art-561725bfff354e53b2c8508ec3b6ee9d2024-12-22T12:40:02ZengBMCBMC Psychiatry1471-244X2024-12-0124111510.1186/s12888-024-06384-wAuxiliary identification of depression patients using interpretable machine learning models based on heart rate variability: a retrospective studyMin Yang0Huiqin Zhang1Minglan Yu2Yunxuan Xu3Bo Xiang4Xiaopeng Yao5School of Public Health, Southwest Medical UniversitySchool of Public Health, Southwest Medical UniversityInstitute of cardiovascular research, Southwest Medical UniversitySchool of Computer Science and Technology, Southwest University of Science and TechnologyDepartment of Psychiatry, Fundamental and Clinical Research on Mental Disorders Key Laboratory of Luzhou, Medical Laboratory Center, Laboratory of Neurological Diseases & Brain Function, Affiliated Hospital of Southwest Medical UniversitySchool of Medical Information and Engineering, Southwest Medical UniversityAbstract Objective Depression has emerged as a global public health concern with high incidence and disability rates, which are timely imperative to identify and intervene in clinical practice. The objective of this study was to explore the association between heart rate variability (HRV) and depression, with the aim of establishing and validating machine learning models for the auxiliary diagnosis of depression. Methods The data of 465 outpatients from the Affiliated Hospital of Southwest Medical University were selected for the study. The study population was then randomly divided into training and test sets in a 7:3 ratio. Logistic regression (LR), support vector machine (SVM), random forest (RF) and eXtreme gradient boosting (XGBoost) algorithm models were used to construct risk prediction models in the training set, and the model performance was verified in the test set. The four models were evaluated by the area under the receiver operating characteristic curve (ROC), calibration curve and the decision curve analysis (DCA). Furthermore, we employed the SHapley Additive exPlanations (SHAP) method to illustrate the effects of the features attributed to the model. Results There were 237 people in the depressed group and 228 in the non-depressed group. In the training set (n = 325) and test set (n = 140), the area under of the curve(AUC) values of the XGBoost model are 0.92 [95% confidence interval (CI) 0.888,0.95] and 0.82 (95% CI 0.754,0.892)] respectively, which are higher than the other three models. The XGBoost model has excellent predictive efficacy and clinical utility. The SHAP method was ranked according to the importance of the degree of influence on the model, with age, heart rate, Standard deviation of the NN intervals (SDNN), two nonlinear parameters of HRV and sex considered to be the top 6 predictors. Conclusion We provided a feasibility study of HRV as a potential biomarker for depression. The proposed model based on HRV provides clinicians with a quantitative auxiliary diagnostic tool, which is assist to improving the accuracy and efficiency of depression diagnosis, and can also be utilized for the monitoring and prevention of depression.https://doi.org/10.1186/s12888-024-06384-wHeart rate variabilityDepressionCorrelationMachine learningPredictive model
spellingShingle Min Yang
Huiqin Zhang
Minglan Yu
Yunxuan Xu
Bo Xiang
Xiaopeng Yao
Auxiliary identification of depression patients using interpretable machine learning models based on heart rate variability: a retrospective study
BMC Psychiatry
Heart rate variability
Depression
Correlation
Machine learning
Predictive model
title Auxiliary identification of depression patients using interpretable machine learning models based on heart rate variability: a retrospective study
title_full Auxiliary identification of depression patients using interpretable machine learning models based on heart rate variability: a retrospective study
title_fullStr Auxiliary identification of depression patients using interpretable machine learning models based on heart rate variability: a retrospective study
title_full_unstemmed Auxiliary identification of depression patients using interpretable machine learning models based on heart rate variability: a retrospective study
title_short Auxiliary identification of depression patients using interpretable machine learning models based on heart rate variability: a retrospective study
title_sort auxiliary identification of depression patients using interpretable machine learning models based on heart rate variability a retrospective study
topic Heart rate variability
Depression
Correlation
Machine learning
Predictive model
url https://doi.org/10.1186/s12888-024-06384-w
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