Predicting depression in patients with heart failure based on a stacking model

Abstract

BACKGROUND There is a lack of literature discussing the utilization of the stacking ensemble algorithm for predicting depression in patients with heart failure (HF). AIM To create a stacking model for predicting depression in patients with HF. METHODS This study analyzed data on 1084 HF patients from the National Health and Nutrition Examination Survey database spanning from 2005 to 2018. Through univariate analysis and the use of an artificial neural network algorithm, predictors significantly linked to depression were identified. These predictors were utilized to create a stacking model employing tree-based learners. The performances of both the individual models and the stacking model were assessed by using the test dataset. Furthermore, the SHapley additive exPlanations (SHAP) model was applied to interpret the stacking model. RESULTS The models included five predictors. Among these models, the stacking model demonstrated the highest performance, achieving an area under the curve of 0.77 (95%CI: 0.71-0.84), a sensitivity of 0.71, and a specificity of 0.68. The calibration curve supported the reliability of the models, and decision curve analysis confirmed their clinical value. The SHAP plot demonstrated that age had the most significant impact on the stacking model's output. CONCLUSION The stacking model demonstrated strong predictive performance. Clinicians can utilize this model to identify high-risk depression patients with HF, thus enabling early provision of psychological interventions.