With the increasing availability of clinical and biomedical big data, machine learning is being widely used in scientific research and academic papers. It integrates various types of information to predict individual health outcomes. However, deficiencies in reporting key information have gradually emerged. These include issues like data bias, model fairness across different groups, and problems with data quality and applicability. Maintaining predictive accuracy and interpretability in real-world clinical settings is also a challenge. This increases the complexity of safely and effectively applying predictive models to clinical practice. To address these problems, TRIPOD+AI (transparent reporting of a multivariable prediction model for individual prognosis or diagnosis+artificial intelligence) introduces a reporting standard for machine learning models. It is based on TRIPOD and aims to improve transparency, reproducibility, and health equity. These improvements enhance the quality of machine learning model applications. Currently, research on prediction models based on machine learning is rapidly increasing. To help domestic readers better understand and apply TRIPOD+AI, we provide examples and interpretations. We hope this will support researchers in improving the quality of their reports.
ObjectiveTo analyze and compare the incidence, mortality, temporal trends, and cancer spectrum differences between China and the United States (US), providing theoretical support for cancer prevention and control in China. MethodsAge standardized incidence rate (ASIR), age standardized mortality rate (ASMR), and cancer site composition were extracted from GLOBOCAN, Cancer Statistics 2025, the China Cancer Registry Annual Report, and other epidemiological sources. Spatial (urban-rural, sex specific) and temporal distributions were described, and average annual growth rate (AAGR) were calculated. ResultsFrom 2005 onward, China exhibited a modest rise in ASIR, whereas the US showed a decline (AAGR: 0.58 vs –0.42); nevertheless, China’s overall incidence remained lower (2022 ASIR = 201.61/100 000) than that of the US (303.60/100 000). Both countries experienced decreasing ASMR (AAGR: –1.03 vs –1.72). In both nations, male ASIR and ASMR were higher than female. Since 2005, the top three US cancers had remained prostate (men) or breast (women), lung and colorectal cancer. In China, incidences of lung, colorectal, female breast and thyroid cancers had continued to rise, while stomach and liver cancer incidences had declined yet still rank high among men. Urban ASIR in China exceeded rural rates, whereas rural ASMR was higher than urban counterparts. ConclusionsAccelerating population ageing and lifestyle transitions have driven an upward incidence trend in China, accompanied by a shift towards a mixed pattern of traditional and emerging cancer risks. Drawing on US experience, China should intensify tobacco control measures, expand organized screening and early detection programs, implement comprehensive interventions for priority cancers, strengthen primary level capacity and improve treatment access in rural areas, thereby establishing a more effective national cancer prevention and control system.
Objective To analyze the trends in the burden of osteoporosis-related disease in China and worldwide from 1990 to 2023, and to further estimate the attributable burden of key determinants, so as to inform the formulation of prevention and control strategies for osteoporosis. Methods Based on the 2023 Global Burden of Disease (GBD) study database, the data on mortality, disability adjusted life years (DALYs), years lived with disability (YLDs), and years of life lost (YLLs) attributable to low bone mineral density (LBMD) among individuals aged 40 years and older in China and globally from 1990 to 2023 were collected. Metrics focused primarily on age-standardized rates, and data were stratified by age group and gender. Joinpoint regression models were employed to estimate the annual percentage change (APC) and average annual percentage change (AAPC) to assess trends in the burden. An age-period-cohort analysis was conducted to characterize age, period, and birth cohort effects. Additionally, the Das Gupta decomposition method was applied to decompose the changes in the number of LBMD-attributable deaths in China from 1990 to 2023, quantifying the contributions of population growth, population aging, and changes in age-specific mortality rates. Results From 1990 to 2023, DALYs rates and YLLs rates attributable to LBMD showed an overall decreasing trend in both China and the world. DALYs rates declined from 311.54/100 000 to 268.55/100 000 in China and from 288.85/100 000 to 265.11/100 000 globally. In China, the YLDs rate increased from 170.42/100 000 to 197.91/100 000, whereas the global YLDs rate remained relatively stable. The burden of LBMD-related disease was consistently higher in women than in men. Falls were the leading cause of LBMD-attributable deaths and DALYs, followed by road injuries, while other types of injuries accounted for a relatively small proportion. Gupta decomposition showed that the number of LBMD-attributable deaths increased by 62.88% in men and 138.25% in women, primarily driven by population growth (contributing 108.33% in men and 138.98% in women) and population aging (contributing 42.26% in men and 70.59% in women), while changes in age-specific mortality rates offset the increase by 87.72% in men and 71.32% in women. Conclusion From 1990 to 2023, the mortality burden attributable to LBMD in China has decreased overall, but the disability burden has continued to rise, suggesting a shift in osteoporosis-related disease burden from lethality toward disability. Falls are the main attributable cause, and the burden is particularly high among older adults and women. Strengthening bone mineral density screening, fall prevention, and secondary fracture prevention and management is essential to reduce the long-term health losses associated with osteoporosis.
Objective?To estimate the population attributable disease burden (PAD) of low bone mineral density (LBMD) related fractures (fragility fractures) among Chinese people over 50 years old from 1990 to 2023, using data from the Global Burden of Disease Study 2023 (GBD 2023), and to provide evidence for prevention strategies and health resource allocation. Methods? Based on the GBD 2023, the LBMD summary exposure values (SEV), fracture incidence, years lived with disability (YLDs), and LBMD-related falls YLDs of Chinese people over 50 years old from 1990 to 2023 were extracted. PAD was calculated with population attributable fraction (PAF), and an entropy-weight method was applied to evaluate the contribution of individual fracture sites. Temporal trends and sex differences were examined with Joinpoint regression. Results?From 1990 to 2023, the age-standardized SEV of LBMD in people over 50 years old showed an overall decline [average annual percent change (AAPC)=?0.564%]. Age-standardized fracture incidence, fracture YLDs rate, and LBMD-related falls YLDs rate all exhibited W-shaped upward trends (AAPC=1.045%, 0.296%, and 0.724%, respectively). PAF-based estimates indicated that LBMD-attributable fracture incidence likewise increased in a “W-shaped” manner (AAPC=0.558%), whereas the corresponding YLDs rate showed an overall W-shaped decline (AAPC=?0.193%). In international comparison, China and the global average displayed broadly concordant directions of change, with greater volatility in China and a progressive narrowing of the gap after 2015. Regarding sex differences, fracture YLDs rates were consistently higher in the males, whereas the other burden indicators were higher in the females; the temporal patterns were similar in both sexes. Entropy weight method identified hip fractures as contributing most to incidence (weight 0.133), and pelvic fractures as the largest contributor to YLDs rate (weight 0.115). ConclusionSince 1990, the LBMD attributable fracture burden in China’s older population has risen, with female and hip or pelvic fractures bearing the heaviest load. Strengthened osteoporosis screening, improved insurance coverage, and targeted health education are urgently needed to curb further increases in disease burden.
