Combined CXR Radiomics and Clinical Model Screens for Preserved Ratio Impaired Spirometry

A combined chest X-ray radiomics and clinical model identified preserved ratio impaired spirometry (PRISm) with AUC 0.759 (95% CI 0.658–0.854) in external validation, outperforming radiomics-alone (AUC 0.618) and clinical-alone (AUC 0.655) models (p<0.001).

• Multicenter study enrolled 1563 participants (422 with PRISm) from 9 hospitals, with paired CXR and spirometry.
• SHAP analysis revealed sex as the top predictor, followed by radiomic features, BMI, age, and smoking status.

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