{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T07:07:37Z","timestamp":1790060857313,"version":"4.0.1"},"reference-count":57,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T00:00:00Z","timestamp":1789084800000},"content-version":"vor","delay-in-days":10,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000052","name":"NIH Office of the Director","doi-asserted-by":"publisher","award":["R03OD038391"],"award-info":[{"award-number":["R03OD038391"]}],"id":[{"id":"10.13039\/100000052","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000052","name":"NIH Office of the Director","doi-asserted-by":"publisher","award":["R03CA317707"],"award-info":[{"award-number":["R03CA317707"]}],"id":[{"id":"10.13039\/100000052","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000057","name":"National Institute of General Medical Sciences","doi-asserted-by":"publisher","award":["P20GM103427"],"award-info":[{"award-number":["P20GM103427"]}],"id":[{"id":"10.13039\/100000057","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000057","name":"National Institute of General Medical Sciences","doi-asserted-by":"publisher","award":["U54GM115458"],"award-info":[{"award-number":["U54GM115458"]}],"id":[{"id":"10.13039\/100000057","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000027","name":"National Institute on Alcohol Abuse and Alcoholism","doi-asserted-by":"publisher","award":["R01 AA029127"],"award-info":[{"award-number":["R01 AA029127"]}],"id":[{"id":"10.13039\/100000027","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000027","name":"National Institute on Alcohol Abuse and Alcoholism","doi-asserted-by":"publisher","award":["P60 AA031124"],"award-info":[{"award-number":["P60 AA031124"]}],"id":[{"id":"10.13039\/100000027","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000027","name":"National Institute on Alcohol Abuse and Alcoholism","doi-asserted-by":"publisher","award":["R21AA032098"],"award-info":[{"award-number":["R21AA032098"]}],"id":[{"id":"10.13039\/100000027","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000027","name":"National Institute on Alcohol Abuse and Alcoholism","doi-asserted-by":"publisher","award":["F32AA032170"],"award-info":[{"award-number":["F32AA032170"]}],"id":[{"id":"10.13039\/100000027","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000027","name":"National Institute on Alcohol Abuse and Alcoholism","doi-asserted-by":"publisher","award":["L30AA032656"],"award-info":[{"award-number":["L30AA032656"]}],"id":[{"id":"10.13039\/100000027","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000027","name":"National Institute on Alcohol Abuse and Alcoholism","doi-asserted-by":"publisher","award":["P50AA030407\u20105126"],"award-info":[{"award-number":["P50AA030407\u20105126"]}],"id":[{"id":"10.13039\/100000027","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction Biology"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    In 2024, approximately 30% of US adolescents reported having consumed alcohol at least once in their lifetime, with about 25% of these individuals engaging in binge drinking. Adolescent alcohol use is associated with neurodevelopmental impairments, elevated risk of later alcohol use and mental health disorders. Therefore, it is important to identify the variables driving adolescent alcohol use and leverage them for early identification and targeted intervention. Previous studies have typically developed machine learning classification models that use neuroimaging data in combination with limited clinical measurements. Neuroimaging data are expensive and difficult to obtain at scale, whereas clinical measures are more practical for large\u2010scale screening due to their low cost and widespread accessibility. However, clinical\u2010only approaches for alcohol drinking classification remain largely underexplored. Furthermore, prior studies have often focused on adults, limiting generalizability to the broader adolescent population. Additionally, confounding factors such as age and substance use, which are strongly correlated with alcohol consumption, have often been inadequately addressed, potentially inflating classification performance. Finally, class imbalance remains a persistent challenge, with prior attempts yielding only limited improvements. To address these limitations, we propose\n                    <jats:italic>FocalTab<\/jats:italic>\n                    , a framework that integrates TabPFN with focal loss for robust generalization and effective mitigation of class imbalance. The approach also incorporates an initial preprocessing step to remove confounding factors to account for age and substance use. We compare\n                    <jats:italic>FocalTab<\/jats:italic>\n                    against state\u2010of\u2010the\u2010art methods across different variable selections and dataset settings.\n                    <jats:italic>FocalTab<\/jats:italic>\n                    achieves the highest accuracy (0.841\u2009\u00b1\u20090.011) and specificity (0.803\u2009\u00b1\u20090.055) in the most stringent setting, in which both age and substance use variables were excluded, whereas competing models drop to near\u2010chance specificity (12%\u201324%). We further applied SHapley Additive exPlanations (SHAP) analysis to identify key clinical predictors of drinker classification, supporting enhanced screening and early intervention.\n                  <\/jats:p>","DOI":"10.1111\/adb.70188","type":"journal-article","created":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T11:16:42Z","timestamp":1789125402000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Classification of Adolescent Drinking via Behavioral, Biological and Environmental Variables: A Machine Learning Approach With Bias Control"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-0853-9389","authenticated-orcid":false,"given":"Ruobing","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Neurological Sciences University of Nebraska Medical Center  Omaha Nebraska USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9007-936X","authenticated-orcid":false,"given":"Mohamed","family":"Azzam","sequence":"additional","affiliation":[{"name":"Department of Neurological Sciences University of Nebraska Medical Center  Omaha Nebraska USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2433-9597","authenticated-orcid":false,"given":"Nicole L.","family":"Zabik","sequence":"additional","affiliation":[{"name":"Munroe\u2010Meyer Institute for Genetics and Rehabilitation University of Nebraska Medical Center  Omaha Nebraska USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0661-2684","authenticated-orcid":false,"given":"Shibiao","family":"Wan","sequence":"additional","affiliation":[{"name":"Department of Genetics, Cell Biology and Anatomy University of Nebraska Medical Center  Omaha Nebraska USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0261-4845","authenticated-orcid":false,"given":"Jennifer Urbano","family":"Blackford","sequence":"additional","affiliation":[{"name":"Munroe\u2010Meyer Institute for Genetics and Rehabilitation University of Nebraska Medical Center  Omaha Nebraska USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-2040-9552","authenticated-orcid":false,"given":"Jieqiong","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurological Sciences University of Nebraska Medical Center  Omaha Nebraska USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,11]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"Substance Abuse and Mental Health Services Administration (SAMHSA) Center for Behavioral Health Statistics and Quality (CBHSQ) \u201cNational Survey on Drug Use and Health. Table\u00a02.44A\u2014Alcohol Use in Lifetime Past Year and Past Month and Binge Alcohol and Heavy Alcohol Use in Past Month: Among People Aged 12 to 20; by Demographic Characteristics Numbers in Thousands 2023 and 2024 \u201d (2024)."},{"key":"e_1_2_11_3_1","unstructured":"American Academy of PediatricandNational Institute on Alcohol Abuse and Alcoholism \u201cAlcohol Screening and Brief Intervention for Youth: A Practitioner's Guide \u201d (2011)."},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/9781118785089.ch3"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2025.1598175"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0276392"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpsc.2023.08.010"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2022.867067"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/nature13402"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/add.14504"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2025.117690"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/hbm.25248"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.2008.02174.x"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0316347"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1101\/lm.053539.121"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1037\/a0012955"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10964-019-01070-7"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/jora.12606"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.addbeh.2021.107122"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pbb.2020.172969"},{"key":"e_1_2_11_21_1","unstructured":"National Institutes of Health \u201cReported Drug Use Among Adolescents Continued to Hold Below Pre\u2010Pandemic Levels in 2023 \u201d (2023)."},{"key":"e_1_2_11_22_1","unstructured":"Substance Abuse and Mental Health Services Administration \u201cKey Substance Use and Mental Health Indicators in the United States: Results From the 2019 National Survey on Drug Use and Health \u201d (2020)."},{"key":"e_1_2_11_23_1","unstructured":"U.S. Food & Drug Administration \u201cYouth Tobacco Use: Results From the National Youth Tobacco Survey \u201d (2020)."},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.3390\/pediatric16040074"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1080\/10826084.2024.2352108"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1613\/jair.953"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dcn.2024.101413"},{"key":"e_1_2_11_28_1","doi-asserted-by":"crossref","unstructured":"T.\u2010Y.Lin P.Goyal R.Girshick K.He andP.Doll\u00e1r \u201cFocal Loss for Dense Object Detection \u201d Proceedings of the IEEE International Conference on Computer Vision (2017) 2980\u20132988.","DOI":"10.1109\/ICCV.2017.324"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.15288\/jsad.2015.76.895"},{"key":"e_1_2_11_30_1","volume-title":"American Drinking Practices: A National Study of Drinking Behavior and Attitudes","author":"Cahalan D.","year":"1969"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.15288\/jsa.1998.59.427"},{"key":"e_1_2_11_32_1","unstructured":"N.Hollmann S.M\u00fcller K.Eggensperger andF.Hutter \u201cTabpfn: A Transformer That Solves Small Tabular Classification Problems in a Second \u201d arXiv preprint arXiv:2207.01848 (2022)."},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.106.682658"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.17849\/insm-47-01-31-39.1"},{"key":"e_1_2_11_35_1","first-page":"40","article-title":"Feature Selection Using a Multilayer Perceptron","volume":"2","author":"Ruck D. W.","year":"1990","journal-title":"Journal of Neural Network Computing"},{"key":"e_1_2_11_36_1","doi-asserted-by":"crossref","unstructured":"S.Mannor D.Peleg andR.Rubinstein \u201cThe Cross Entropy Method for Classification \u201d Proceedings of the 22nd International Conference on Machine Learning (2005) 561\u2013568.","DOI":"10.1145\/1102351.1102422"},{"key":"e_1_2_11_37_1","first-page":"4768","article-title":"A Unified Approach to Interpreting Model Predictions","volume":"30","author":"Lundberg S. M.","year":"2017","journal-title":"Advances in Neural Information Processing Systems"},{"key":"e_1_2_11_38_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41586-024-08328-6"},{"key":"e_1_2_11_39_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2007-2243D"},{"key":"e_1_2_11_40_1","first-page":"822","article-title":"Focused Anchors Loss: Cost\u2010Sensitive Learning of Discriminative Features for Imbalanced Classification","volume":"101","author":"Baloch B. K.","year":"2019","journal-title":"Proceedings of the Eleventh Asian Conference on Machine Learning"},{"key":"e_1_2_11_41_1","article-title":"Effectiveness of Focal Loss for Minority Classification in Network Intrusion Detection Systems","volume":"4","author":"Mulyanto M.","year":"2021","journal-title":"Symmetry"},{"key":"e_1_2_11_42_1","doi-asserted-by":"crossref","unstructured":"Y.Cui M.Jia T.\u2010Y.Lin Y.Song andSBelongie \u201cClass\u2010Balanced Loss Based on Effective Number of Samples \u201d 2019 IEEE\/CVF Conference on Computer Vision and Pattern Recognition (CVPR) (2019) 9260\u20139269 https:\/\/doi.org\/10.1109\/CVPR.2019.00949.","DOI":"10.1109\/CVPR.2019.00949"},{"key":"e_1_2_11_43_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41380-019-0534-x"},{"key":"e_1_2_11_44_1","doi-asserted-by":"publisher","DOI":"10.1002\/9780471726746.ch21"},{"key":"e_1_2_11_45_1","doi-asserted-by":"publisher","DOI":"10.15288\/jsad.2014.75.945"},{"key":"e_1_2_11_46_1","doi-asserted-by":"publisher","DOI":"10.1037\/0021-843X.104.1.32"},{"key":"e_1_2_11_47_1","doi-asserted-by":"publisher","DOI":"10.1037\/1064-1297.6.1.64"},{"key":"e_1_2_11_48_1","doi-asserted-by":"publisher","DOI":"10.1037\/adb0000732"},{"key":"e_1_2_11_49_1","doi-asserted-by":"publisher","DOI":"10.3928\/00485713-20081101-01"},{"key":"e_1_2_11_50_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychires.2007.01.002"},{"key":"e_1_2_11_51_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.addbeh.2012.03.026"},{"key":"e_1_2_11_52_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.addbeh.2009.06.008"},{"key":"e_1_2_11_53_1","doi-asserted-by":"publisher","DOI":"10.35946\/arcr.v40.2.05"},{"key":"e_1_2_11_54_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.alcohol.2014.06.010"},{"key":"e_1_2_11_55_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-7795.2010.00721.x"},{"key":"e_1_2_11_56_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2015.07.003"},{"key":"e_1_2_11_57_1","doi-asserted-by":"publisher","DOI":"10.1111\/add.15279"},{"key":"e_1_2_11_58_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2016-013994"}],"container-title":["Addiction Biology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/adb.70188","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/adb.70188","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/adb.70188","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T06:41:07Z","timestamp":1790059267000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/adb.70188"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9]]},"references-count":57,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1111\/adb.70188"],"URL":"https:\/\/doi.org\/10.1111\/adb.70188","archive":["Portico"],"relation":{},"ISSN":["1355-6215","1369-1600"],"issn-type":[{"value":"1355-6215","type":"print"},{"value":"1369-1600","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9]]},"assertion":[{"value":"2026-03-20","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-01","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-11","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70188"}}