{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T01:54:28Z","timestamp":1792806868055,"version":"4.5.0"},"reference-count":41,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T00:00:00Z","timestamp":1769472000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cell Dev. Biol."],"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To develop and interpret a clinical prediction model for identifying children at risk of poor 5-year axial length (AL) control following orthokeratology (Ortho-K) lens wear, integrating traditional regression modeling with explainable machine learning.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 504 children with baseline myopia were included. The 5-year AL control outcome was defined as an AL increase of &amp;lt;1.0\u00a0mm (effective control, EC) or \u22651.0\u00a0mm (ineffective control, IC). Feature selection was performed using least absolute shrinkage and selection operator (LASSO), Boruta, and multivariable logistic regression. Machine learning (ML) model performance was evaluated across multiple algorithms, including logistic regression (LR), random forest (RF), support vector machine (SVM), artificial neural network (ANN), decision tree, light gradient boosting machine (lightGBM), and XGBoost. The best-performing model was visualized as a nomogram, dynamically deployed as a web-based risk calculator, and further interpreted using SHapley Additive exPlanations (SHAP) analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Feature selection consistently identified a change in AL over the 3\u00a0years (\u03941, \u03942, \u03943), and flat E as the most stable predictors of 5-year AL control. Among all models, logistic regression achieved the best overall performance (F1 = 0.897, AUC = 0.969), while XGBoost showed the highest F1-score among ML methods. Enhancing clinical applicability and further simplifying the included parameters, the results \u03941, \u03943, and flat E still demonstrate strong predictive performance (F1 = 0.714, AUC = 0.949). The nomogram demonstrated good calibration and discrimination, with decision curve analysis confirming its clinical utility. SHAP interpretation revealed that \u03943 and \u03941 had the greatest influence on risk prediction, with a notable inflection point around 0.05\u00a0mm, beyond which the predicted risk of poor control increased sharply.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A robust and interpretable predictive model was developed to estimate 5-year Ortho-K lens control efficacy using \u03941, \u03943, and flat E. The integrated SHAP analysis provided mechanistic insight and highlighted the clinical threshold (\u03943 = 0.05\u00a0mm) as a potential early warning indicator for suboptimal myopia control. The dynamic online nomogram enables individualized risk estimation and supports precision-guided intervention in pediatric myopia management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcell.2026.1743506","type":"journal-article","created":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T06:41:52Z","timestamp":1769496112000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":6,"title":["Establishing and validating a predictive model for long-term control outcomes following orthokeratology lenses wear: a five-year cohort study"],"prefix":"10.3389","volume":"14","author":[{"given":"Zixun","family":"Wang","sequence":"first","affiliation":[{"name":"Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital","place":["Tianjin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoling","family":"Zhang","sequence":"additional","affiliation":[{"name":"Handan Eye Hospital (The Third Hospital of Handan)","place":["Handan, Hebei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoxue","family":"Hu","sequence":"additional","affiliation":[{"name":"Wuhan Children\u2019s Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology","place":["Wuhan, Hubei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Miao","sequence":"additional","affiliation":[{"name":"Handan Eye Hospital (The Third Hospital of Handan)","place":["Handan, Hebei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shujun","family":"Zhang","sequence":"additional","affiliation":[{"name":"Handan Eye Hospital (The Third Hospital of Handan)","place":["Handan, Hebei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, General Hospital of the Central Theater Command of the People\u2019s Liberation Army of China","place":["Wuhan, Hubei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruihua","family":"Wei","sequence":"additional","affiliation":[{"name":"Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital","place":["Tianjin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zheng","family":"Guo","sequence":"additional","affiliation":[{"name":"Wuhan Children\u2019s Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology","place":["Wuhan, Hubei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,27]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"498","DOI":"10.1186\/s12886-025-04356-6","article-title":"Baseline ocular biometrics in children with orthokeratology-induced axial length reduction or elongation","volume":"25","author":"Ai","year":"2025","journal-title":"BMC Ophthalmol."},{"key":"B2","doi-asserted-by":"publisher","first-page":"2518","DOI":"10.1167\/iovs.02-0680","article-title":"The effects of overnight orthokeratology lens wear on corneal thickness","volume":"44","author":"Alharbi","year":"2003","journal-title":"Invest Ophthalmol. Vis. Sci."},{"key":"B3","doi-asserted-by":"publisher","first-page":"106156","DOI":"10.1016\/j.compbiomed.2022.106156","article-title":"Explanatory classification of CXR images into COVID-19, pneumonia and tuberculosis using deep learning and XAI","volume":"150","author":"Bhandari","year":"2022","journal-title":"Comput. Biol. Med."},{"key":"B4","doi-asserted-by":"publisher","first-page":"e489","DOI":"10.1016\/S2214-109X(20)30488-5","article-title":"The lancet global health commission on global eye health: vision beyond 2020","volume":"9","author":"Burton","year":"2021","journal-title":"Lancet Glob. Health"},{"key":"B5","doi-asserted-by":"publisher","first-page":"337","DOI":"10.1177\/0272989X221143058","article-title":"Decision curve analysis for personalized treatment choice between multiple options","volume":"43","author":"Chalkou","year":"2023","journal-title":"Med. Decision Making"},{"key":"B6","doi-asserted-by":"publisher","first-page":"04144","DOI":"10.7189\/jogh.13.04144","article-title":"Significant myopic shift over time: sixteen-Year trends in overall refraction and age of myopia onset among Chinese children, with a focus on ages 4-6 years","volume":"13","author":"Chen","year":"2023","journal-title":"J. Global Health"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1136\/bjo-2025-327768","article-title":"Time outdoors prevents myopia in hyperopic children, but protection is weaker in premyopic children: a post-hoc analysis of a cluster-randomised trial","author":"Chen","year":"2025","journal-title":"Br. Journal Ophthalmology"},{"key":"B8","doi-asserted-by":"publisher","first-page":"M184","DOI":"10.1167\/iovs.18-25977","article-title":"IMI - Clinical management guidelines report","volume":"60","author":"Gifford","year":"2019","journal-title":"Invest Ophthalmol. Vis. Sci."},{"key":"B9","doi-asserted-by":"publisher","first-page":"349","DOI":"10.1186\/s13054-024-05138-0","article-title":"Interpretable machine learning model for new-onset atrial fibrillation prediction in critically ill patients: a multi-center study","volume":"28","author":"Guan","year":"2024","journal-title":"Crit. Care London, Engl."},{"key":"B10","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1097\/ICL.0000000000001142","article-title":"Clinical investigation of short-term axial elongation control after orthokeratology lens correction: exploring its predictive role in long-term therapeutic efficacy","volume":"51","author":"Han","year":"2025","journal-title":"Eye & Contact Lens."},{"key":"B11","doi-asserted-by":"publisher","first-page":"1595","DOI":"10.1016\/j.ophtha.2009.11.003","article-title":"Long-term pattern of progression of myopic maculopathy: a natural history study","volume":"117","author":"Hayashi","year":"2010","journal-title":"Ophthalmology"},{"key":"B12","doi-asserted-by":"publisher","first-page":"1750","DOI":"10.3390\/jcm14051750","article-title":"Axial length stabilization or reduction in over 40% of patients wearing extended depth-of-focus contact lenses","volume":"14","author":"Hazra","year":"2025","journal-title":"J. Clin. Med."},{"key":"B13","doi-asserted-by":"publisher","first-page":"1036","DOI":"10.1016\/j.ophtha.2016.01.006","article-title":"Global prevalence of myopia and high myopia and temporal trends from 2000 through 2050","volume":"123","author":"Holden","year":"2016","journal-title":"Ophthalmology"},{"key":"B14","doi-asserted-by":"publisher","first-page":"466","DOI":"10.1186\/s12886-025-04303-5","article-title":"Orthokeratology for myopia control: a three-year longitudinal study on axial length modulation influenced by baseline age and spherical equivalent","volume":"25","author":"Hu","year":"2025","journal-title":"BMC Ophthalmol."},{"key":"B15","doi-asserted-by":"publisher","first-page":"246","DOI":"10.1186\/s12931-024-02874-3","article-title":"An explainable machine learning-based model to predict intensive care unit admission among patients with community-acquired pneumonia and connective tissue disease","volume":"25","author":"Huang","year":"2024","journal-title":"Respir. Research"},{"key":"B16","doi-asserted-by":"publisher","first-page":"1317","DOI":"10.1038\/s41467-024-55635-7","article-title":"Multi-omic spatial effects on high-resolution AI-derived retinal thickness","volume":"16","author":"Jackson","year":"2025","journal-title":"Nat. Commun."},{"key":"B17","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1167\/iovs.66.9.7","article-title":"IMI-instrumentation for myopia management","volume":"66","author":"Jones","year":"2025","journal-title":"Invest Ophthalmol. Vis. Sci."},{"key":"B18","doi-asserted-by":"publisher","first-page":"194","DOI":"10.1186\/s12874-024-02319-x","article-title":"Handling missing data and measurement error for early-onset myopia risk prediction models","volume":"24","author":"Lai","year":"2024","journal-title":"BMC Med. Res. Methodol."},{"key":"B19","doi-asserted-by":"publisher","first-page":"1180","DOI":"10.1016\/j.ophtha.2020.12.036","article-title":"Age effect on treatment responses to 0.05%, 0.025%, and 0.01% atropine: low-concentration atropine for myopia progression study","volume":"128","author":"Li","year":"2021","journal-title":"Ophthalmology"},{"key":"B20","doi-asserted-by":"publisher","first-page":"04274","DOI":"10.7189\/jogh.15.04274","article-title":"Combined and interaction effects of outdoor and reading time on myopia onset: evidence from over 210 000 schoolchildren in China","volume":"15","author":"Li","year":"2025","journal-title":"J. Global Health"},{"key":"B21","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1186\/s40662-025-00427-3","article-title":"Myopia control efficacy of spectacle lenses with highly aspherical lenslets: results of a 5-year follow-up study","volume":"12","author":"Li","year":"","journal-title":"Eye Vision Lond. Engl."},{"key":"B22","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1167\/iovs.66.4.30","article-title":"Clinical and molecular landscape of GLRA2 in X-Linked early-onset high myopia","volume":"66","author":"Li","year":"","journal-title":"Invest Ophthalmol. Vis. Sci."},{"key":"B23","doi-asserted-by":"publisher","first-page":"739","DOI":"10.1007\/s40123-023-00875-x","article-title":"The effects of repeated low-level red-light therapy on the structure and vasculature of the choroid and retina in children with premyopia","volume":"13","author":"Liu","year":"2024","journal-title":"Ophthalmol. Ther."},{"key":"B24","doi-asserted-by":"publisher","first-page":"1435","DOI":"10.1111\/opo.13530","article-title":"Axial elongation as a marker to identify obvious myopic shift in non-myopic eyes of Chinese children","volume":"45","author":"Liu","year":"2025","journal-title":"Ophthalmic Physiol. Opt."},{"key":"B25","doi-asserted-by":"publisher","first-page":"223","DOI":"10.1016\/j.ajo.2025.07.030","article-title":"Axial length growth trajectories in children transitioning to myopia","volume":"279","author":"Liu","year":"2025","journal-title":"Am. J. Ophthalmol."},{"key":"B26","doi-asserted-by":"publisher","first-page":"102390","DOI":"10.1016\/j.clae.2025.102390","article-title":"European trends in attitudes and strategies for myopia management in clinical practice","volume":"48","author":"Mart\u00ednez-P\u00e9rez","year":"2025","journal-title":"Cont. Lens Anterior Eye."},{"key":"B27","doi-asserted-by":"publisher","first-page":"101484","DOI":"10.1016\/j.lanwpc.2025.101484","article-title":"Prevalence and temporal trends in myopia and high myopia children in China: a systematic review and meta-analysis with projections from 2020 to 2050","volume":"55","author":"Pan","year":"2025","journal-title":"Lancet Regional Health West. Pac."},{"key":"B28","doi-asserted-by":"publisher","first-page":"662","DOI":"10.3390\/jcm14030662","article-title":"Peripheral defocus in orthokeratology myopia correction: systematic review and meta-analysis","volume":"14","author":"Queir\u00f3s","year":"2025","journal-title":"J. Clin. Med."},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1136\/bjo-2025-327171","article-title":"Development and validation of predictive models based on the first-month axial length change for the long-term efficacy of orthokeratology in myopic children","author":"Ruan","year":"2025","journal-title":"Br. J. Ophthalmol."},{"key":"B30","doi-asserted-by":"publisher","first-page":"2563752","DOI":"10.1080\/07853890.2025.2563752","article-title":"Tracking myopia development through axial length progression: a retrospective longitudinal study","volume":"57","author":"Tao","year":"2025","journal-title":"Ann. Med."},{"key":"B31","doi-asserted-by":"publisher","first-page":"191","DOI":"10.1016\/j.jare.2022.08.021","article-title":"A hybrid explainable ensemble transformer encoder for pneumonia identification from chest X-ray images","volume":"48","author":"Ukwuoma","year":"2023","journal-title":"J. Advanced Research"},{"key":"B32","doi-asserted-by":"publisher","first-page":"230","DOI":"10.1186\/s12916-019-1466-7","article-title":"Calibration: the achilles heel of predictive analytics","volume":"17","author":"Van Calster","year":"2019","journal-title":"BMC Med."},{"key":"B33","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1016\/j.ajo.2025.08.005","article-title":"Variations in physiological and myopic eye growth among children from different populations","volume":"280","author":"Wong","year":"2025","journal-title":"Am. J. Ophthalmol."},{"key":"B34","doi-asserted-by":"publisher","first-page":"3554","DOI":"10.1186\/s12889-025-24750-5","article-title":"The current status of primary and secondary school students with myopia in the shekou district of shenzhen: a retrospective study","volume":"25","author":"Xiao","year":"2025","journal-title":"BMC Public Health"},{"key":"B35","doi-asserted-by":"publisher","first-page":"1304","DOI":"10.1016\/j.ophtha.2024.05.015","article-title":"Myopia control effect of repeated low-level red-light therapy combined with orthokeratology: a multicenter randomized controlled trial","volume":"131","author":"Xiong","year":"2024","journal-title":"Ophthalmology"},{"key":"B36","doi-asserted-by":"publisher","first-page":"102342","DOI":"10.1016\/j.clae.2024.102342","article-title":"Longitudinal changes in choroidal structures among children with low to moderate myopia under orthokeratology treatment","volume":"48","author":"Xu","year":"","journal-title":"Cont. Lens Anterior Eye."},{"key":"B37","doi-asserted-by":"publisher","first-page":"1260","DOI":"10.1016\/j.ophtha.2025.06.010","article-title":"Establishment of myopia occurrence prediction model in children without myopia using cycloplegic refraction and prior axial length change","volume":"132","author":"Xu","year":"","journal-title":"Ophthalmology"},{"key":"B38","doi-asserted-by":"publisher","first-page":"415","DOI":"10.1097\/ICL.0000000000001195","article-title":"Multivariable model to predict toric Ortho-K lens prescription","volume":"51","author":"Yang","year":"2025","journal-title":"Eye & Contact Lens"},{"key":"B39","doi-asserted-by":"publisher","first-page":"1011","DOI":"10.1016\/j.ophtha.2024.03.013","article-title":"Five-year clinical trial of the low-concentration atropine for myopia progression (LAMP) study: phase 4 report","volume":"131","author":"Zhang","year":"2024","journal-title":"Ophthalmology"},{"key":"B40","doi-asserted-by":"publisher","first-page":"284","DOI":"10.1016\/j.jad.2025.02.063","article-title":"A machine-learning-derived online prediction model for depression risk in COPD patients: a retrospective cohort study from CHARLS","volume":"377","author":"Zhao","year":"2025","journal-title":"J. Affective Disorders"},{"key":"B41","doi-asserted-by":"publisher","first-page":"2566869","DOI":"10.1080\/07853890.2025.2566869","article-title":"Predicting six-month mortality in adult hemophagocytic lymphohistiocytosis with machine learning: a prognostic approach utilizing laboratory data","volume":"57","author":"Zhou","year":"2025","journal-title":"Ann. Med."}],"container-title":["Frontiers in Cell and Developmental Biology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcell.2026.1743506\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T09:13:20Z","timestamp":1771924400000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcell.2026.1743506\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,27]]},"references-count":41,"alternative-id":["10.3389\/fcell.2026.1743506"],"URL":"https:\/\/doi.org\/10.3389\/fcell.2026.1743506","relation":{},"ISSN":["2296-634X"],"issn-type":[{"value":"2296-634X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,27]]},"article-number":"1743506"}}