{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T21:44:42Z","timestamp":1769031882245,"version":"3.49.0"},"reference-count":19,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T00:00:00Z","timestamp":1768953600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100016107","name":"Science and Technology Department of Tibet Autonomous Region","doi-asserted-by":"publisher","award":["XZ202401JD0013"],"award-info":[{"award-number":["XZ202401JD0013"]}],"id":[{"id":"10.13039\/501100016107","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100016107","name":"Science and Technology Department of Tibet Autonomous Region","doi-asserted-by":"publisher","award":["XZ202201ZY0018"],"award-info":[{"award-number":["XZ202201ZY0018"]}],"id":[{"id":"10.13039\/501100016107","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>High-altitude polycythemia (HAPC) lacks a lifestyle-focused risk-stratification tool among lifelong high-altitude residents. Here we aimed to develop and validate a novel machine-learning predictive scoring system for HAPC using readily modifiable lifestyle variables in this population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In a high altitude cohort (\u22654,500 m,\n                      <jats:italic>n<\/jats:italic>\n                      = 1,089), 82 candidate variables were reduced to seven lifestyle predictors via LASSO, Logistic regression, XGBoost and random forest models were trained and compared (10 fold cross validation).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Logistic regression achieved the best balance (AUC 0.848, sensitivity 0.81, specificity 0.79). Low SpO\n                      <jats:sub>2<\/jats:sub>\n                      (&amp;lt; 83%), male sex, age \u226550 year, smoking, hypertension, higher body mass index (BMI) and lower tea consumption were independent predictors.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This score equips frontline health workers in extremely high-altitude, resource-scarce settings to rapidly pinpoint high-risk residents and initiate low-cost lifestyle interventions, thereby curbing the incidence of chronic altitude-related illnesses, easing local medical burdens, and improving overall quality of life for native high-altitude populations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>ChiCTR2100047945.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2025.1739909","type":"journal-article","created":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T06:51:22Z","timestamp":1768978282000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Development and validation of a machine learning based early warning scoring system for high altitude polycythemia"],"prefix":"10.3389","volume":"13","author":[{"given":"Yangzong","family":"Suona","sequence":"first","affiliation":[{"name":"High Altitude Medical Research Institute of Tibet Autonomous Region","place":["Lhasa, China"]},{"name":"Tibet Autonomous Region People's Hospital","place":["Lhasa, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhuoga","family":"Danzeng","sequence":"additional","affiliation":[{"name":"High Altitude Medical Research Institute of Tibet Autonomous Region","place":["Lhasa, China"]},{"name":"Tibet Autonomous Region People's Hospital","place":["Lhasa, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luobu","family":"Gesang","sequence":"additional","affiliation":[{"name":"High Altitude Medical Research Institute of Tibet Autonomous Region","place":["Lhasa, China"]},{"name":"Tibet Autonomous Region People's Hospital","place":["Lhasa, China"]},{"name":"Key Laboratory of Transitional Medicine for Human Adaptation to the High Altitude of Tibet Autonomous Region, Tibet Autonomous Region People's Hospital","place":["Lhasa, China"]},{"name":"Tibet Autonomous Region Clinical Research Center for High Altitude Diseases, Tibet Autonomous Region People's Hospital","place":["Lhasa, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Panduo","family":"Zhuoma","sequence":"additional","affiliation":[{"name":"Tibet Autonomous Region People's Hospital","place":["Lhasa, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yangjin","family":"Baima","sequence":"additional","affiliation":[{"name":"Tibet Autonomous Region People's Hospital","place":["Lhasa, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhuoma","family":"Pubu","sequence":"additional","affiliation":[{"name":"Tibet Autonomous Region People's Hospital","place":["Lhasa, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wangjie","family":"Suolang","sequence":"additional","affiliation":[{"name":"Tibet Autonomous Region Center for Disease Control and Prevention","place":["Lhasa, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bai","family":"Ci","sequence":"additional","affiliation":[{"name":"Tibet Autonomous Region People's Hospital","place":["Lhasa, China"]},{"name":"Key Laboratory of Transitional Medicine for Human Adaptation to the High Altitude of Tibet Autonomous Region, Tibet Autonomous Region People's Hospital","place":["Lhasa, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ju","family":"Huang","sequence":"additional","affiliation":[{"name":"Tibet Autonomous Region People's Hospital","place":["Lhasa, China"]},{"name":"Key Laboratory of Transitional Medicine for Human Adaptation to the High Altitude of Tibet Autonomous Region, Tibet Autonomous Region People's Hospital","place":["Lhasa, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Quzong","family":"Zhaxi","sequence":"additional","affiliation":[{"name":"Tibet Autonomous Region People's Hospital","place":["Lhasa, China"]},{"name":"Key Laboratory of Transitional Medicine for Human Adaptation to the High Altitude of Tibet Autonomous Region, Tibet Autonomous Region People's Hospital","place":["Lhasa, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Binyun","family":"Liu","sequence":"additional","affiliation":[{"name":"Tibet Autonomous Region People's Hospital","place":["Lhasa, China"]},{"name":"Key Laboratory of Transitional Medicine for Human Adaptation to the High Altitude of Tibet Autonomous Region, Tibet Autonomous Region People's Hospital","place":["Lhasa, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rui","family":"Zhang","sequence":"additional","affiliation":[{"name":"Tibet Autonomous Region People's Hospital","place":["Lhasa, China"]},{"name":"Key Laboratory of Transitional Medicine for Human Adaptation to the High Altitude of Tibet Autonomous Region, Tibet Autonomous Region People's Hospital","place":["Lhasa, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Quzhen","family":"Gesang","sequence":"additional","affiliation":[{"name":"Tibet Autonomous Region People's Hospital","place":["Lhasa, China"]},{"name":"Key Laboratory of Transitional Medicine for Human Adaptation to the High Altitude of Tibet Autonomous Region, Tibet Autonomous Region People's Hospital","place":["Lhasa, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qiangba","family":"Dingzeng","sequence":"additional","affiliation":[{"name":"Tibet Autonomous Region People's Hospital","place":["Lhasa, China"]},{"name":"Key Laboratory of Transitional Medicine for Human Adaptation to the High Altitude of Tibet Autonomous Region, Tibet Autonomous Region People's Hospital","place":["Lhasa, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhuoga","family":"Baima","sequence":"additional","affiliation":[{"name":"Tibet Autonomous Region People's Hospital","place":["Lhasa, China"]},{"name":"Key Laboratory of Transitional Medicine for Human Adaptation to the High Altitude of Tibet Autonomous Region, Tibet Autonomous Region People's Hospital","place":["Lhasa, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,21]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"3806","DOI":"10.1016\/j.scib.2024.11.008","article-title":"Epigenetics in high altitude adaptation and disease","volume":"69","author":"Wang","year":"2024","journal-title":"Sci Bull"},{"key":"B2","doi-asserted-by":"publisher","first-page":"147","DOI":"10.1089\/ham.2005.6.147","article-title":"Consensus statement on chronic and subacute high altitude diseases","volume":"6","author":"Le\u00f3n Velarde","year":"2005","journal-title":"High Alt Med Biol"},{"key":"B3","volume-title":"Disease Control Priorities in Developing Countries","author":"Jamison","year":"2006"},{"key":"B4","volume-title":"Global Report on Diabetes","year":"2018"},{"key":"B5","doi-asserted-by":"publisher","first-page":"m141","DOI":"10.1136\/bmj.m141","article-title":"Prevention of non-communicable disease: best buys, wasted buys, and contestable buys","volume":"368","author":"Isaranuwatchai","year":"2020","journal-title":"BMJ"},{"key":"B6","volume-title":"Global Report on Diabetes","year":"2018"},{"key":"B7","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s40779-016-0108-z","article-title":"Association between smoking and the risk of acute mountain sickness: a meta analysis of observational studies","volume":"3","author":"Xu","year":"2016","journal-title":"Mil Med Res"},{"key":"B8","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1016\/j.ijcard.2013.08.059","article-title":"Strategies for the prevention of acute mountain sickness and treatment for large groups making a rapid ascent in China","volume":"169","author":"Luo","year":"2013","journal-title":"Int J Cardiol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"457","DOI":"10.1089\/ham.2004.5.457","article-title":"VI World Congress on Mountain Medicine & High Altitude Physiology, Xining, Qinghai, and Lhasa, Tibet, August 12\u201318, 2004","volume":"5","author":"Milledge","year":"2004","journal-title":"High Alt Med Biol"},{"key":"B10","doi-asserted-by":"publisher","first-page":"1448654","DOI":"10.3389\/fmed.2024.1448654","article-title":"High altitude polycythemia and its maladaptive mechanisms: an updated review","volume":"11","author":"Tang","year":"2024","journal-title":"Front Med."},{"key":"B11","doi-asserted-by":"publisher","first-page":"1327","DOI":"10.1161\/HYPERTENSIONAHA.119.12780","article-title":"Global REACH 2018: high blood viscosity and hemoglobin concentration contribute to reduced flow mediated dilation in high altitude excessive erythrocytosis","volume":"73","author":"Tremblay","year":"2019","journal-title":"Hypertension"},{"key":"B12","doi-asserted-by":"publisher","first-page":"204","DOI":"10.1111\/nyas.14136","article-title":"The increase in hemoglobin concentration with altitude varies among human populations","volume":"1450","author":"Gassmann","year":"2019","journal-title":"Ann N Y Acad Sci"},{"key":"B13","doi-asserted-by":"publisher","first-page":"6699","DOI":"10.3390\/jcm11226699","article-title":"Effects of acute exposure and acclimatization to high altitude on oxygen saturation and related cardiorespiratory fitness in health and disease","volume":"11","author":"Furian","year":"2022","journal-title":"J Clin Med"},{"key":"B14","doi-asserted-by":"publisher","first-page":"493","DOI":"10.1007\/s00421-003-1015-z","article-title":"The effect of drinking tea at high altitude on hydration status and mood","volume":"91","author":"Scott","year":"2004","journal-title":"Eur J Appl Physiol"},{"key":"B15","doi-asserted-by":"publisher","first-page":"164","DOI":"10.1016\/j.wem.2014.10.006","article-title":"Smoking increases the risk of acute mountain sickness","volume":"26","author":"Vinnikov","year":"2015","journal-title":"Wilderness Environ Med"},{"key":"B16","doi-asserted-by":"publisher","first-page":"410","DOI":"10.1089\/ham.2004.5.410","article-title":"Awareness, prevalence, medication use, and risk factors of acute mountain sickness in tourists trekking around the Annapurnas in Nepal: a 12 year follow up","volume":"5","author":"Gaillard","year":"2004","journal-title":"High Alt Med Biol"},{"key":"B17","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1089\/152702904322963681","article-title":"Absence of work efficiency differences during cycle ergometry exercise in Bolivian Aymara","volume":"5","author":"Brutsaert","year":"2004","journal-title":"High Alt Med Biol"},{"key":"B18","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1056\/NEJM200107123450206","article-title":"High altitude illness","volume":"345","author":"Hackett","year":"2001","journal-title":"N Engl J Med"},{"key":"B19","doi-asserted-by":"publisher","first-page":"467","DOI":"10.1016\/j.pcad.2010.02.003","article-title":"Acute mountain sickness: pathophysiology, prevention, and treatment","volume":"52","author":"Imray","year":"2010","journal-title":"Prog Cardiovasc Dis"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2025.1739909\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T06:51:24Z","timestamp":1768978284000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2025.1739909\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,21]]},"references-count":19,"alternative-id":["10.3389\/fpubh.2025.1739909"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2025.1739909","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,21]]},"article-number":"1739909"}}