Interpretable chronic obstructive pulmonary disease identification using chest X-ray radiomics: a multicenter study

The clinical screening rate for COPD remains severely inadequate. The combined model integrating chest X-ray radiomic features and clinical variables enables accurate differentiation between patients with COPD and non-COPD individuals. Global SHAP analysis reveals that radiomic features are the primary factor influencing COPD identification, followed by age, sex, and smoking status. Local SHAP analysis can intuitively visualize the model's decision-making process at the individual sample level.