Selective prediction as a triage gate for primary-care depression screening: quantifying and mitigating selection bias in CHARLS-2011
This study demonstrates that cumulative selection bias in primary-care depression screening inflates machine-learning metrics while distorting epidemiological associations, and proposes a decoupled selective prediction framework using a four-variable CART rule to safely triage only the most reliable 20% of patients for algorithmic scoring while routing the remainder to human evaluation.