{
  "abstract": "Background: High vascular transcriptomic discrimination may obscure dependence on comparison populations, gene selection, and score scale. We examined these properties separately. Methods: GSE100927 compared surgical atherosclerotic tissue with lesion-free deceased-donor arteries: 104 arrays formed 95 complete-label groups, versus 96 arteries reported originally; independent donor identities remained unresolved. Within held-out folds, pooled area under the receiver-operating-characteristic curve (AUROC) was decomposed into nine case-bed-control-bed comparisons. Seven fixed rules underwent ten repeated three-fold splits. The primary ridge model used sample-wise gene ranks and training-only selection of 200 genes. External tests involved 32 paired plaque/intact patients in GSE43292 and 29 early/advanced specimens in GSE28829. Post-result explorations added random and disjoint gene-panel controls, feature stability, frozen-score accounting, source-only threshold learning, and individual-failure analyses. Results: Primary mean held-out-fold pooled AUROC was 0.9968, versus a within-bed mean of 1.0000 and contrast -0.0032; the empirical ceiling constrained this contrast to be nonpositive. Paired external AUROC was 0.877 (conditional 95% interval 0.792-0.947), with plaque ranked higher in 29/32 patients. Histological AUROC was 0.986 (0.942-1.000). All primary external probabilities fell below 0.5. Both source-derived thresholds also gave zero external sensitivity. Twenty outcome-independent random panels retained source AUROCs of 0.9932-0.9992, while external ranking varied substantially. Across 30 primary fits, 619 genes were selected at least once and 45 every time. Fixed-score failure analyses distinguished shared from model-specific discordance. Conclusions: Strong source ranking did not establish a unique gene signature or transferable technical thresholds. Procurement confounding, uncertain donor identities, inherited preprocessing, changed endpoints, and the exploratory status of added analyses limit interpretation. This is a comparison-population audit, not a clinically calibrated risk model.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai 200032, China"
  ],
  "article_type": "PUBLISHAHEADOFPRINT",
  "arxiv": null,
  "author_total": 5,
  "authors": [
    {
      "name": "L. You"
    },
    {
      "name": "Z. Peng"
    },
    {
      "name": "Y. Guo"
    },
    {
      "name": "L. Shen"
    },
    {
      "affs": [
        0
      ],
      "name": "J. Ge"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/26hdcjbfrzb9e.bib",
  "cited_by": 0,
  "doi": "10.64898/2026.10.29.26366564",
  "fulltext_url": "https://www.medrxiv.org/content/10.64898/2026.10.29.26366564v1.full",
  "id": "26hdcjbfrzb9e",
  "issns": [],
  "landing_url": "https://www.medrxiv.org/content/10.64898/2026.10.29.26366564v1",
  "language": null,
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "medrxiv",
      "cardiovascular medicine"
    ]
  ],
  "openalex": null,
  "pdf_url": "https://www.medrxiv.org/content/10.64898/2026.10.29.26366564v1.full.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-29",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/26hdcjbfrzb9e.ris",
  "sources": [
    {
      "first_seen": "2026-10-31T00:20:43Z",
      "native_id": "10.64898/2026.10.29.26366564",
      "source": "medrxiv",
      "url": "https://www.medrxiv.org/content/10.64898/2026.10.29.26366564v1"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "medrxiv:cardiovascular medicine",
      "subfield": "cardiovascular"
    }
  ],
  "title": "Anatomical comparison populations and threshold transport in vascular transcriptomic classification",
  "title_text": "Anatomical comparison populations and threshold transport in vascular transcriptomic classification",
  "type": "preprint",
  "updated_at": "2026-11-01T00:20:31Z",
  "url": "https://research.draconitic.com/paper/26hdcjbfrzb9e",
  "venue": "medRxiv",
  "versions": []
}