{
  "abstract": "Digital exclusion may limit access to increasingly digital health and public services, yet its cross-national structure and model transportability remain uncertain. We analysed harmonised cross-sectional data from 71,689 middle-aged and older adults in CHARLS, ELSA, HRS, MHAS and SHARE. Digital exclusion was defined as no reported internet or email use, a proxy for basic digital participation. Gradient Boosting discriminated concurrent exclusion with AUCs of 0.734-0.850, but logistic regression performed similarly (0.721-0.846; differences 0.001-0.013). Within SHARE, descriptive country-level exclusion ranged from 20.1% in Denmark to 79.2% in Poland. Leave-one-cohort-out validation showed partial transportability, with mean AUC attenuation of 0.026. Cross-fitted classification scores were associated with concurrent depression (pooled adjusted OR 2.23, 95% CI 1.83-2.71). These findings support population-level characterization of digital exclusion but not prospective or individual-level risk prediction without external validation.",
  "abstract_shown": true,
  "affiliations": [
    "School of Agricultural Economics and Rural Development, Renmin University of China, Beijing, China.",
    "Department of Gastrointestinal Colorectal Surgery, The First Hospital of Jilin University, Changchun, China.",
    "School of Medicine and Health Management, Huazhong University of Science and Technology, Wuhan, China.",
    "Institute of Agricultural Information, Chinese Academy of Agricultural Sciences, Beijing, China.",
    "First Department of Neurology, First Affiliated Hospital of Kunming Medical University, Kunming, China. leixg@ydyy.cn."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 7,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Shenwei Wan",
      "orcid": "0009-0000-1962-6132"
    },
    {
      "affs": [
        1
      ],
      "name": "Cong Fu"
    },
    {
      "affs": [
        2
      ],
      "name": "Can Lu",
      "orcid": "0009-0009-7959-7121"
    },
    {
      "affs": [
        3
      ],
      "name": "Zhiwen Ding",
      "orcid": "0009-0009-2451-793X"
    },
    {
      "affs": [
        0
      ],
      "name": "Shiyuan Wang"
    },
    {
      "affs": [
        0
      ],
      "name": "Lei Zhou"
    },
    {
      "affs": [
        4
      ],
      "name": "Xiaoguang Lei"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/bm073j59epnnn.bib",
  "cited_by": 0,
  "doi": "10.1038/s41746-026-03268-z",
  "fulltext_url": "https://europepmc.org/articles/PMC13694266",
  "id": "bm073j59epnnn",
  "issns": [
    "2398-6352"
  ],
  "landing_url": "https://europepmc.org/article/MED/42919895",
  "language": "eng",
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "lcc",
      "R858-859.7"
    ],
    [
      "openalex",
      "3317|Technology Use by Older Adults"
    ]
  ],
  "openalex": "W7220714769",
  "pdf_url": "https://europepmc.org/articles/PMC13694266?pdf=render",
  "pmcid": "PMC13694266",
  "pmid": "42919895",
  "published": "2026-10-06",
  "publisher": "Nature Portfolio",
  "ris": "https://research.draconitic.com/paper/bm073j59epnnn.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:36Z",
      "native_id": "MED:42919895",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42919895"
    },
    {
      "first_seen": "2026-10-30T13:46:27Z",
      "native_id": "d9146caf573641548ace5ef55ce614b9",
      "source": "doaj",
      "url": "https://doi.org/10.1038/s41746-026-03268-z"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "lcc:R858-859.7",
      "subfield": "general"
    }
  ],
  "title": "Machine learning classification of digital exclusion in ageing populations across five international cohorts.",
  "title_text": "Machine learning classification of digital exclusion in ageing populations across five international cohorts.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T13:46:27Z",
  "url": "https://research.draconitic.com/paper/bm073j59epnnn",
  "venue": "NPJ digital medicine",
  "versions": []
}