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BackgroundMachine learning (ML) algorithms are now increasingly used in infectious disease epidemiology. Epidemiologists should understand how ML algorithms behave within the context of outbreak data where missingness of data is almost ubiquitous.MethodsUsing simulated data, we use a ML algorithmic framework to evaluate data imputation performance and the resulting case fatality ratio (CFR) estimates, focusing on the scale and type of data missingness (i.e., missing completely at random-MCAR, missing at random-MAR, or missing not at random-MNAR).ResultsAcross ML methods, dataset sizes and proportions of training data used, the area under the receiver operating characteristic curve decreased by 7% (median, range: 1%-16%) when missingness was increased from 10% to 40%. Overall reduction in CFR bias for MAR across methods, proportion of missingness, outbreak size and proportion of training data was 0.5% (median, range: 0%-11%).ConclusionML methods could reduce bias and increase the precision in CFR estimates at low levels of missingness. However, no method is robust to high percentages of missingness. Thus, a datacentric approach is recommended in outbreak settings-patient survival outcome data should be prioritised for collection and random-sample follow-ups should be implemented to ascertain missing outcomes.

Original publication

DOI

10.1371/journal.pone.0257005

Type

Journal article

Journal

PloS one

Publication Date

01/2021

Volume

16

Addresses

School of Computing Science, Simon Fraser University, Burnaby, British Columbia, Canada.

Keywords

Humans, Hemorrhagic Fever, Ebola, Data Interpretation, Statistical, Models, Statistical, Survival Analysis, Disease Outbreaks, Research Design, Computer Simulation, Datasets as Topic, Machine Learning