Literature DB >> 34522147

Combining Resampling Strategies and Ensemble Machine Learning Methods to Enhance Prediction of Neonates with a Low Apgar Score After Induction of Labor in Northern Tanzania.

Clifford Silver Tarimo1,2, Soumitra S Bhuyan3, Quanman Li1, Weicun Ren4, Michael Johnson Mahande5, Jian Wu1.   

Abstract

OBJECTIVE: The goal of this study was to establish the most efficient boosting method in predicting neonatal low Apgar scores following labor induction intervention and to assess whether resampling strategies would improve the predictive performance of the selected boosting algorithms.
METHODS: A total of 7716 singleton births delivered from 2000 to 2015 were analyzed. Cesarean deliveries following labor induction, deliveries with abnormal presentation, and deliveries with missing Apgar score or delivery mode information were excluded. We examined the effect of resampling approaches or data preprocessing on predicting low Apgar scores, specifically the synthetic minority oversampling technique (SMOTE), borderline-SMOTE, and the random undersampling (RUS) technique. Sensitivity, specificity, precision, area under receiver operating curve (AUROC), F-score, positive predicted values (PPV), negative predicted values (NPV) and accuracy of the three (3) boosting-based ensemble methods were used to evaluate their discriminative ability. The ensemble learning models tested include adoptive boosting (AdaBoost), gradient boosting (GB) and extreme gradient boosting method (XGBoost).
RESULTS: The prevalence of low (<7) Apgar scores was 9.5% (n = 733). The prediction models performed nearly similar in their baseline mode. Following the application of resampling techniques, borderline-SMOTE significantly improved the predictive performance of all the boosting-based ensemble methods under observation in terms of sensitivity, F1-score, AUROC and PPV.
CONCLUSION: Policymakers, healthcare informaticians and neonatologists should consider implementing data preprocessing strategies when predicting a neonatal outcome with imbalanced data to enhance efficiency. The process may be more effective when borderline-SMOTE technique is deployed on the selected ensemble classifiers. However, future research may focus on testing additional resampling techniques, performing feature engineering, variable selection and optimizing further the ensemble learning hyperparameters.
© 2021 Tarimo et al.

Entities:  

Keywords:  ensemble learning; imbalanced data; labor induction; low Apgar score; machine learning; resampling methods

Year:  2021        PMID: 34522147      PMCID: PMC8434924          DOI: 10.2147/RMHP.S331077

Source DB:  PubMed          Journal:  Risk Manag Healthc Policy        ISSN: 1179-1594


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