Abstract

BackgroundMissing data is a pervasive problem in clinical research. Generative adversarial imputation nets (GAIN), a novel machine learning data imputation approach, has the potential to substitute missing data accurately and efficiently but has not yet been evaluated in empirical big clinical datasets.ObjectivesThis study aimed to evaluate the accuracy of GAIN in imputing missing values in large real-world clinical datasets with mixed-type variables. The computation efficiency of GAIN was also evaluated. The performance of GAIN was compared with other commonly used methods, MICE and missForest.MethodsTwo real world clinical datasets were used. The first was that of a cohort study on the long-term outcomes of patients with diabetes (50,000 complete cases), and the second was of a cohort study on the effectiveness of a risk assessment and management programme for patients with hypertension (10,000 complete cases). Missing data (missing at random) to independent variables were simulated at different missingness rates (20, 50%). The normalized root mean square error (NRMSE) between imputed values and real values for continuous variables and the proportion of falsely classified (PFC) for categorical variables were used to measure imputation accuracy. Computation time per imputation for each method was recorded. The differences in accuracy of different imputation methods were compared using ANOVA or non-parametric test.ResultsBoth missForest and GAIN were more accurate than MICE. GAIN showed similar accuracy as missForest when the simulated missingness rate was 20%, but was more accurate when the simulated missingness rate was 50%. GAIN was the most accurate for the imputation of skewed continuous and imbalanced categorical variables at both missingness rates. GAIN had a much higher computation speed (32 min on PC) comparing to that of missForest (1300 min) when the sample size is 50,000.ConclusionGAIN showed better accuracy as an imputation method for missing data in large real-world clinical datasets compared to MICE and missForest, and was more resistant to high missingness rate (50%). The high computation speed is an added advantage of GAIN in big clinical data research. It holds potential as an accurate and efficient method for missing data imputation in future big data clinical research.Trial registrationClinicalTrials.gov ID: NCT03299010; Unique Protocol ID: HKUCTR-2232

Highlights

  • Missing data is a pervasive problem in clinical research

  • Both missForest and Generative adversarial imputation nets (GAIN) were more accurate than Multiple imputation by chained equations (MICE)

  • GAIN showed similar accuracy as missForest when the simulated missingness rate was 20%, but was more accurate when the simulated missingness rate was 50%

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Summary

Introduction

Missing data is a pervasive problem in clinical research. Generative adversarial imputation nets (GAIN), a novel machine learning data imputation approach, has the potential to substitute missing data accurately and efficiently but has not yet been evaluated in empirical big clinical datasets. Missing data is a pervasive problem in big data research, clinical trials and epidemiological studies [1]. The problem of missing data can be classified into three categories, including missing completely at random (MCAR), missing at random (MAR), and missing not at random (MNAR) [6,7,8]. The majority of the missing data in medical research are assumed to be MAR [9]. In contrast to MCAR, where there are no systematic differences between the missing and observed values, with MAR data, there will be differences between missing and observed values but these differences can be explained by other observed data [10,11,12]

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