American Association for Cancer Research
epi-22-0677_supplementary_table_s1_suppst1.pdf (170.53 kB)

Supplementary Table S1 from Performance of Statistical and Machine Learning Risk Prediction Models for Surveillance Benefits and Failures in Breast Cancer Survivors

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journal contribution
posted on 2023-04-03, 08:20 authored by Yu-Ru Su, Diana S.M. Buist, Janie M. Lee, Laura Ichikawa, Diana L. Miglioretti, Erin J. Aiello Bowles, Karen J. Wernli, Karla Kerlikowske, Anna Tosteson, Kathryn P. Lowry, Louise M. Henderson, Brian L. Sprague, Rebecca A. Hubbard

Supplementary Table S1 shows the calibration assessment in a sensitivity analysis on LASSO and Elastic-net by enforcing the adjustment of the matching factor.


National Institutes of Health (NIH)

Patient-Centered Outcomes Research Institute (PCORI)

Agency for Healthcare Research and Quality (AHRQ)



Machine learning (ML) approaches facilitate risk prediction model development using high-dimensional predictors and higher-order interactions at the cost of model interpretability and transparency. We compared the relative predictive performance of statistical and ML models to guide modeling strategy selection for surveillance mammography outcomes in women with a personal history of breast cancer (PHBC). We cross-validated seven risk prediction models for two surveillance outcomes, failure (breast cancer within 12 months of a negative surveillance mammogram) and benefit (surveillance-detected breast cancer). We included 9,447 mammograms (495 failures, 1,414 benefits, and 7,538 nonevents) from years 1996 to 2017 using a 1:4 matched case–control samples of women with PHBC in the Breast Cancer Surveillance Consortium. We assessed model performance of conventional regression, regularized regressions (LASSO and elastic-net), and ML methods (random forests and gradient boosting machines) by evaluating their calibration and, among well-calibrated models, comparing the area under the receiver operating characteristic curve (AUC) and 95% confidence intervals (CI). LASSO and elastic-net consistently provided well-calibrated predicted risks for surveillance failure and benefit. The AUCs of LASSO and elastic-net were both 0.63 (95% CI, 0.60–0.66) for surveillance failure and 0.66 (95% CI, 0.64–0.68) for surveillance benefit, the highest among well-calibrated models. For predicting breast cancer surveillance mammography outcomes, regularized regression outperformed other modeling approaches and balanced the trade-off between model flexibility and interpretability. Regularized regression may be preferred for developing risk prediction models in other contexts with rare outcomes, similar training sample sizes, and low-dimensional features.

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