arXiv Statistics ML By Lasai Barre\~nada, Andrew Vickers, Laure Wynants, Bieke Tack, Dirk Timmerman, Ewout Steyerberg, Ben Van Calster

Cost-based variable selection for prediction models

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The article introduces a decision‑analytic variable selection algorithm that optimizes clinical prediction models by balancing predictive performance against the costs and harms of measuring variables. It exhaustively compares net benefit across all predictor combinations, with a backward‑elimination extension for high‑dimensional data, and selects variables only when their added predictive value outweighs their measurement costs. The method, implemented in the R package NBvarsel, was demonstrated on simulated data and three real case studies, producing parsimonious models that maintained discrimination and calibration while reducing unnecessary clinical burden.

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arXiv Machine Learning
Sep 14

Optimizing for the decision not the prediction: an exploration of Smooth Net Benefit as a training objective

The study introduces Smooth Net Benefit (σNB), a differentiable approximation of Net Benefit, as a training objective aimed at aligning predictive models with threshold‑specific clinical decisions. Experiments on the Framingham cardiovascular risk dataset and 44 TabZilla datasets show that σNB training yields modest improvements for logistic regression but little to no benefit for more flexible models such as GAMs and XGBoost. The authors conclude that σNB is not a universal replacement for negative log‑likelihood training, though it may be worth exploring in contexts where model flexibility is limited.

By Koen M. F. Gorgels, Lasai Barre\~nada, Maarten van Smeden, Ben Van Calster, Ewout W. Steyerberg, Wouter A. C. van Amsterdam