Beyond Area Under the Receiver Operating Characteristic Curve: Evaluating Predictive Performance Metrics Under Class Imbalance in Real-World Clinical Data

Vanessa das Graças José Ventura   ¹ , MSc, MD ;   Claudio Moisés Valiense de Andrade   ² , BSc, MSc ;   Jussara Marques de Almeida   ² , MSc, PhD ;   Bruno Porto Pessoa   ³ , MSc, MD ;   Carísi Anne Polanczyk   ^{4, 5, 6} , MSc, MD, PhD ;   Guilherme Fonseca do Nascimento   ² , BSc ;   Eric Boersma   ⁷ , MSc, PhD ;   Heloisa Reniers Vianna   ⁸ , MSc, MD ;   Katia de Paula Farah   ¹ , MSc, MD, PhD ;   Leonardo Chaves Dutra da Rocha   ² , MSc, PhD ;   Marcos André Gonçalves   ² , MSc, PhD ;   Milena Soriano Marcolino   ^{5, 9, 10} , MSc, MD, PhD

¹ Medical School and University Hospital, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil

² Department of Computer Science, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil

³ Hospital Júlia Kubitschek, Belo Horizonte, Brazil

⁴ Department of Medicine Internal, Medical School, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil

⁵ Institute for Health Assessment and Translation for Chronic and Neglected Diseases of High RElevance (IATS-CARE), Belo Horizonte, Brazil

⁶ Hospital Moinhos de Vento, Porto Alegre, Brazil

⁷ Erasmus University Medical Center, Rotterdam, The Netherlands

⁸ Hospital Universitário Ciências Médicas, Belo Horizonte, Brazil

⁹ Department of Internal Medicine, Medical School, Medical School and University Hospital, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil

¹⁰ Telehealth Center, University Hospital, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil