Comparison of AdaBoost and Random Forest Methods in Osteoporosis Risk Prediction Based on Machine Learning

Abstract

This study aims to determine the most effective ensemble machine learning algorithm for osteoporosis risk prediction in resource-constrained healthcare settings, specifically comparing AdaBoost and Random Forest performance on Southeast Asian population data. We implemented nested 5-fold cross-validation on a dataset of 1,958 records with 15 lifestyle and demographic attributes. Both algorithms underwent hyperparameter optimization, and performance was evaluated using accuracy, precision, recall, F1-score, and clinical utility metrics including cost-effectiveness analysis. AdaBoost achieved superior performance with 86.90% accuracy (95% CI: 84.2-89.6%) and perfect precision (1.00) compared to Random Forest's 84.69% accuracy and 0.92 precision. Statistical significance testing confirmed AdaBoost's advantage (p=0.032). Clinical implementation in three health centers demonstrated 60% reduction in unnecessary referrals. This is the first study to compare these algorithms specifically for Southeast Asian populations with clinical validation and cost-effectiveness analysis, providing a ready-to-deploy model for resource-limited healthcare settings.

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