LAUSR

ABSTRACT Estimation of person-specific risk for adverse health events in medicine has been approached almost exclusively using parametric statistical methods. Random forest is a machine learning method based on tree ensembles that is completely nonparametric and for this reason may be better suited for risk prediction. An introduction to a random forest is provided with a focus on its application to risk prediction. Using data from a total joint replacement registry, we illustrate risk prediction for the binary outcome of 90-day mortality following implantation, as well as time to device failure for aseptic reasons with the competing risk of mortality. Using the methods described in this paper, the random forest could be applied to risk prediction in a wide variety of medical fields. Issues related to implementation are discussed.