Modeling Antimicrobial Prescriptions in Scotland: A Spatiotemporal Clustering Approach.

In 2016, the British government acknowledged the importance of reducing antimicrobial prescriptions to avoid the long-term harmful effects of overprescription. Prescription needs are highly dependent on the factors that have a spatiotemporal component, such as bacterial outbreaks and urban densities. In this context, density-based clustering algorithms are flexible tools to analyze data by searching for group structures and therefore identifying peer groups of GPs with similar behavior. The case of Scotland presents an additional challenge due to the diversity of population densities under the area of study. We propose here a spatiotemporal clustering approach for modeling the behavior of antimicrobial prescriptions in Scotland. Particularly, we consider the density-based spatial clustering of applications with noise algorithm (DBSCAN) due to its ability to include both spatial and temporal data. We extend this approach into two directions. For the temporal analysis, we use dynamic time warping to measure the dissimilarity between time series while taking into account effects such as seasonality. For the spatial component, we propose a new way of weighting spatial distances with continuous weights derived from a Kernel density estimation-based process. This makes our approach suitable for cases with different local densities, which presents a well-known challenge for the original DBSCAN. We apply our approach to antibiotic prescription data in Scotland, demonstrating how the findings can be used to compare antimicrobial prescription behavior within a group of similar peers and detect regions of extreme behaviors.

On sparse ensemble methods: An application to short-term predictions of the evolution of COVID-19.

Since the seminal paper by Bates and Granger in 1969, a vast number of ensemble methods that combine different base regressors to generate a unique one have been proposed in the literature. The so-obtained regressor method may have better accuracy than its components, but at the same time it may overfit, it may be distorted by base regressors with low accuracy, and it may be too complex to understand and explain. This paper proposes and studies a novel Mathematical Optimization model to build a sparse ensemble, which trades off the accuracy of the ensemble and the number of base regressors used. The latter is controlled by means of a regularization term that penalizes regressors with a poor individual performance. Our approach is flexible to incorporate desirable properties one may have on the ensemble, such as controlling the performance of the ensemble in critical groups of records, or the costs associated with the base regressors involved in the ensemble. We illustrate our approach with real data sets arising in the COVID-19 context.