SMOTE-VAR: An Uncertainty-Aware Oversampling Method for Predicting Depression Remission in University Students
Authors: Dang Nguyen, Arun Kumar A, Taylor A. Braund, Wu Yi Zheng, Debopriyo Bal, Leonard Hoon, Jill Newby, Helen Christensen, +3 more
Organizations: Applied Artificial Intelligence Initiative (A2I2), Deakin University, Geelong, VIC, Australia · Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
Abstract
University students experience disproportionately high rates of common mental health conditions, such as depression, which can impair learning, social functioning, and overall well-being. Although lifestyle interventions such as mindfulness and physical activity can reduce the symptoms, many do not achieve symptomatic remission. Developing new approaches to identify students with poor outcomes could enable earlier and more targeted intervention. Machine learning (ML) methods have increasingly been used to predict remission in depressive patients. However, these ML models often suffer from class imbalance, where there may be an unequal proportion of people in the remitted group relative to the non-remitted group. This imbalance can reduce model accuracy and bias predictions. To address this, studies commonly employ the popular oversampling strategy SMOTE. However, SMOTE has a notable limitation: it may generate invalid synthetic minority samples. In a clinical context, these false positives can lead to incorrect risk stratification, potentially delaying necessary escalated care for patients unlikely to remit. In this paper, we introduce a novel and effective oversampling method that addresses this shortcoming. Our approach leverages the variance function of a Gaussian process to estimate the uncertainty of generated minority samples to reduce false positives. We validate our method on a depression dataset collected from university students and demonstrate that it is better than existing oversampling approaches in predicting remission (i.e., treatment outcome). By improving the reliable identification of non-responders, our method provides a robust computational tool to help clinicians rapidly pivot to adjunctive therapies, thereby personalizing and optimizing mental health care pathways.
Resampling methods such as SMOTE and random under/over-sampling are standard tools for class-imbalanced classification, almost always evaluated by minority-class accuracy or F1. Prior work has established that undersampling degrades probability calibration by distorting the training prior [1]. We extend this lens to synthetic oversampling (SMOTE) and provide a practical, evidence-based guide to when calibration damage matters and how to fix it. Across five public datasets (imbalance ratio 1.9-70) and two ensemble models (random forest, gradient boosting), with ten seeds and paired statistics, we find: (1) SMOTE's calibration cost is real but small (ECE +0.009; Cliff's delta = +0.27, small-to-moderate) across the studied imbalance range (IR 1.9-70) and its discrimination gains typically outweigh the calibration penalty; (2) random undersampling is the genuine danger -- its damage grows sharply with imbalance, inflating ECE from 0.008 to 0.395 on a dataset with ratio 70, largely because the resulting training sets are too small to estimate probabilities reliably; (3) a single post-hoc recalibration step (Platt or isotonic) eliminates the damage, reducing ECE by up to 66% at a negligible ranking-power cost (AUC -0.002, Cliff's delta = -0.07); and (4) the analytic prior-shift correction that repairs undersampling does not transfer to SMOTE, because SMOTE distorts the class-conditional density rather than only the prior -- so data-driven recalibration remains necessary. We recommend that imbalanced-learning studies report calibration alongside discrimination, and that practitioners recalibrate after resampling whenever predicted probabilities drive decisions.
Class imbalance complicates probabilistic classification because standard training objectives emphasize majority-class performance. Synthetic oversampling can reduce imbalance, but discrepancies between the synthetic and target minority distributions may bias the fitted classifier, especially because synthetic samples depend on the observed data. We propose a bias-correction procedure that estimates the generator-induced loss discrepancy from a held-out subset of majority observations and transfers this correction to the minority class under a uniform bias-transfer condition. We establish finite-sample bounds for bias transfer and for the excess balanced risk of the resulting empirical risk minimizer, and characterize a regime in which SMOTE induces non-negligible loss bias. The framework can also be implemented in imbalanced multi-task learning and propensity-score estimation, with details provided in the Supplementary Material. Real data analyses show that the correction is most useful when synthetic distortion is appreciable.
Class imbalance poses a significant challenge in classification, where existing methods such as SMOTE often generate low-quality synthetic samples in regions with noise or class overlap. We propose QC-SMOTE, a quality-controlled oversampling framework that estimates minority sample reliability using a composite neighbourhood trustworthiness score combining local density, safe-level, and isolation from the majority class. Synthetic candidates are generated using an IPQ-guided best-of-K strategy that evaluates midpoint purity and, when required, majority clearance, with allocation guided by sample reliability and boundary informativeness. Generation behaviour adapts across overlap--imbalance regimes, adjusting interpolation range and selection criteria to match local data geometry. Low-quality synthetic samples are replaced with original minority duplicates when neighbourhood purity falls below an adaptive threshold, providing graceful degradation by reverting to duplication in severely noisy regions. Experiments on 30 imbalanced datasets using repeated stratified cross-validation show that QC-SMOTE achieves the strongest average AUC-ROC and Macro F1 among the compared oversampling methods, with particularly clear gains under moderate and severe imbalance. These results demonstrate the importance of quality-aware, geometry-adaptive synthetic sampling for robust imbalanced classification.