Evidence map›Paper›PMID 42667682›Full record

ArticleInternational journal of epidemiology2026

Can synthetic data reproduce real-world findings in epidemiology? A replication study using adversarial random forests.

Jan Kapar, Kathrin Günther, Lori Ann Vallis, Klaus Berger, Nadine Binder, Hermann Brenner, Stefanie Castell, Beate Fischer, Volker Harth, Bernd Holleczek and 20 more

Abstract read
In one paragraph

Article in International journal of epidemiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

30 authors.

Jan KaparLeibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany.ORCID 0009-0000-6408-2840
Kathrin GüntherLeibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany.ORCID 0000-0003-3801-4769
Lori Ann VallisDepartment of Human Health Sciences, University of Guelph, Guelph, Ontario, Canada.ORCID 0000-0003-3970-9159
Klaus BergerInstitute of Epidemiology and Social Medicine, University of Münster, Münster, Germany.
Nadine BinderInstitute of General Practice/Family Medicine, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany.
Hermann BrennerCancer Prevention Graduate School, German Cancer Research Center (DKFZ), Heidelberg, Germany.
Stefanie CastellDepartment of Epidemiology, Helmholtz Centre for Infection Research (HZI), Brunswick, Germany.
Beate FischerDepartment of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany.
Volker HarthInstitute for Occupational and Maritime Medicine (ZfAM), University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Bernd HolleczekSaarland Cancer Registry, Saarbrücken, Germany.
Timm IntemannLeibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany.
Till IttermannInstitute for Community Medicine, University Medicine Greifswald, Greifswald, Germany.
André KarchInstitute of Epidemiology and Social Medicine, University of Münster, Münster, Germany.
Thomas KeilInstitute of Social Medicine, Epidemiology and Health Economics, Charité Universitätsmedizin Berlin, Berlin, Germany.
Lilian KristInstitute of Social Medicine, Epidemiology and Health Economics, Charité Universitätsmedizin Berlin, Berlin, Germany.
Berit LangeDepartment of Epidemiology, Helmholtz Centre for Infection Research (HZI), Brunswick, Germany.
Michael F LeitzmannDepartment of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany.
Katharina NimptschMolecular Epidemiology Research Group, Max Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany.
Nadia ObiInstitute for Occupational and Maritime Medicine (ZfAM), University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Iris PigeotLeibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany.
Tobias PischonMolecular Epidemiology Research Group, Max Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany.
Tamara SchikowskiIUF-Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany.
Börge SchmidtInstitute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, University of Duisburg, Essen, Germany.
Carsten Oliver SchmidtInstitute for Community Medicine, University Medicine Greifswald, Greifswald, Germany.
Anja M SedlmairDepartment of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany.
Justine TanoeyLeibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany.
Harm WienbergenBremen Institute for Heart and Circulation Research (BIHKF), Bremen, Germany.
Andreas WienkeInstitute of Medical Epidemiology, Biometry, and Informatics, Profile Center Health Sciences, Faculty of Medicine, Martin Luther University Halle-Wittenberg, Halle, Germany.
Claudia WigmannIUF-Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany.
Marvin N WrightLeibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany.ORCID 0000-0002-8542-6291

Funding

Canada Foundation for Innovation 36619CIHR 376067DFG 442326535Federal State of BremenGerman Research Foundation (Deutsche Forschungsgemeinschaft, DFG) 499552394Ministry of Culture and Science of North Rhine-Westphalia and the Federal Ministry of Research, Technology and Space of GermanyNFDI4Health (National Research Data Infrastructure for Personal Health Data)the European Union's ERASMUSU Bremen Research Alliance/AI Center for Health Care
6 · The paper itself

Abstract

backgroundSynthetic data hold substantial potential to address practical challenges in epidemiology due to restricted data access and privacy concerns. However, many current methods suffer from limited quality, high computational demands, and complexity for non-experts. Furthermore, common evaluation strategies for synthetic data often fail to directly reflect statistical utility and measure privacy risks sufficiently. Against this background, a critical underexplored question is whether synthetic data can reliably reproduce key findings from epidemiological research while preserving privacy.

methodsWe propose adversarial random forests (ARF) as an efficient and convenient method for synthesizing tabular epidemiological data. To evaluate its performance, we replicated statistical analyses from six epidemiological publications covering blood pressure, anthropometry, myocardial infarction, accelerometry, loneliness, and diabetes, from the German National Cohort (NAKO Gesundheitsstudie), the Bremen STEMI Registry U45 Study, and the Guelph Family Health Study. We further assessed how dataset dimensionality and variable complexity affect the quality of synthetic data, and contextualized ARF's performance by comparison with commonly used tabular data synthesizers in terms of utility, privacy, generalization, and runtime.

resultsAcross all replicated studies, results on ARF-generated synthetic data consistently aligned with original findings. Even for datasets with relatively low sample size-to-dimensionality ratios, replication outcomes closely matched the original results across descriptive and inferential analyses. Reduced dimensionality and variable complexity further enhanced synthesis quality. ARF demonstrated favourable performance regarding utility, privacy preservation, and generalization relative to other synthesizers and superior computational efficiency.

conclusionsIn summary, ARF reliably generates high-quality synthetic data that replicate diverse epidemiological analyses while offering a competitive privacy-utility trade-off.

Indexed as

EpidemiologyRandom ForestHumansReproducibility of Resultsadversarial random forestsgenerative artificial intelligencegenerative machine learningGuelph Family Health StudyNAKO German National Cohortsynthetic data

Identifiers

PMID42667682
PMCPMC13525842

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