Evaluation metrics for temporal preservation in synthetic longitudinal patient data

This study introduces a set of metrics for evaluating temporal preservation in synthetic longitudinal patient data, defined as artificially generated data that mimic real patients' repeated measurements over time. The proposed metrics assess how synthetic data reproduces key temporal characteristics, categorized into marginal, covariance, individual-level and measurement structures. We show that strong marginal-level resemblance may conceal distortions in covariance and disruptions in individual-level trajectories. Temporal preservation is influenced by factors such as original data quality, measurement frequency, and preprocessing strategies, including binning, variable encoding and precision. Variables with sparse or highly irregular measurement times provide limited information for learning temporal dependencies, resulting in reduced resemblance between the synthetic and original data. No single metric adequately captures temporal preservation; instead, a multidimensional evaluation across all characteristics provides a more comprehensive assessment of synthetic data quality. Overall, the proposed metrics clarify how and why temporal structures are preserved or degraded, enabling more reliable evaluation and improvement of generative models and supporting the creation of temporally realistic synthetic longitudinal patient data.