Machine learning (ML) is set to accelerate innovations in clinical microbiomics, such as in disease diagnostics and prognostics. This will require high-quality, reproducible, interpretable workflows whose predictive capabilities meet or exceed the high thresholds set for clinical tools by regulatory agencies. Here, we capture a snapshot of current practices in the application of supervised ML to microbiomics data, through an in-depth analysis of 100 peer-reviewed journal articles published in 2021-2022. We apply a data-driven approach to steer discussion of the merits of varied approaches to experimental design, including key considerations such as how to mitigate the effects of small dataset size while avoiding data leakage. We further provide guidance on how to avoid common experimental design pitfalls that can hurt model performance, trustworthiness, and reproducibility. Discussion is accompanied by an interactive online tutorial that demonstrates foundational principles of ML experimental design, tailored to the microbiomics community. Formalizing community best practices for supervised ML in microbiomics is an important step towards improving the success and efficiency of clinical research, to the benefit of patients and other stakeholders.
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