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Logistic Regression and the new: Residual Logistic Regression F. Berenice Baez-Revueltas Wei Zhu 1 Outline 1. 2. 3. 4. 5. 6. 7. 8. Logistic Regression Confounding Variables Controlling for Confounding Variables Residual Linear Regression Residual Logistic Regression Examples Discussion Future Work 2 1. Logistic Regression Model In 1938, Ronald Fisher and Frank Yates suggested the logit link for regression with a binary response variable. ln(Odds of Y 1| x) P(Y 1| x) P(Y 1| x) ln ln P ( Y 0 | x ) 1 P ( Y 1| x ) x ln 0 1 x 1 x A popular model for categorical response variable Logistic regression model is the most popular model for binary data. Logistic regression model is generally used to study the relationship between a binary response variable and a group of predictors (can be either continuous or categorical). Y = 1 (true, success, YES, etc.) or Y = 0 ( false, failure, NO, etc.) Logistic regression model can be extended to model a categorical response variable with more than two categories. The resulting model is sometimes referred to as the multinomial logistic regression model (in contrast to the ‘binomial’ logistic regression for a binary response variable.) More on the rationale of the logistic regression model Consider a binary response variable Y=0 or 1and a single predictor variable x. We want to model E(Y|x) =P(Y=1|x) as a function of x. The logistic regression model expresses the logistic transform of P(Y=1|x) as a linear function of the predictor. P(Y 1| x) ln 0 1 x 1 P(Y 1| x) This model can be rewritten as exp( 0 1 x) P(Y 1 | x) 1 exp( 0 1 x) E(Y|x)= P(Y=1| x) *1 + P(Y=0|x) * 0 = P(Y=1|x) is bounded between 0 and 1 for all values of x. The following linear model may violate this condition sometimes: P(Y=1|x) = 0 1 x More on the properties of the logistic regression model In the simple logistic regression, the regression coefficient 1 has the interpretation that it is the log of the odds ratio of a success event (Y=1) for a unit change in x. P(Y 1 | x 1) P(Y 1 | x) ln [ 0 1 ( x 1)] [ 0 1 x] 1 ln P(Y 0 | x 1) P(Y 0 | x) For multiple predictor variables, the logistic regression model is P(Y 1 | x1 , x2 ,..., xk ) 0 1 x1 ... k xk ln P(Y 0 | x1 , x2 ,..., xk ) Logistic Regression, SAS Procedure http://www.ats.ucla.edu/stat/sas/output/SAS_logit_output.htm Proc Logistic This page shows an example of logistic regression with footnotes explaining the output. The data were collected on 200 high school students, with measurements on various tests, including science, math, reading and social studies. The response variable is high writing test score (honcomp), where a writing score greater than or equal to 60 is considered high, and less than 60 considered low; from which we explore its relationship with gender (female), reading test score (read), and science test score (science). The dataset used in this page can be downloaded from http://www.ats.ucla.edu/stat/sas/webbooks/reg/default.htm. data logit; set "c:\temp\hsb2"; honcomp = (write >= 60); run; proc logistic data= logit descending; model honcomp = female read science; 7 run; Logistic Regression, SAS Output 8 2. Confounding Variables Correlated with both the dependent and independent variables Represent major threat to the validity of inferences on cause and effect Add to multicollinearity Can lead to over or underestimation of an effect, it can even change the direction of the conclusion They add error in the interpretation of what may be an accurate measurement 9 For a variable to be a confounder it needs to have Relationship with the exposure Relationship with the outcome even in the absence of the exposure (not an intermediary) Not on the causal pathway Uneven distribution in comparison groups Exposure Outcome Third variable 10 Birth order Down Syndrome Maternal Age Confounding Maternal age is correlated with birth order and a risk factor for Down Syndrome, even if Birth order is low Alcohol Lung Cancer Smoking No Confounding Smoking is correlated with alcohol consumption and is a risk factor for Lung Cancer even for persons who don’t drink alcohol 11 3. Controlling for Confounding Variables In study designs Restriction Random allocation of subjects to study groups to attempt to even out unknown confounders Matching subjects using potential confounders 12 In data analysis Stratified analysis using Mantel Haenszel method to adjust for confounders Case-control studies Cohort studies Restriction (is still possible but it means to throw data away) Model fitting using regression techniques 13 Pros and Cons of Controlling Methods Matching methods call for subjects with exactly the same characteristics Risk of over or under matching Cohort studies can lead to too much loss of information when excluding subjects Some strata might become too thin and thus insignificant creating also loss of information Regression methods, if well handled, can control for confounding factors 14 4. Residual Linear Regression Consider a dependant variable Y and a set of n independent covariates, from which the first k (k<n) of them are potential confounding factors Initial model treating only the confounding Y as 0 follows 1X1 2 X2 ... k Xk variables Residuals from ˆ calculated ˆ X ˆ X ... ˆ Xthis model, let ˆ are Y 0 1 1 2 2 k k 15 The residuals are e j Yj Yj with the following properties: Zero mean Homoscedasticity Normally distributed Corr ei , e j 0 , i j This residual will be considered the new dependant variable. That is, the new model to be fitted is Y Y 0 k 1 X k 1 k 2 X k 2 ... t X t which is equivalent to: Y 0 Y k 1 X k 1 k 2 X k 2 ... t X t 16 The Usual Logistic Regression Approach to ‘Control for’ Confounders Consider a binary outcome Y and n covariates where the first k (k<n) of them being potential confounding factors The usual way to ‘control for’ these confounding variables is to simply put all the n variables in the same model as: log X 2 X 2 ... k X k ... n X n 1 0 1 1 17 5. Residual Logistic Regression Each subject has a binary outcome Y Consider n covariates, where the first k (k<n) are potential confounding factors Initial model with as the probability of success where only confounding effect is analyzed log 0 1 X1 2 X 2 ... k X k 1 18 Method 1 The confounding variables effect is retained and plugged in to the second level regression model along with the variables of interest following the residual linear regression approach. That is, let T 1X1 2 X2 ... k Xk The new model to be fitted is log 0 T k 1 X k 1 k 2 X k 2 ... n X n 1 19 Method 2 Pearson residuals are calculated from the initial model using the Pearson Yresidual (Hosmer and Lemeshow, 1989) Z 1 where is the estimated probability of success based on the confounding variables alone: X k e 0 1 e i i 1 0 i 1 k i i X i 0,1 The second level regression will use this residual 20 as the new dependant variable. Therefore the new dependant variable is Z, and because it is not dichotomous anymore we can apply a multiple linear regression model to analyze the effect of the rest of the covariates. The new model to be fitted is a linear regression model Z 0 k1Xk1 k2 Xk2 ... n Xn 21 6. Example 1 Data: Low Birth Weight Dow. Indicator of birth weight less than 2.5 Kg Age: Mother’s age in years Lwt: Mother’s weight in pounds Smk: Smoking status during pregnancy Ht: History of hypertension Correlation matrix with alpha=0.05 Age Lwt Smk Ht Age Lwt Smk Ht 1.0000 0.1738 -0.0444 -0.0158 1.0000 -0.0408 0.2369 1.0000 0.0134 1.0000 22 Potential confounding factor: Age Model for (probability of low birth weight) Logistic regression log 0 1age 2 lwt 3 smk 4 ht 1 Residual logistic regression initial model Method 1 T 1age log age 1 0 1 log T 2 lwt 3smk 4 ht 1 0 Method 2 2lwt 3smk 4 ht Z 0 23 Results Variables Logistic Regression RLR Method1 Odds ratio P-value SE Odds ratio P-value SE lwt 0.988 0.060 0.0064 0.989 0.078 0.0065 smk 3.480 0.001 0.3576 3.455 0.001 0.3687 ht 3.395 0.053 0.6322 3.317 0.059 0.6342 RLR Method 2 Variables P-value Conf. factors SE lwt 0.077 0.0024 Smk 0.000 0.1534 ht 0.042 0.3094 Variables Age P-value Log reg Ini model 0.055 0.027 24 Example 2 Data: Alzheimer patients Decline: Whether the subjects cognitive capabilities deteriorates or not Age: Subjects age Gender: Subjects gender MMS: Mini Mental Score PDS: Psychometric deterioration scale HDT: Depression scale Age Correlation matrix with alpha=0.05 Gender MMS PDS HDT Age Gender MMS PDS HDT 1.0000 0.0413 -0.2120 0.3327 0.9679 1.0000 -0.1074 0.2020 -0.1839 1.0000 0.3784 -0.1839 1.0000 0.0110 1.0000 25 Potential confounding factors: Age, Gender Model for (probability of declining) Logistic regression log 0 1age 2 gender 3 mms 4 pds 5 hdt 1 Residual logistic regression initial model log 1age 2 gender 1 0 Method 1 T 1age 2gender log T 3mms 4 pds 5 hdt 1 0 Method 2 Z 0 3mms 4 pds 5hdt 26 Results Variables Logistic Regression RLR Method1 Odds ratio P-value SE Odds ratio P-value SE mms 0.717 0.023 0.1451 0.720 0.023 0.1443 pds 1.691 0.001 0.1629 1.674 0.001 0.1565 hdt 1.018 0.643 0.0380 1.018 0.644 0.0377 RLR Method 2 Conf. factors Variables P-value SE mms <0.001 0.0915 pds <0.001 0.0935 hdt 0.061 0.0273 Variables P-value Log reg Ini model Age 0.004 0.000 Gender 0.935 0.551 27 7. Discussion The usual logistic regression is not designed to control for confounding factors and there is a risk for multicollinearity. Method 1 is designed to control for confounding factors; however, from the given examples we can see Method 1 yields similar results to the usual logistic regression approach Method 2 appears to be more accurate with some SE significantly reduced and thus the p-values for some regressors are significantly smaller. However it will not yield the odds ratios as Method 1 can. 28 8. Future Work We will further examine the assumptions behind Method 2 to understand why it sometimes yields more significant results. We will also study residual longitudinal data analysis, including the survival analysis, where one or more time dependant variable(s) will be taken into account. 29 Selected References Menard, S. Applied Logistic Regression Analysis. Series: Quantitative Applications in the Social Sciences. Sage University Series Lemeshow, S; Teres, D.; Avrunin, J.S. and Pastides, H. Predicting the Outcome of Intensive Care Unit Patients. Journal of the American Statistical Association 83, 348-356 Hosmer, D.W.; Jovanovic, B. and Lemeshow, S. Best Subsets Logistic Regression. Biometrics 45, 1265-1270. 1989. Pergibon, D. Logistic Regression Diagnostics. The Annals of Statistics 19(4), 705-724. 1981. 30 Questions? 31