Logistics LT

ANALYSIS OF DATA IN HEALTH SCIENCE RESEARCH USING
LOGISTIC REGRESSION
1
f(z)=1+e-z
1
2
0
Z +
, Ph.D.(Statistics)

II
ANALYSIS OF DATA IN HEALTH SCIENCE RESEARCH USING

LOGISTIC REGRESSION

.. ()
M.P.H. (Epidemiology)
Grad. Dip. Medical Statistics
Ph.D. (Statistics)
III

(Multivariable analysis)
(Logistic
Regression)

2543
II

David G. Kleinbaum

2 5

III

5 4

1
2
STATA
IV

.................................................................................................................................................... I
..................................................................................................................................II
............................................................................................................ III
1 (Introduction)................................................................................................................1
1. Logistic Regression................................................................................2
1.1 ............................................................................................2
1.2 ......................................................................................2
1.3 .............................................................3
1.4 Logistic regression .................................................................................4
1.5 ................................................................................................................5
2. (E) (D)........................................6
2.1 Crude analysis...........................................................................................................6
2.2 Stratified analysis ....................................................................................................10
2.2.1 Confounding Effect .........................................................................................10
2.2.2. Interaction effect ............................................................................................12
3. Logistic regression .........................................................................................14
1...................................................................................................17
1 ....................................................................................................................18
2 Logistic Regression
..................................................................................................................................28
1. Logistic Model...............................................................................29
2. Logistic Model.........................................................................................31
2....................................................................................................35
2 ....................................................................................................................36
3 Odds Ratio Logistic Regression Model
..............................................................................................................................43
1. .............................................................................................................................44
2. OR Additive Model..............................................................................45
2.1 0,1 ...............................................46
2.2 0,1................................................46
2.3 ..................................................................47
2.4 ..............................................................................50
2.5 ..............................................................................52
2.6 .................................................................................53
V
3. OR Multiplicative model........................................................................54
3.1 Second order term......................................................................56
3.2 Third order term ........................................................................57
4. OR......................................................................................................59
5. OR...........................................................................................59
3...................................................................................................61
3 ....................................................................................................................62
4 Odds Ratio Logistic Regression
Model.......................................................................................................................................67
4..............................................................................................74
4...............................................................................................................75
5 Logistic Regression Model .............................................................................81
1. Model...............................................................................................................82
1.1 Model .........................................................................................82
1.2 Model............................................................................................83
1.3 Model....................................................................................84
1.3.1 Multicolinearity .............................................................................................84
1.3.2 Multiple Testing.............................................................................................85
1.3.3 Outlier ..........................................................................................................85
1.3.4 Non-linear Relationship..................................................................................86
2. Model .................................................................................................87
3. Model.....................................................................................89
4. Interaction Effect Confounding Effect .................................................94
5. Conditional Logistic Regression Unconditional Logistic Regression ...............................98
5.................................................................................................100
5 ....................................................................................................................96
....................................................................................................................................118
1 ...........................................................................................................119
1 ...........................................................................................................119
2 ...........................................................................................................123
3 ...........................................................................................................126
4 ...........................................................................................................128
2 ............................................................................132
1
1
(Introduction)
1. Logistic Regression
2. (Crude analysis)
3. Stratified Analysis
4. Confounding effect Interaction effect
2. Bivariate analysis Logistic Regression
3. Stratified analysis Logistic Regression : Confounding Interaction effect
1. 1
2.
3.
2

1.1
1.1
Logistic Regression
LOGISTIC REGESSION

E ? D
:
D = (CHD)
E = (SMK)
[Exposure (E)]
SMK ? CHD [Disease (D)]

[Coronary Heart Disease (CHD)]
[Smoking (SMK)]
1.2 D
(Dependent Variable) D
E D
SMK CHD Outcome
Response variable (event)
E (Independent
Variable)
Independent variable Dependent variable
predictor Outcome
Explanatory variable Response variable

Predictor Explanatory Variable
(factor)
1.2

(CHD)
(SMK)

3

1.3

(Effect of smoking on
coronary heart disease)
(factor)
(

,

2542)

Factor of interest Extraneous factors

Extraneous factors
(Extraneous
Extraneous variables
factors)
Covariates

Controlled variables

Confounders ()
1.3

2
1.4 1)

(Extraneous factors) (Matching)
1. (Design stage) (Restriction)
Matched
Restriction in study design
(Randomization) 2)
Randomization

2. (Analysis stage)
Subgroup analysis
Stratified analysis
Multivariable analysis Logistic regression (Subgroup analysis)
(Stratified analysis)
(Multivariable analysis)
Logistic regression
4
Multivariable analysis
1.4 Logistic regression

Logistic Regression
1.5
Logistic Regression (Categorical variable)

Dichotomous outcome (Dichotomous variable)
D D = 0
D(0,1)
D D = 1
:
CHD = 0
D D
= 1 0 1

D D 0
1

CHD = 0

CHD = 1
1.6

Dichotomous outcome Logistic regression
(1 =
Polytomous outcome Multinomial logistic regression
2 = 3 =
Ordinal outcome Ordinal logistic regression )

(Proportional odds model)
Multinomial logistic regression
(1 =
2 = 3 = )
Ordinal logistics regression (
Proportional odds model)
Logistic
regression
5
( Dichotomous)
Dichotomous outcome Logistic regression
Polytomous outcome Multinomial logistic regression
Ordinal outcome Ordinal logistic regression

(Proportional odds model)
1.5
Logistic regression
2
6
1.7 (Risk assessment)

(Prediction)
Risk assessment
1.

(Effect of smoking on coronary heart disease) 2
(Factor of interest)
2. (
)

(Factors affecting coronary heart disease) "
(Factors
affecting coronary heart disease)"
2.
(E) (D)

Logistic regression

2.1 Crude analysis
1.8

2 X 2
ID E D D Total

1. 1 1 E 1 0
2. 1 0
1
0
a
c
b
d
a+b
c+d
(Crude analysis) Bivariate
3. 0 1 Total a+c b+d
b+d n=a+b+c+d
4. 0 0 analysis
5. 1 1
6. 1 0
D Total

7. 0 0
E 1 0
8.
9.
0
1
0
1
1 4 2 6
0 1 3 4
10. 1 1 Total 5 5 10 Dichotomous
ID E (1= 0=) D (1= 0=)
Dichotomous

E
D (Contingency table)
22 SMK 0
7
1
0
1 4
(cell)
1. (Measure of association)

1.1) Relative Risk
1.2) Odds Ratio
2. (Test of association) E D

Chi-square test (Test of
Fishers exact test
association) - (2-test)
McNemar test
Binomial probability test Expected value
5 20%
Fishers Exact test
Note: Chi-square valid Expected (Measure of
value 5 20%
association) Relative Risk (RR.)
Fishers
Exact test Cohort study Odds
Ratio (OR) Cross-
sectional Case-control Study
1.9

Crude analysis
1
CHD
0
359 Cohort

1 42 203 245 study
SMK
0 7 107 114 245 (a+b) 114
49 310 359 (n)
:-
(c+d) 10
Cohort study Cross-sectional Case-control study 42 (a)
X2 = 7.99 X2 = 7.99
df = 1 p-value = 0.005 df = 1 p-value = 0.005 7 (c)
RR = 2.8 OR = 3.2
95%CI : 1.3 6.0 95% CI : 1.4 7.1 (Row totals are
fixed )
Cross-sectional
study
359 (n)

4
a=42 b=203 c=7 d=107

8
(Grand totals is fixed )

: 2 x 2 Case-
D+ D- control 49 (a+c)
310 (b+d)
E+ a b a+b
E- c d c+d

a+c b+d a+b+c+d=N (Column totals are fixed )
1. (Test of association)
n 2
N ad bc
=
2 2 SMK CHD 2-
( a + b )( a + c )( b + d )( c + d )
test (
P = a + b ! cN+! ad! !b !ac+! dc! ! b + d !

( )( )( )( )
Fishers exact test )
Cohort study
Cross-sectional study Case-control
study 2 = 7.99
2. (Measure of association)
2.1 Relative Risk
a -
RR.= c b
a + (R-1)(C-1) = (2-
c+d
[ ]
1)(2-1) = 1 p-value 0.005
95%CI . RR. = RR.exp 196
. a(a b+ b) + c(c d+ d) 0.05

2.2 Odds Ratio (Significance)
OR.= ad
[ ]
bc

95%CI . OR. = OR. exp 196
. 1a + 1b + 1c + d1

RR. Cohort study
2.8 RR. =
[a/(a+c)]/[b/(b+c)]

2.8

Cross-
sectional Case-control study
RR.
RR. OR
9
OR 3.2
OR = ad/bc
RR OR
95% [95% Confidence Interval (95%CI.)]
OR 1.4 7.1
1 1

1.4 < 3.2< 7.1

0.5 1 2 4 6 8
0.05
0 0.25
p-value RR OR

(p-value < 0.05) RR
OR
95% CI RR.
OR

1.10
(E) 1
E D
:
E, C
SMK, SEX
D
CHD

CHD
1 0

1 50 10 X2 = 38.10
= <0.01
SMK
0 50
CHD
90
P
OR
95%CI
= 9.0
= 4.0-20.8
?
1 0
M 90 50 X2 = 38.10
SEX
F 10 50
P
OR
95%CI
= <0.01
= 9.0
= 4.0-20.8
X SMK
CHD SEX CHD

9

9

SMK CHD

10

SEX CHD

2.2 Stratified analysis

E D
C ( C
Covariate) C SEX
(Stratified
analysis)
1.11
E D C [
Stratified analysis (1)
Stratified analysis Kleinbaum,
1 Crude Odds Ratio (ORC ) Kupper, and Morgenstern (1986) 321-
2 Stratum Specific Odds Ratio (OR1)
(OR2) 376 Fleiss (1981)
(OR3)
... 160-187]
(ORK)
3 Adjusted Odds Ratio (ORMH )
4 Test of homogeneity of odds ratios across stratum (p-value)
)
: Crude
odds ratio (ORC) Crude
analysis , Stratum
specific odds ratio (OR1, OR2, , ORK
C K ), Adjusted odds ratio
(ORMH MH
Mantel-Haenszel), P-value
Stratum specific odds
ratio (Test of homogeneity of
odds ratios across stratum Woolf's test)
2.2.1 Confounding Effect

4
p-value > 0.05
Stratum specific OR Strata

1.12
11

Stratified analysis (2)
Stratum specific OR
Test of homogeneity of OR p-value > 0.05
Stratum Specific OR
(
)
ORMH ORC
Stratum specific OR

ORMH
Confounding effect Confounding effect
ORMH ORC
ORMH ORC ORMH
()
Confounding effect C
Confounder
E D ORMH
ORMH ORC
ORMH
ORC
ORMH
C
ORC ORMH
1.13
confounding Effect
CHD 5.4
1 0
1 140 60 ORc = 5.4 ORC
SMK 95%CI = 3.5 8.3
0 60 140 (SEX) OR1
Strata 1 9
CHD CHD
1 0 1 0
1 50 10 1 90 50
OR2 Strata 2
SMK SMK
50 90 10 50 9 OR1= OR2 p-
0 0
OR1 = 9.0 OR2 = 9.0
95%CI = 4.2 19.0 95%CI = 4.2 19.0 value = 0.999 ORMH = 9.0
Test
Test of
of homogeneity
homogeneity of
of odds ratios :: p-value
odds ratios p-value == 0.999
0.999 ; OR
ORMH = 9.0 (95%CI: 5.2 15.4)
MH = 9.0 (95%CI: 5.2 15.4)
Test of homogeneity of
odds ratios Stratum-specific odds
ratios
ORMH ORC
(9.0 5.4 )
Confounding effect
Confounder

ORMH

"
12

1.14
Output STATA
(p-value < 0.001)

SEX ||
SEX OR
OR [95%
[95% Conf.
Conf. Interval]
Interval] M-H
M-H Weight
Weight
-----------------+-------------------------------------------------
-----------------+-------------------------------------------------
11 || 99 4.241913
4.241913 19.04442
19.04442 2.5
2.5
9 (95%CI: 5.2
22 || 99 4.241913
4.241913 19.04442
19.04442 2.5
2.5 -----------------+----------------------
-----------------+----------------------
---------------------------
---------------------------
Crude ||
Crude 5.444444
5.444444 3.5527
3.5527 8.343513
8.343513
15.4)"
M-H combined ||
M-H combined 99 5.251333
5.251333 15.42465
15.42465
-----------------+-------------------------------------------------
-----------------+-------------------------------------------------
Test
Test of homogeneity (M-H)
of homogeneity (M-H) chi2(1) ==
chi2(1) 0.00 Pr>chi2 == 1.0000
0.00 Pr>chi2 1.0000
p-value Mantel-
Test
Test that
that combined OR == 1:1:
combined OR
Mantel-Haenszel chi2(1) ==
Mantel-Haenszel chi2(1)
Pr>chi2 ==
Pr>chi2
75.81
75.81
0.0000
0.0000
Haenszel chi-square test ORMH
1

STATA ( 1)
1.15
Confounding Effect Confounding Effect
E D
(ORC)
ORc X
ORMH
ORMH ORMH
OR
C
2.2.2. Interaction effect

1.16
p-value < 0.05
Stratum Specific Odds Ratio
Stratified analysis (3) Heterogeneity of
Test of homogeneity of OR p-value < 0.05 odds ratio Interaction effect
p-value > 0.05 Stratum Specific OR
E D
Heterogeneity of Odds Ratio C C Effect
Interaction effect
modifier E D
ORMH OR Stratum

13
1.17 (SMK)
Interaction Effect
CHD (CHD)
1 0
1 75 60 ORc = 1.5 1.5
SMK 95%CI = 0.9 2.4
0 75 90
(ACT)
CHD CHD
1 0 1 0
1 50 50 1 25 10
1
SMK SMK
50 50 25 40 4
0 0
OR1 = 1.0 OR2 = 4.0
95%CI = 0.6 1.7 95%CI = 1.7 9.6 (SMK)
Test
Test of
of homogeneity
homogeneity of
of odds ratios : p-value
odds ratios p-value == 0.009
0.009 ;; OR
ORMH = 1.5 (95%CI: 0.9 2.4)
MH 1.5 (95%CI: 0.9 2.4)
(CHD)
(ACT)
C
Interaction effect E D Effect
Modifier
Effect Modifier
(SMK)
(CHD)
1.18
Output STATA

(SMK)
ACT
ACT || OR
OR [95%
[95% Conf.
Conf. Interval]
Interval] M-H
M-H Weight
Weight
-----------------+-------------------------------------------------
-----------------+-------------------------------------------------
11 ||
22 ||
11
44
.5754505
.5754505
1.663145
1.663145
1.737769
1.737769
9.596975
9.596975
12.5
12.5
2.5
2.5
(CHD)
-----------------+-------------------------------------------------
-----------------+-------------------------------------------------
M-H
Crude ||
Crude
combined ||
M-H combined
1.5
1.5
1.5
1.5
.9504315
.9504315
.949093
.949093
2.367332
2.367332
2.370685
2.370685
(ACT)
-----------------+-------------------------------------------------
-----------------+-------------------------------------------------
homogeneity (M-H) chi2(1) == 6.75 Pr>chi2 == 0.0094
Test
Test of
of homogeneity (M-H) chi2(1) 6.75 Pr>chi2 0.0094
STATA (
Test
Test that
that combined OR == 1:1:
combined OR
Mantel-Haenszel chi2(1) ==
Mantel-Haenszel chi2(1) 3.07
3.07
Pr>chi2 ==
Pr>chi2 0.0796
0.0796 1)
1.19 Interaction effect

Interaction Effect E D
Crude Odds Ratio
ORc
X Stratum Specific Odds Ratio
OR1
OR2
...
ORn Effect Modifier
ORMH Adjusted Odds Ratio
Note : Interaction effect

(ORMH)
14

E Risk effect ( OR
1) C=1
Protective effect ( OR 1)
C=2
C

C
1.20

ORc Confounding
Interaction effect Confounder Effect
Modifier

Confounder

E D
Effect Modifier
Stratified analysis
E
D Dichotomous
C Dichotomous
Polytomous 2
Strata
C
3. Logistic regression
1.21
Confounding effect
Interaction effect
Logistic Regression Logistic Regression

Confounder
Model Confounder Logistic regression
model
OR Model OR Adjusted Odds
Adjusted Odds Ratio
Ratio
Interaction effect Interaction effect

15
1.22
E D : Crude Analysis E D
E,C D : Stratified Analysis Crude
E, C1, C2,,Cn D :?
analysis
:
C1 = AGE (C)
C2 = OCC
C3 = SEX Stratified analysis
E, C1, C2,,Cn D

C
Logistic Regression Analysis
1 (AGE)
(OCC) (SEX)

Stratified analysis
Logistic Regression
1.23 Model OR
Logistic Regression Model Model
95% CI
Logit P(D=1) = + ()

OR Logistic regression

STATA
1.24
(
Confounding effect Crude analysis STATA OR 95%CI
. cc CHD SMK
| SMK
| Exposed Unexposed |
|
Total
Proportion
Exposed
)
-----------------+------------------------+----------------------
Cases |
Controls |
140
60
60 |
140 |
200
200
0.7000
0.3000

-----------------+------------------------+----------------------
Total |
|
200 200 |
|
400 0.5000 (SMK)
| Point estimate | [95% Conf. Interval]
|------------------------+----------------------
Odds ratio | 5.444444 | 3.5527 8.343513 (Cornfield) (CHD) (SEX)
Attr. frac. ex. | .8163265 | .7185239 .8801464 (Cornfield)
Attr. frac. pop | .5714286 |
+-----------------------------------------------
chi2(1) = 64.00 Pr>chi2 = 0.0000
Confounder
Crude analysis
ORC = 5.4
16
1.25 Crude analysis Logistic

Confounding effect Univariate Logistic regression regression (
STATA ( Crude analysis)
SMK) Model
. logistic CHD SMK
Logit estimates Number of obs = 400 ORC = 5.4 ( CHD

LR chi2(1) = 65.83
Prob > chi2 = 0.0000
Log likelihood = -244.34572 Pseudo R2 = 0.1187 Model )
------------------------------------------------------------------------------
CHD | Odds Ratio Std. Err. z P>|z| [95% Conf. Interval]
---------+--------------------------------------------------------------------
SMK | 5.444444 1.188075 7.766 0.000 3.549819 8.350279
------------------------------------------------------------------------------

Confounding effect Stratified analysis STATA SEX Stratified variable
. cc CHD SMK, by(SEX)
SEX | OR [95% Conf. Interval] M-H Weight

ORMH = 9.0 OR
-----------------+-------------------------------------------------
1|
2|
9
9
4.241913 19.04442
4.241913 19.04442
2.5 (Cornfield)
2.5 (Cornfield)
SMK CHD
-----------------+-------------------------------------------------
Crude | 5.444444
M-H combined | 9
3.5527 8.343513
5.251333 15.42465
(Cornfield) SEX
-----------------+-------------------------------------------------
Test of homogeneity (M-H) chi2(1) = 0.00 Pr>chi2 = 1.0000
Test that combined OR = 1:

Mantel-Haenszel chi2(1) = 75.81
Pr>chi2 = 0.0000
1.27 Multiple logistic regression

ORSMK = 9.0
Confounding effect Multiple Logistic regression
STATA ( Stratified analysis)
Model SMK
. logistic CHD SMK SEX
SEX OR
Logit estimates Number of obs = 400
LR chi2(2)
Prob > chi2
=
=
81.40
0.0000
SMK CHD
Log likelihood = -236.55918 Pseudo R2 = 0.1468
------------------------------------------------------------------------------
SEX
CHD | Odds Ratio Std. Err. z P>|z| [95% Conf. Interval]
---------+--------------------------------------------------------------------
SMK | 9 2.473863 7.994 0.000 5.251333 15.42465
SEX | .36 .0989545 -3.717 0.000 .2100533 .6169862
------------------------------------------------------------------------------
17
1
. (2541). .
. 3(3) :20-25.
Fleiss, J.L. (1981). Statistical methods for rates and proportions. 2nd edition. New York: John
Willey & Sons.
Kleinbaum, D.G., Kupper, L.L., and Morgenstern, H. (1982). Epidemiologic research: principles
and qualitative methods. London: Lifetime Learning Publications.
18
1
1. 1 1.24 1.27
1.13 STATA
1.1

STATA
STATA
MALE FEMALE sex smk chd n
CHD+ CHD- Total CHD+ CHD- Total 1 1 1 50
SMK+ 50 10 60 SMK- 90 50 140
SMK- 50 90 140 SMK- 10 50 60 1 1 0 10
Total 100 100 200 Total 100 100 200 1 0 1 50
1 0 0 90
2 1 1 90
2 1 0 50
SEX 1=Male, 2=Female 2 0 1 10
SMK 0=No, 1=Yes 2 0 0 50
CHD 0=No, 1=Yes
001
400

1. SEX [ ]
[ ]1. [ ]2.
2. SMK [ ]
[ ]0. [ ]1.
3. CHD [ ]
[ ]0. [ ]1.
19
1.2
STATA ( STATA
STATA )
1.2.1 STATA
((MMeennuu BBaarr))

((IIccoonn BBaarr))

1.2.2
.edit <ENTER> STATA Editor
1.2.3 1.1
( STATA var<X> X 1
) STATA Editor

20
1. Edit icon 2. 3. Double click
4. 5. OK 6. Data Editor
1.2.4 1 record ( n ) 1 record
.expand n <ENTER>
.drop n <ENTER> n
1.2.5
.list <ENTER>
: . records
1.2.6 Save save <ENTER>

.save example1 <ENTER> EXAMPLE1.DTA
1.3 1.24 1.27
21
2. 1.17
2.1 STATA
STATA
EXERCISE+ EXERCISE-
CHD+ CHD- Total CHD+ CHD- Total

SMK+ 50 50 100 SMK+ 25 10 35
SMK- 50 50 100 SMK- 25 40 65
Total 100 100 200 Total 50 50 100
001
.

2.2 STATA EXAMPLE2.DTA
2.3 1.18
: ..
2.5 Logistic regression 2.3

: ..
22
3. ANC
()
Cohort Study
()

28
1 939 944
65 28
(Neonatal death) 400 ( LOGISTIC.DTA
)
ID DEAD AREA MALPRES BWT MAGE DCHILD

1 1 1 0 2600 30 0
2 1 1 0 2900 29 1
3 1 1 0 3100 25 0
4 1 1 0 3000 21 0
----------------------- 460 -------------------------
465 0 1 0 3200 22 1
LOGISTIC.DTA

ID 1 465
DEAD 28 0= 1=
AREA 0= 1=
MALPRES 0= 1=
BWT ()
MAGE ()
DCHILD
()
3.1 3.7
3.1 Dichotomous
23
.................................................................................................. ......................................
3.2 Continuous
........................................................................................................................................
3.3 (D)
..................................................................................................................
3.4 (E)
..........................................................................................................
3.5 (C)
......................................
3.6
(
)
.

1. 28 DEAD[ ]
[ ]1. [ ]0.
2. AREA[ ]
[ ]1. [ ]0.
3. MALPRES[ ]
[ ]1. [ ]0.
4. ................ BWT[ ][ ][ ][ ]
5. .................................... AGE[
][ ]
6. DCHILD[ ]
..........
3.7
24
3.8 3.9 ( Odds Ratio

Relative risk Cohort study
Logistic regression)
3.8 Crude (Bivariate) analysis
3.8.1
DEAD

37 204
AREA 28 196
ORC =
3.8.2 STATA
. cc dead area
| area | Proportion
| Exposed Unexposed | Total Exposed
-----------------+------------------------+----------------------
Cases | 37 28 | 65 0.5692
Controls | 204 196 | 400 0.5100
-----------------+------------------------+----------------------
Total | 241 224 | 465 0.5183
| |
|------------------------+----------------------
Odds ratio | 1.269608 | .7512221 2.145309 (Cornfield)
Attr. frac. ex. | .2123552 | -.3311642 .5338668 (Cornfield)
Attr. frac. pop | .1208791 |
+-----------------------------------------------
chi2(1) = 0.79 Pr>chi2 = 0.3754

3.9.1 Stratified analysis MALPRES Stratified variable
3.9.1.1
Stratum 1 MALPRES = 0 Stratum 2 MALPRES = 1
DEAD DEAD

18 196 19 8
ARE 26 190 ARE 2 6
OR1 = OR2 =
Woolfs test for heterogeneity of Odds Ratios

25
p-value = 0.015 ( Computer output 3.9.1.2)
3.9.1.2 STATA
. cc dead area, by(malpres)
malpres | OR [95% Conf. Interval] M-H Weight

-----------------+-------------------------------------------------
0 | .6711146 .3590862 1.254787 11.85116 (Cornfield)
1 | 7.125 1.297704 37.58284 .4571429 (Cornfield)
-----------------+-------------------------------------------------
Crude | 1.269608 .7512221 2.145309 (Cornfield)
M-H combined | .9108184 .5136778 1.615001
-----------------+-------------------------------------------------

Pr>chi2 = 0.7453
3.9.1.3
ORC = ......................................
OR1 = ......................................
OR2 = ......................................
Woolfs test p-value = ................
ORMH = ......................................
3.9.1.4
3.9.2 Stratified analysis DCHILD Stratified variable DCHILD

2
3.9.1
3.9.2.1
DCHILD = 0 DCHILD = 1 ()
DEAD DEAD DEAD

167 21 29 7 196 28
170 17 34 20 204 37
26
OR1 = OR2 = . ORC = 1.27
3.9.2.2 STATA
. replace dchild = 1 if dchild > 1 & dchild ~= .

(22 real changes made)
. cc dead area, by( dchild)
dchild | OR [95% Conf. Interval] M-H Weight

-----------------+-------------------------------------------------
0 | .7952381 .4090156 1.546609 9.52 (Cornfield)
1 | 2.436975 .9184562 6.424761 2.644444 (Cornfield)
-----------------+-------------------------------------------------
Crude | 1.269608 .7512221 2.145309 (Cornfield)
M-H combined | 1.152137 .6695645 1.982513
-----------------+-------------------------------------------------

Pr>chi2 = 0.6098
3.9.2.3
ORC = ......................................
OR1 = ......................................
OR2 = ......................................
ORMH = ......................................
3.9.2.4
3.9.3 Stratified analysis BWT Stratified variable

BWT 3.9.1 BWT

1 = 2500
2 = 2500-2999
27
3 = 3000
3.9.3.2 STATA
. gen bwtg = .
(465 missing values generated)
. replace bwtg = 1 if bwt < 2500
. replace bwtg = 2 if bwt >= 2500 & bwt < 3000
. replace bwtg = 3 if bwt >= 3000
. cc dead area, by(bwtg)
bwtg | OR [95% Conf. Interval] M-H Weight

-----------------+-------------------------------------------------
1 | .49 .1209808 1.95487 2.564103 (Cornfield)
2 | 2.097917 .8631402 5.078711 3.428571 (Cornfield)
3 | .8043011 .3620455 1.788335 6.503497 (Cornfield)
-----------------+-------------------------------------------------
Crude | 1.269608 .7512221 2.145309 (Cornfield)
M-H combined | 1.094738 .6363404 1.883351
-----------------+-------------------------------------------------

Pr>chi2 = 0.7438
3.9.3.3)
ORC = ......................................
OR1 = ......................................
OR2 = ......................................
OR3 = ......................................
ORMH = ......................................
3.9.3.4
3.10 Multivariable analysis

28

Logistic Regression
2
:
1. Multivariable analysis
2. Simple Linear Regression Logistic Regression
3. Logistic Model
4. Odds Ratio (OR) Logistic Model
:
1. Logistic Regression Model
2. Logistic Regression Model
1. 1
2.
3.
29

1. Logistic Model
1
2.1
(E)
E D
E,C1 D (D) (C)
E,C1,C2,C3 D

X
X1, X2, ... Xk D (Product term)
:
X1 = E X4 = E*C1 X
X2 = C1 Main effect X5 = C1*C2 Product
term
X3 = C2 X6 = E 2 ()
X1 1 X2 2
Xk K
6 X1
E X2 C1 X3 C2
X4 E C1 X5
C1 C2 X6
E
X4 X5 X6 Product term
X4 X5 Interaction term
Interaction effect
C1 C2 Product term

2.2
(Multi-factorial Outcome)
X1, X2,, XK D
(Mathematical model)
Mathematical Model
(D)
Logistic Model D Dichotomous Dichotomous
Logistic Model
30
2.3
Y = a + bX
Intercept
(Simple Linear Regression)
() (Slope ) Y = a + bX a Y
Y
Y X 0 Y
y = a+bX Intercept
Simple Linear Regression
a
X Slope b
Y +
Y X
0 Y +1 Y -
(, )
+
Y
Dichotomous 2 1
0
Dichotomous

0 1
2.4
Logistic
Logistic Function 1
1 function f(z) = 1/(1+e-z)

f ( z) =
1 + ez
1
2
plot Z

S 0 1
0
Z +
0 f(z) 1
e-z= 2.7183-z
= Exponential(-z)
= EXP(-z)
31
2.5 Logistic Model Logistic

function Z
Z = a +b1X1 +b2X2+...+ bkXk
Z Logistic
1
f ( z )=
1 function f ( z) = Logistic
1 + ez 1 + ez
1 1
=
Model f ( z)=
1+ e
( a + bi xi )
1 + e ( a +b1 x1 + b2 x2 +...+bk xk )
1 f(z)
= ( a + bi xi )
1+ e P (D=1
P (Y = 1 | X 1 , X 2 ,..., X k X k )= P ( X )
X1, X2,..., Xk)
P(X) X
2.6
Logistic Model : Logistic Model
f (z) =
1 P(X)= 1/[1+e-(a+bixi)]
1+ e(a+ bixi )

a
(Constant) bi
a : (Constant)
b : (Coefficient) (Coefficient)
(Estimation)
Fit Model
Maximum Likelihood
Fit Model

Maximum Likelihood
2. Logistic Model
2.7 ( Kleinbaum, 1994)
Cohort Study

609
Logistic Model
(CHD) Dichotomous
Y = CHD(0,1) 0 1
X 1 = SMK(0,1) 3 (SMK)
X 2 = AGE() 1 0 1
P ( X )=
X 3 = ECG(0,1) 1 + e ( a + b1 SMK + b2 AGE + b3 ECG )
n = 609
(AGE)
9 Electrocardiogram (ECG) 0
1
Logistic Model :
32
1
P( X ) =
1 + e ( a+ b1SMK + b2AGE+ b3 ECG )
a b
Maximum Likelihood

Logistic Regression SAS,
BMDP, SPSS, STATA, GLIM, EGRET
STATA ( StataCorp.,
1999)

a = -3.911 b1 = 0.652
b2 = 0.029 b3 = 0.342
2.8 Logistic
1
P( X )= Model
-[-3.991+ 0.652(SMK) + 0.029( AGE) + 0.342(ECG)]
1+ e
SMK =?

AGE =? P(X) CHD SMK AGE
ECG =?
SMK = 1 AGE = 40 ECG = 0
ECG Model
1
P(X) = -(-3.991+ 0.652(1)+ 0.029(40)+ 0.342(0))
1+ e
1 1 Predicted Risk
= -(-2.101) = 1+8.173 = 0109 . 109 1,000
1+ e 40 ECG
SMK = 0 AGE = 40 ECG = 0 ( SMK)
P(D) = 0.06 60 1,000 SMK=1
P(X) Smoker 0.109
=
P(X) Non - smoker 0.06
= 1.82 = Relative Risk (RR.) AGE=40 ECG=0 Model
0.109
0.109
40 ECG
1000
109 9 (follow-up time)

(SMK=0) AGE ECG
0.06 60
1000
(Ratio) Risk
Risk

0.109/ 0.060=1.82
Risk Ratio Relative Risk (RR.)
33
RR.
ECG (Adjusted RR.)
2.9 RR.
MEASURE OF ASSOCIATION (Direct measure)
Logistic Regression Model
Direct Method Indirect Method
Cohort study
RR () OR ( RR)
Cohort study X
(Cohort / Cross-sectional / Case-control)
Logistic Model Logistic Model
OR
Cohort X X Cohort
P( X1 ) OR. = ebi (X1i X0 i )
RR. =
P( X 0 ) study Case-control Cross-
( a ) ( a )
P(X) P(X)
sectional study
X
OR
RR.
()

OR RR.
RR.
Case-
control Cross-sectional
(a)

RR.

2.10
OR Logistic Model
: OR Logistic
k
b (X X )
OR X1 X O = e i=1 i 1i 0 i
: Regression Model Odds
1
P( X ) = (a + bi x i ) Logistic Model Odds
1+ e
Logit transformation
P(X)
Logit P(X) = ln

= ln Odds
1 - P(X)
P(X) 1/[1 + e ( a + b i X i ) ]
(Ratio) Logistic function
Logit P(X) =a + b X Logit Model
i i
ln Odds = a + b X
a+b X
i i (Linear sum)
Odds = e i i
Logit P(X) = a+biXi
Logit P(X) Log e
34
Natural Log Odds (ln

)
log
Exponential e ea+biXi
Exponential a+biXi
Odds
2.11 ( 10) Odds Ratio

odds X 1
Odds Exponential
OR X X = Exponential (ea/eb) =
1 0 odds X 0
ea-b OR
e( a + b i X 1i )
= Logistic Regression Model OR X1
e( a + b i X 0i )
]
= e[( a + b i X 1i ) ] [( a + b i X 0i )
X0 Exponential
bi(x1i-X0i)
= e ( a a + b i (X 1i X 0 i )
b (X X )
OR
OR X X = e i 1i 0 i
b i ( X1 i X 0 i )
1 0
OR X1 X 0 = e
2.12 OR Logistic
OR
Regression Model X
X = (SMK, AGE, ECG) X1
X1 = (SMK =1, AGE =40, ECG =0)
X0 = (SMK =0, AGE =40, ECG =0)
40 ECG
X0
fixed
Logit P(X) = a + b1SMK + b2AGE + b3ECG ECG
k
b (X X )
OR X X = e i=1 i 1i 0 i
OR X1
1 O
= e b1 +0+ 0 X0 AGE ECG
= e b1
b1 = 0.652 e 0.652 = 1.92 OR = 1.92
SMK
1-0 1 b1
b1 Exponential b1 OR
(SMK)
(CHD)
AGE ECG
X1 X0
35
2
Kleinbaum, D.G. (1994). Logistic Regression: A self-learning text. New York Springer-Verlag.
StataCorp. (1999). Stata statistical software: Release 6.0. College Station. TX: Stata
Corporation.
36
2
1. 2 3
1.1) Logistic Function :
1.2) Logistic Model :
1.3) Logit transformation :
2. Odds Ratio (OR) Bivariate model

2.1) OR Logistic Model
()
Cohort study
Case-control study
Cross-sectional Study
Output STATA
. logit dead area
Iteration 0: log likelihood = -188.1264


LR chi2(1) = 0.79
Prob > chi2 = 0.3745
------------------------------------------------------------------------------
dead | Coef. Std. Err. z P>|z| [95% Conf. Interval]
---------+--------------------------------------------------------------------
area | .2387081 .2697124 0.885 0.376 -.2899185 .7673346
_cons | -1.94591 .2020295 -9.632 0.000 -2.341881 -1.54994
------------------------------------------------------------------------------
2.2) OR
(i) ORx1,Xo =
37
(ii) X1 =.
X0
=.
(iii) ORX1,X0 =
STATA
. logistic dead area

LR chi2(1) = 0.79
Prob > chi2 = 0.3745
------------------------------------------------------------------------------
dead | Odds Ratio Std. Err. z P>|z| [95% Conf. Interval]
---------+--------------------------------------------------------------------
area | 1.269608 .342429 0.885 0.376 .7483246 2.154017
------------------------------------------------------------------------------
(iv) .............................................................
2.3) 2 x 2
DEAD
1 0
1
AREA
0 OR = ............................................
2.4) Logistic Model 2 x 2

2.5) Logistic Model Logit transformation

38
3. Odds Ratio (OR) Multivariable model

3.1) STATA AREA DEAD
DCHILD
. logit dead area dchild


LR chi2(2) = 20.56
Prob > chi2 = 0.0000
------------------------------------------------------------------------------
---------+--------------------------------------------------------------------
area | .1419709 .2775134 0.512 0.609 -.4019454 .6858872
dchild | 1.321847 .287817 4.593 0.000 .7577363 1.885958
_cons | -2.255301 .2251246 -10.018 0.000 -2.696537 -1.814065
------------------------------------------------------------------------------
3.2) OR
(I) ORx1,Xo =
(ii) DCHILD X1 =..........................
DCHILD X0 =..........................
(iii) ORx1,Xo =
STATA
. logistic dead area dchild

LR chi2(2) = 20.56
Prob > chi2 = 0.0000
------------------------------------------------------------------------------
---------+--------------------------------------------------------------------
area | 1.152543 .3198462 0.512 0.609 .6690173 1.985533
dchild | 3.750343 1.079412 4.593 0.000 2.133441 6.592668
------------------------------------------------------------------------------
(iv)
39
3.3) Logistic Model Stratified analysis 1 3.9.2.2

4. 1 3.9.2.1 Stratified analysis AREA

DEAD MALPRES Logistic Regression
Model ( Logit transformation)
5. Output STATA logistic logit

( http://www.ats.ucla.edu/stat/stata/output/lognoframe.htm 2 2544)
( A N )
40
. logistic hicrime maleteen south educ police59
Logit estimates Number of obsA = 47

LR chi2(4)B = 13.93
Prob > chi2C = 0.0075
Log likelihoodD = -18.606959 Pseudo R2E = 0.2724
------------------------------------------------------------------------------
hicrimeF | Odds RatioB Std. Err.H zI P>|z|J [95% Conf. Interval]K
---------+--------------------------------------------------------------------
maleteen | 1.086959 .0478646 1.894 0.058 .9970804 1.184939
south | .3272305 .4449077 -0.822 0.411 .0227796 4.70068
educ | 1.023187 .5723757 0.041 0.967 .3418133 3.062818
police59 | 1.059909 .0222633 2.770 0.006 1.01716 1.104455
------------------------------------------------------------------------------
. logit
Logit estimates Number of obsA = 47

LR chi2(4)B = 13.93
Prob > chi2C = 0.0075
Log likelihoodD = -18.606959 Pseudo R2E = 0.2724
------------------------------------------------------------------------------
hicrimeF | Coef.L Std. Err.M zI P>|z|J [95% Conf. Interval]N
---------+--------------------------------------------------------------------
maleteen | .0833837 .0440353 1.894 0.058 -.0029239 .1696914
south | -1.117091 1.359616 -0.822 0.411 -3.781888 1.547707
educ | .0229224 .5594047 0.041 0.967 -1.073491 1.119335
police59 | .0581834 .0210049 2.770 0.006 .0170147 .0993522
_cons | -17.70177 9.495993 -1.864 0.062 -36.31357 .9100364
------------------------------------------------------------------------------
[A] This is the number of observations being analyzed.
[B] This is the likelihood ratio chi-square with 4 degrees of freedom. One degree of freedom is used for each
predictor variable in the logistic regression model. The likelihood-ration chi-square is defined as 2(L1 - L0),
where L0 represents the log likelihood for the "constant-only" model and L1 is the log likelihood for the full
model with constant and predictors. In this example, L0 = -25.573407 (which doesn't show up in the output)
and L1 = -18.606959 (which is found in item d below). Thus, the likelihood-ratio chi-square = 2*(-
25.573407 - (-18.606959)) = 13.93.
[C] This is the p-value associated the chi-square with 4 degrees of freedom. The value of .0075 indicates that the
model as a whole is statistically significant.
41
[D] This is the values of the log likelihood for the model including the constant and all of the predictors that was
computed using the maximum-likelihood logit model.
[E] Technically, R2 cannot be computed the same way in logistic regression as it is in OLS regression. The pseudo-
R2, in logistic regression, is defined as (1 - L1)/L0, where L0 represents the log likelihood for the "constant-
only" model and L1 is the log likelihood for the full model with constant and predictors.
[F] This column starts with the name of the response variable (hicrime) and then lists the names of the predictor
variables (maleteen south educ police59).
[G] The odds ratio column gives the amount of change expected in the odds ratio when there is a one unit change in
the predictor variable with all of the other valiables in the model held constant. An odds ratio close to 1.0 suggest
that there is no change due to the predictor variable.
In this example, the odds ratio for police59 is 1.059909. Thus, you would predict that the odds ratio would
change by 1.059909 for every one unit change in police59 when maleteen, south and educ are held constant.
For a more detailed explanation of odds rations see the Stata FAQ: How do I interpret odds ratios in logistic
regression?
[H] The standard error for the odds ratio is obtained from the logistic regression coefficient and its standard error using
the formula:
se(odds ratio) = exp(coef.)*se(coef.)
[I] This column contains the z-statistic testing the logistic coeffieient.
In the case of the logit command, z = (coef.)/(Std. Err). For this example, z(police59) = .0581834/.0210049
= 2.770.
Stata uses the same z-test value computed for the logistic coefficient as the test of the odds ratio.
[J] This column contains the two-tail p-value for the z-test. Stata uses the same p-value computed testing the
hypothesis, H0: b = 0, for both the logistic coefficients and for the odds ratios.
[K] This column contains the 95% confidence intervals for the odds ratios. Significant effects are suggested when
confidence intervals do not contain 1.0. In this example, the only interval that would be considered significant at
the .05 level is the one for police59. All of the other confidence intervals contain the value 1.0.
42
[L] The coefficient column gives the values for the logistic regression coefficients. These coefficients indicate the
amount of change expected in the log odds when there is a one unit change in the predictor variable with all of the
other variables in the model held constant. A coefficient close to 0 suggest that there is no change due to the
predictor variable.
There is a relationship between the logistic coefficients and the odds ratios, odds ration = exp(coefficient). In this
example the logistic coefficienct for police59 is .0581834, exp(.0581834) = 1.0599094, which is very close
to the value of the odds ratio for police59.
Also in this example, the logistic coefficient for police59 is .0581834. Thus, you would predict that the log odds
for hicrime would change by .0581834 for every one unit change in police59 when maleteen, south and educ are
held constant.
The logistic coefficients can be used in a manner very similar to regression coefficient to generate predicted values.
In this example,
predicted = -17.70177 + .0833837*maleteen -1.117091*south + .0229224*educ + .0581834*police59
You would get the same results in you used the predict command with the xb option.
[M] This column contains the standard error for the logistic regression coefficient which is used to compute the z-test
for the coefficient.
[N] This column contains the 95% confidence intervals for the logistic regression coefficients. Significant effects are
suggested when confidence intervals do not contain 0. In this example, the only interval that would be considered
significant at the .05 level is the one for police59. All of the other confidence intervals contain the value 0.
43
Odds Ratio Logistic Regression Model

:
3
1. Odds Ratio Logistic Regression
2. Odds Ratio Logistic Model
3. Odds Ratio
:
1.
2. Odds Ratio Model Main effect Additive model
2.1) (Categorical Variable)
2.1.1) 2 (Dichotomous)
2.1.1.1) 0,1
2.1.1.2) (Arbitrary coding of E)
2.1.2) 2
2.2) (Ordinal Scaled Variable)
2.3) (Continuous variable)
2.4) Odds Ratio Exposing factor
3. Odds Ratio Model Interaction term Multiplicative model
3.1) Interaction term (Second order term)
3.2) Interaction term (Third order term)
:
1. 1
2.
3.
44

1.
3.1
Odds Ratio Logistic

OR
Logistic Regression
Regression
Adjusted OR (Magnitude of association)
Logistic Model
E, C1, C2, ..., Ck D

(E)
( ) (D)

OR
Adjusted OR. Logistic Regression
C1, C2,..., Ck E
D OR. E
Model Adjusted OR
3.2 OR
:
Risk Profile 2
OR X 1 ,X 0 = e bi (X 1i X 0 i ) Risk Profile

Risk Profile 2
Model
X = (E, C1, C2,..., Ck) Risk Profile

X1 = (E = 1, C1 =?, C2 =?,..., Ck =?)
D
X0 = (E = 0, C1 =?, C2 =?,..., Ck =?) (Fixed)
E Risk
Profile (X1) (X0)
C1 C2
Ck
(Unspecified but fixed)
Ci
E Dichotomous
45
1 Risk Profile Risk

Profile
3.3

(Reference) O
Model : Risk Profile OR
Logit P(X) = a + b1E + b2C1 + b3C2 + + bk+1Ck Ci 0
Risk Profile OR
E
OR = eb1(1 0) + b2(??) + b3(??)+...+bk +1(??)
OR = eb1(1) + b2( 0) + b3( 0)+...+bk +1( 0)
OR = eb1 OR
OR = Exponential Model :-
E (0,1) (Dichotomous Variable)
E Dichotomous
Model Main effect (E, C1, C2, ..., Ck) Interaction term Model ( Interaction
Interaction term ( E*C1, E*Ck ) effect) Model
Main Effect
2. OR Additive Model
3.4

Model :
Logistic Model
Logit P(X) = a + b1E + b2c1 + b3c2 + ... + bk+1ck
E = x1, c1=x2, c2=x3 ,... ck=xk+1 Xi X1 Xk
K
Logit P(X) = a + b1x1 + b2x2 +... + bkxk OR
OR Xi X
OR X1 , X0 = e bi (X 1i X 0 i ) Risk Profile X
2 OR
Logistic Regression Model Main
effect
Model Additive
model OR

46
2.1
0,1
OR Model
Main effect
Dichotomous
0 (Non-exposed)
1 (Exposed)
3.5
OR Exponential

OR Model
Additive Model X Dichotomous
X 0 1

Logit P(X) = a + b1x1 + b2x2 +... + bkxk x(0,1)
OR Exponential
OR = eb
:-
SMK
Logit P(X) = -3.991 + 0.652SMK + 0.029AGE + 0.342ECG 0.652 OR 1.92
ORSMK=1 = e0.652
= 1.92 ECG

ORECG=1 = e0.342
ECG
1.92
= 1.40

1.9
ECG

2.2
0,1
3.6
OR (Arbitrary coding of E)
Additive Model X Dichotomous
X 0 1 0 1 1 -1
: X(1,-1)
1 (Exposed)
Logit P(X) = -6.7727 + 0.3260SMK + 0.0322AGE + 0.0087ECG -1 (Non-exposed)
SMK = 1
= -1 OR X1
ORSMK=1 = e0.3260(1-(-1))
X0 1 2
= e0.3260(2)
= e0.652 ( 1-(-1) 1+1 2)
= 1.9 ( OR. Model 0,1) Exponential
OR
Model 0 1
47
3.7 Logistic
Regression Model
Coding OR
. E(0,1) OR = eb
. E(1,-1) OR = e2b
. E(100,0) OR = e100b
Model OR

2.3
3.8
OR (E)
Additive model X (Categorical variable)
X 2
2 Polytomous
X q OR q-1
: X = 1 = variable 4 (Categories)
2 = E
3 =
4 =
D OR
X 4 (q = 4)
Dummy variable = q - 1 = 4 - 1 = 3 (Reference group) OR
q-1 q
E E
q-1 Model
Dummy Variable
Fit model

Dummy Variable

Dummy variable
48
3.9
Dummy Variable Fit Models Dummy Variable

E1 E2 E3 Dummy Variable
(OCC) 4
0 0 0 , , ,
1 0 0

Dummy Variable 3
0 1 0
0 0 1 E1 (1= 0=) E2(1=
0=) E3 (1=
Logit P(X) = a+b1E1+b2E2+b3E3+b4C
. Reference group 0=) Fit Model
OR.E1 =1 = eb1 E1 E2 E3 Model
OR.E2 =1 = eb2 etc.
OCC
Fit Model E1 E2
E3 0
E1 1 0

(Reference group) 0
Dummy Variable
Dichotomous Variable
OR
E(0,1)
Exponential

Reference group
OR
3.10 Exponential

. Reference group
( : ea=Exp(a)

: E3 E1
X1 = (E1=0, E0=0, E3=1, C=0) OR Risk profile
X0 = (E1=1, E2=0, E3=0, C=0)

ORE3,E1 = Exp [a+b1(0-1)+b2(0-0)+b3(1-0)+b4 (0-0)] Dummy
= Exp [a+b1(-1)+b2(0)+b3(1) +b4 (0)]
= Exp (b3 -b1) Variable
= e b3 b1
OR E 1 OR E 1
49
3.11 OR
2
Polytomous Model

:
= CHD (MAR)
= MAR (1 , 2 , 3 , 4 )
= SEX (1 = , 2 = ) 4
= AGE ()
= SMK (0=, 1=) Dichotomous (AGE)
Model :

Logit P(X) = a + b1MAR + b2SEX + b3AGE + b4SMK X
Logit P(X) = a + b1MAR1 + b2MAR2 + b3MAR3 + b4SEX + b5AGE + b6SMK

Dummy variable Model
MAR
(SEX)
(AGE) (SMK)
MAR

3.12 X Polytomous
Dummy Variable Fit Model
1. Polytomous
= CHD
= MAR (1 , 2 , 3 , 4 )
= SEX (1 = , 2 = )
= AGE ()
(MAR) 3 Model
= SMK (0=, 1=)

2. Dummy variable
(Dummy variable) : MAR1 MAR1 MAR1

{ MAR =
MAR =
MAR =
MAR =
Reference group
1
0
0
0
0
1
0
0
0
0
1
0
Dummy Variable
3. Fit Model Logit P(X) = a + b1MAR1 + b2MAR2 + b3MAR3 + b4SEX + b5AGE + b6SMK
Partial method
Reference cell coding

(Reference group)

()
50
3.13 OR
OR
ORMAR1 Exponential
ORMAR1 = eb1
MAR1 eb1
( SEX, AGE SMK )
OR

X1 = (MAR1=1,MAR2=0, MAR3=0, SEX, AGE, SMK)
X0 = (MAR1=0,MAR2=0, MAR3=1, SEX, AGE, SMK)
[eb1 ]

ORX1,X0 = ORMAR1, MAR3

= eb1-b3
ORMAR1,MAR3 Exponential
(b1)
Note: Fit Model : (b3)
- > 2 categories
- Dummy variable

- Reference group [eb1-b3 ]

2.4

(Ordinal Variable)
(Social Support
3.14 Status) SSU

OR
Additive Model X (Ordinal variable)
:
0
Logit P(X) = a + b1SSU + b2SEX + b3AGE
SSU = (Social Support Status) 4
0=, 1=, 2=, 3=, 4=
OR
ORssu=2, ssu=0 = EXP [b1(2-0)]
= 2b1
e .... Fixed AGE SEX SSU MAR
OR
ORssu=4, ssu=2 = EXP [b1(4-2)]
= 2b1
e ..... Fixed AGE SEX SSU
: OR SSU CHD
SSU Polytomous
MAR
SSU
(CHD)
51
SSU Model
SSU
CHD (Linear relationship)

(Dummy variable) OR
( OR = Exp
[bi(X1i-X0i)]
SSU CHD AGE
SEX Odds
Risk Profile 2 AGE
SEX ( Risk Profile)
SSU

3.15 OR

Logit P(X) = 2.6341 - 0.4540SSU + 0.2016AGE + 1.010SEX
ORSSU2,SSU0 Risk
ORSSU=2,SSU=0 = Exp [b1(2-0) + b2(0) + b3(0)]
= Exp [b1(2)] Profile
= e2b 1 OR SSU
= e 2(-0.4540)
= e -0.908 AGE SEX 0
= 0.4
SSU
2 SSU
2 0 SSU
2 OR
Exponential
SSU Exp2b1

(-
0.454) OR 1 (
0.4)
(Protective factor)
52
2.5
OR Model
Product term
(Continuous variable)

3.16
(Ordinal variable)
OR
(Systolic
Additive Model X Blood Pressure SBP) 200
(Continuous variables)
mmHg
: Model
Logit P(x) = a+b1SBP+b2SMH+ b3ECG
ORSBP200,SBP120 = Exp [b1(200-120)+b2(0)+ b3(0)]
= Exp [b1(80)+0+0]
= Exp [b1(80)] (
= e80b1 5) OR
Risk Profile

OR
200 mmHg
120
mmHg Risk
Profile 0
SBP 200 120
80 OR Exponential
80
SBP b1
ECG
200 mmHg
e80b1
120 mmHg OR
Risk profile
80 mmHg
Linear relationship

OR eb
53

Dichotomous

eb Odds

Odds CHD
3.17 200 199
Odds
OR
Odds ratio "
OR = eb X1-X0 = 1
mmHg Odds

eb"
(SBP)
(GAGE)

- (Preterm)
- (Normal)
- (Post term)
Mean Median
Fit Model

OR

Fit Model X Model
OR
2.6
OR Main Effect
3.18
Model
OR
Exposure (E)
E1, C1, C2,...,Ck D (D)
E1, E2, E3 ,...,C1 , C2,...,Ck D (C)
Logit P(X) = a+b1SMK+b2AGE+b3SEX

X1 = (SMK = 1, AGE = 60, SEX = 1) E D E
X2 = (SMK = 0, AGE = 40, SEX = 1)
OR = Exp [b1 (1-0)+b2(60-40)+b3(1-1)]
1
= Exp [b1 (1)+b2(20)+b3(0)] Risk Profile 2
= Exp [b1 + 20 b2] = e b1+20b2

OR (SMK=1)
54
60 (AGE=60)
(SEX = 1)
(SMK=0) 40 (AGE=40)
(SEX=1)
SEX
(E)
OR
Risk Profile 2
SMK 1-0 1
AGE 60-40 20
SEX 0
OR Exponential
SMK 20
AGE

60
[eb1+20b2 ]
40

E 1

3. OR Multiplicative model
3.19 OR
OR Additive model OR

Additive Model ( Interaction term)

E
- Dichotomous
- >2 Categories
- Ordinal
- Continuous
E 1
( Joint effect )
Multiplicative Model ( Interaction term) Model Product term
Interaction term Model
55
Multiplicative model

Interaction term
3.20 Model ()

Interaction term
term Second order term
Second order term 2 term
E*C1, E*C2
Third order term
SMK*AGE, SMK*SEX

Third order term 3
E*C1*C2
SMK*AGE*SEX

Third order term
Model

Interaction effect
3.21
Model Main
effect Interaction term
Hierarchical Well-Formated Models
Model
Second Order term
Logit P(X) = a + b1E + b2c1+b3c2 + b4(E *c1) + b5(E*c2) 4 Model
Third Order term Third order term Model
Logit P(X) = a + b1E + b2c1 + b3c2 + b4(E*c1) + b5(E*c2) Main effect
+b6(c1*c2) + b7(E*c1*c2)
Second order term term
Third order term
Hierarchical Well-formatted model
Model

OR
OR Interaction term

Risk Profile 2

OR
56
3.1 Second order term
Interaction term
Second Order term
(SMK)
3.22
(CHD)

OR
Multiplicative model
(Confounder) (AGE)
1 Second order term (SEX)
Logit P(x) = a + b1SMK + b2AGE + b3SEX + b4ECG + b5SBP
(ECG) (SBP)
+ b6(SMK*SEX)
Model
ORSMK(1,0) e b1 b6(SMK*SEX)

ORSMK SEX
Effect Modifier
Model Interaction term
SEX Effect Modifier term
SMK*SEX Model OR
SMK CHD Model
Interaction term term
SMK Interaction
term SMK*SEX
ORSMK SEX

3.23 ORSMK
SEX = 1 Risk Profile 2
SEX = 1 ()
Model
X1 = (SMK=1, SEX=1) AGE,ECG, SBP SMK SEX SMK
X2 = (SMK=0, SEX=1) Fixed
() ( Odds
ORSMK(1,0) = Exp {b1(1-0)+b3(1-1)+b6[(1x1)-(0 x1)]}
) SEX
= Exp [b1(1)+b3(0)+b6(1-0)] 1 Risk
= Exp (b1 +b6)
profile ( OR SMK
= e b1 + b6 CHD SEX)

Fixed (
)
57

OR Risk Profile
(X1i-X0i)
2 Interaction
term
(X11X12-X01 X02)
Interaction term Risk Profile
1 (X1) Risk Profile 2 (X2)
ORSMK Exponential
SMK
Interaction term
(SMK*SEX) ORSMK
eb1 + b6 ORSMK
3.24 SEX=0
OR = eb1
SEX = 0 ()

X1 = (SMK=1, SEX=0) AGE, ECG, SBP ECG
X2 = (SMK=0, SEX=0) Fixed

eb1 + b6
ORSMK(1,0) = Exp {b1(1-0) + b3(0-0) + b6[(1x0)-(0x0)]}
= Exp [b1(1) + b3(0) + b6(0)]

= e b1 ECG

eb1

3.2 Third order term
3.25
OR Third order term

Interaction term
Hierarchical Well-
2 Third order term formatted Model term Second
Logit P(x) = a + b1SMK + b2AGE + b3SEX + b4ECG + b5SBP
order term Third order
+ b6(SMK*SEX) + b7(SMK*ECG) term Model 3
+ b8(SEX*ECG) + b9(SMK*SEX*ECG) term Third order term
(SMK*SEX*ECG) Second order
term 3 term (SMK*SEX)
58
(SMK*ECG) (SEX*ECG)
Main effect SMK SEX
ECG Model AGE
Model

3.26
SEX = 1 ECG = 1

X1 = (SMK=1, SEX=1,ECG=1) AGE SMK CHD
X2 = (SMK=0, SEX=1,ECG=1) SBP Fixed
SEX ECG ORSMK
ORSMK(1,0) = Exp {b1(1-0) + b3(1-1) + b4[1-1) + b6[(1x1)-(0x1)]
+ b7[(1x1)-(0x1)] + b9[1x1)-(1x1)] + b9[(1x1x1)-(0x1x1)]}
ECG
= Exp {b1(1) + b3(0) + b4(0)+b6[(1)-(0)] + b7 [(1)-(0)]
+b9 [(0)-(0)] + b9 [(1)-(0)]}
ORSMK
= Exp [ b1 + 0 + 0 + b6 + b7+ 0 + b9]
ECG ORSMK ECG
= e( b1 + b6 + b7 + b9 ) ORSMK ECG
4 OR
22 (
Effect Modifier)
3.27 ORSMK 4

SEX = 1 ECG = 0
=? Second order term
SEX = 0 ECG = 1
SEX = 0 ECG = 0 } OR SMK
Risk Profile 2 X1
X0
( ORSMK)
OR

2. ORSMK = e b1+b6

3. ORSMK = e b1+b7 Exponential
4. ORSMK = e b1
Exponential
OR

OR ECG
eb1

ECG

eb1
59
4. OR
3.28 OR Logistic
Regression model
OR
1. Risk Profile
X1 = (X1 =..., X2=..., ..., Xk=...)
X0 = (X1 =..., X2=..., ..., Xk=...) Risk Profile 2
Fixed Risk Profile

2.
Model Profile
OR X
1 ,X 0 = e bi (X 1i X 0 i )
bi
3.
bi

OR

Exponential OR
5. OR
OR
Odds (
3.29
) (Exposed

X1) (Non-exposed
OR
OR X1,X0 X0) OR
Odds ( (X1) Model
(X0) X0 (Reference group)
Adjusted OR => Model Adjusted Odds Ratio
=>
=>

OR RR
OR 1=>
OR 1 => Risk factor ( )
OR 1 => Protective factor ( )

Model"

OR RR
OR 1
(Risk factor)
OR 1
60
(Protective factor)
Protective factor
3.30
OR (
1)
ORX1,X0 1 Protective effect ( Risk)
Protective effect
Protective effect No effect Risk effect
"
"
0 0.25 0.5 1 2 3 4 5 ""

Protective effect

X1 X0 X0 X1
OR 1/ OR .

1
ORX0 ,X1 = ORX1,X0
OR, = 0.05 OR, = 1/0.05 = 20 0 1 1 2
OR (
Jaeschke et al., 1995
)
OR 1.05 1.5
()
0.05 0.5
OR
1/0.05 = 20 1/0.5 = 2
( 20
2 )

OR 1
OR
OR
61
3
Jaeschke, R., Guyatt, G., Shannon, H., Walter, S. Cook, D. Heddle, N. (1995). Assessing the
effects of treatment: measures of association . Canadian Medical Association Journal. 152:
351-357
62
1. 1 2.2.3 BWT
BWTG
1.1
Dummy Variable BWTG

BWTG = 2 (Reference group)

(Dummy Variable)
BWTD1 BWTD3
BWTG = 1
BWTG = 2
BWTG = 3
1.2 Output STATA Logistic regression model

. tab bwtg, gen(bwtd)
bwtg | Freq. Percent Cum.

------------+-----------------------------------
1 | 39 8.39 8.39
2 | 140 30.11 38.49
3 | 286 61.51 100.00
------------+-----------------------------------
Total | 465 100.00
. logit dead area bwtd1 bwtd3


LR chi2(3) = 16.67
Prob > chi2 = 0.0008
------------------------------------------------------------------------------
---------+--------------------------------------------------------------------
area | .0911082 .2777323 0.328 0.743 -.4532371 .6354536
bwtd1 | .6092406 .40922 1.489 0.137 -.1928159 1.411297
bwtd3 | -.8628492 .2980022 -2.895 0.004 -1.446923 -.2787755
_cons | -1.483589 .2677199 -5.542 0.000 -2.00831 -.9588672
------------------------------------------------------------------------------
1.3 OR
63
1.3.1) OR

(I) ORx1,Xo =
(ii)
X1 =
.................................................................................................

X0 =
.................................................................................................
(iii) ORx1,Xo =
1.3.2) OR

(I) ORx1,Xo =
(ii)
X1 =
.................................................................................................

X0 =
.................................................................................................
(iii) ORx1,Xo =
64
1.3.3) STATA
. logistic dead area bwtd1 bwtd3

LR chi2(3) = 16.67
Prob > chi2 = 0.0008
------------------------------------------------------------------------------
---------+--------------------------------------------------------------------
area | 1.095388 .3042245 0.328 0.743 .6355674 1.887878
bwtd1 | 1.839034 .7525696 1.489 0.137 .8246337 4.101271
bwtd3 | .4219581 .1257445 -2.895 0.004 .2352932 .7567098
------------------------------------------------------------------------------
2. Stratified analysis 1 3.9.2.1 4

2 (MALPRES) Effect Modifier
(DEAD) (AREA)
2.1) Model Logit transformation
2.2) STATA
. gen a_mal = area * malpres
. logit dead area malpres a_mal


LR chi2(3) = 52.05
Prob > chi2 = 0.0000
------------------------------------------------------------------------------
---------+--------------------------------------------------------------------
area | -.3988154 .3230824 -1.234 0.217 -1.032045 .2344146
malpres | .8903152 .8428469 1.056 0.291 -.7616343 2.542265
a_mal | 2.362425 .9739987 2.425 0.015 .4534228 4.271427
_cons | -1.988928 .2091045 -9.512 0.000 -2.398765 -1.57909
------------------------------------------------------------------------------
65
2.3) OR
28
Logistic Model:
Logit P(X) = -1.989 - 0.399AREA + 0.890MALPRES + 2.362A_MAL
MALPRES = 0
OR(AREA1,0) = Exp{[-1.989-0.399(1)+0.890(0)+2.362(1)(0)]
-[-1.989-0.399(0)+0.890(0)+2.362(0)(0)]}
= Exp(-0.399)
= ..
MALPRES = 1
OR(AREA1,0) = Exp{[-1.989-0.399(1)+0.890(1)+2.362(1)(1)]
-[-1.989-0.399(0)+0.890(1)+2.362(0)(1)]}
= Exp(-0.399 + 2.362)
= Exp(1.963)
=
2.4) OR Stratified analysis
3.9.2.1 1
2.5) OR STATA
OR Exponential Coefficient
( Output 2.3)
. logistic dead area malpres a_mal

LR chi2(3) = 52.05
Prob > chi2 = 0.0000
------------------------------------------------------------------------------
---------+--------------------------------------------------------------------
area | .6711146 .2168253 -1.234 0.217 .3562775 1.264168
malpres | 2.435897 2.053089 1.056 0.291 .4669028 12.70842
a_mal | 10.61667 10.34062 2.425 0.015 1.573689 71.6238
------------------------------------------------------------------------------
3. Model Interaction term AREA*MALPRESS*MAGE

Model
3.1) Term ()
66
Main effect
Second order term
Third order term
3.2) Model Hierarchical Well-formatted Model

Logistic Regression Model Logit transformation
67
Odds Ratio
4
:
1. Odds Ratio
2. Odds Ratio Interaction
:
2. Interaction term
3. Interaction term
:
1. 1
2.
3.
68

Logistic Regression
Model

Logistic Regression 2
4.1 Best Predicted Model

Logistic Regression (
( Case-control study ) Cohort study)
Measure of association ( Coefficient) (Risk
Case Control OR (95%CI) assessment)
(n=....) (n=....) (Unadjusted) (Adjusted)
1. % % (
2. % %
3. % %
Lang and Secic, 1997)
...
Risk assessment
Logistic
Regression
Cohort study
Case-control cross-
sectional study

Model
4.2
OR

Logistic Regression 95%CI p-value
...

Logit P(X) = 1.421 + 1.609SMK + 0.095SEX + 0.301AGE
5 (95%CI.OR: 2.1 11.7)
... ( 1)
1 Adjusted Odds Ratio (%)
Case Control OR(95%CI) Crude OR Adjusted OR
(n = 150) (n = 150) (Unadjusted) (Adjusted)
1.
-
-
80.7%
19.3%
30.0%
70.0%
9.7(5.5 17.3) 5(2.1 11.7) (Confidence Interval)
2.
- 73.3% 63.3% 1.6(1.0 2.7) 1.1(0.8 3.7)
95%CI p-value
- 36.7% 33.7%
... ... ... ... ... Adjusted OR
69

Study design
Case-control study

Lang and Secic (1997)
95%CI OR
OR
95% CI OR
(Lower Limit)
(Upper Limit)

4.3 OR (Precision )
95% Confidence Interval
(Precision )
(95% CI. OR.)
Precision OR Significant risk factor
Lower Limit Estimated OR. Upper Limit
. 30-35
.
.
2-80
0 1 + ()
(Null value)
: OR
. Precision
. .
. Precision
(Sample Size)

(Hypothesis testing)
1
Null value

p-value >0.05
1

(p-value <0.05)
Guyatt et al.(1995)
70
95% OR

() 0.05
95%
4.4 Z0.05/2 1.96
OR
[
100 (1 )% CI .OR . = EXP L Z / 2 Var ( L ) ] 3
OR. Standard error SE ( Standard Error) OR
EXP(L) = OR. L
square root variance
= 0.05 : -
OR Var (OR)
[
95 % CI .OR . = EXP L 1 . 96 Var ( L ) ]
Logistic regression model OR
L OR. : -
OR. = EXP[ bi(X1i - X0i)] OR = EXP[bi(X1-X0)]
[ bi(X1i - X0i)] =
L = bi(X1-X0) OR =
L
OR. = EXP(L)
EXP(L) SE OR = Var (L)
L
4.5 OR
Model
Interaction term
Interaction term
OR = EXP (b) 95% CI OR = Exp [b (1.96 Var(b))]
}
Computer Print out

:- Interaction term Variance
Computer print out
Variable1 Coefficient SE Chisq p
L print out
ORSMK = e0.5976 = 1.82
Constant -6.7727 1.1401 35.29 0.0000 ( SE
95% CI ORSMK
SMK 0.5976 0.3520 2.88 0.0896
= e[0.5976+1.96(0.3520)]
ECG 0.0322 0.0152 4.51 0.0337
= e(-0.09,1.29)
) Var (L)
CHL 0.0087 0.0033 7.17 0.0074
= 0.91, 3.63
HPT 0.3695 0.2936 1.58 0.2083
Interaction term
Variance L
Variance-covariance matrix Final model

( StataCorp.,
71
1999).
Interaction

(CHD)
(SMK) (ECG)
(CHL)
(HPT)
SE
(
Chi-
square p-value
5)
OR

OR
SMK 1.82 95% CI
0.91 3.63

OR

(
StataCorp., 1999).
4.6
ORSMK = 1.82
95% CI. ORSMK = 0.91, 3.63
Lower Limit Estimated OR. Upper Limit
0 1 2 3 4

Null value 1.82
1 95%
Non Significant ( p-value 0.05)
print out p-value = 0.0896
0.91 3.63
p-value = 0.09 (p-
value = 0.0896)

72

( precision )
1

(Significance) p-value
0.05
p-value
OR 95%CI

4.7 Interaction Var(L)

Interaction SE

Logistic Regression Model 1. OR.
Variable Coefficient SE Chisq
SMK 2.6809 3.1042 16.69 0.0000
p
ECG 0.0349 0.0161 4.69 0.0303
CHL -0.0065 0.3278 1.25 0.2635 Interaction
HPT 1.0468 0.3316 9.96 0.0016 OR = eL
SMK*CHL 0.0029 0.7422 9.85 0.0417
Constant -4.0474 1.2549 10.40 0.0013 95%CI= EXP[L (1.96 Var(L))]
L = bSMK + bSMK*CHLCHL Var(L)
( 200 . CHL = 200)
OR. = EXP[2.6809 + (0.0029 x200)] = EXP(3.2609) = 26.1 variance covariance
CHL = 200 , ORSMK = 26.1

OR.ECG HPT
Fit Model
Interaction SMK
CHL OR SMK
CHL CHL
()

200 220 240
CHL 200 ORSMK 26.1

Var(L)
73
4.8 L bSMK + bSMK*CHL

Var (L) var(bSMK) +
2. OR.
[
95%CI .OR.= Exp L 1.96 Var ( L) ] 2(200)cov(bSMK,bSMK*CHL) + (200)2 var
Variance-Covariace Matrix
SMK ECG CHL HPT SMKxCHL Constant (bSMK*CHL)

SMK 1.7619
ECG 0.2849 9.5361 Computer print out
CHL -0.0140 -0.3278 0.0003
HPT 0.1468 0.3316 0.9631 0.1075
SMKxCHL -11.014 -0.7422 1.9878 -0.6717 0.1101 Variance Covariance Matrix
Constant 0.4474 0.2549 0.4056 0.8673 0.9104 1.3570
Var(L) = var (bSMK) + 2(200)cov(bSMK ,bSMKxCHL)+(200)2var(bSMKxCHL) Var (L)

= 1.7619 + 2(200)(-11.014) + (200)2(0.1101) = 0.1619
95% CI ORSMK = EXP(3.2609 1.96 ( 0.1619 ) = 11.85 , 57.37 OR
CHL = 200 , ORSMK = 26.1 (95%CI.OR ; 11.85 57.37)
CHL = 200
4.9 Var(L)
Var(L ) Model
X1 Dichotomous (1,0) Interaction
Model: Logit P(X) = a + b1X1 + b2X2 + b3X1X2 Model
L = b1X1 + b3(X1X2)

Var (L) = Var(b1) + (X2)2var(b3) + 2(X2)cov(b1,b3)

Model: Logit P(X) = a + b1X1 + b2X2 + b3X3 + b4X1X2 + b5X1X3
L = b1 X1 + b4X1X2 + b5X1X3 Var(L) Model (
Var (L) = Var(b1) + (X2)2var(b4) + (X3)2var(b5) + 2X2cov(b1,b4) L)
+ 2X3cov(b1,b5) + 2X2X3Cov (b4,b5)

( Kleinbaum, 1994. 141 - 144)
Interaction term
(Second order term ) Var(L)


Effect Modifier
(
Kleinbaum, 1994. 141 - 144)
74
4
Guyatt, G., Jaeschke, R., Heddle, N., Cook, D., Shannon, H., and Walter S. (1995). Interpreting
study results: confidence intervals. Canadian Medical Association Journal. 152:169-173.
Lang, TA., Secic, M. (1997). How to report statistics in medicine: annotated guidelines for
authors, editors, and reviewers. Philadelphia: American College of Physician.
Corporation.
75
4
1. 1 (
LOGISTIC.DAT) OR. 95%

1.1)
28 2 x 2
1.1.1) a b c d OR.
95%

1 OR. = ad /bc
1
a b OR. = ........................................................
c d
[ ]
0
)100%CI
( 195%CI.OR. . OR. = OR.exp Z / 2 + + +
1 1 1 1
=.............................................
a b c d
1.1.2) STATA 2 2
( epitab cc)
1.2.3
76
1.2) Logistic Regression Model 1.1

Logit transformation ( b )
1.3) Fit Model STATA Logistic Regression Model Fit

Model ( logit)
1.4) OR. 95% Model
1.5) OR. 95% STATA ( logistic)
1.6) OR 95%CI 1.1.1 1.1.2 1.4 1.5
77
2. OR. (MAGE)
(DEAD) 30 20
2.1) STATA Fit Model

2.2) OR MAGE30,20 = eL
L =......................................................
OR. =......................................................
95% CI
95% CI OR. = exp [L + 1.96var (L)]
Var(L) = ........................................................
95% CI OR. = ........................................................

........................................................
.................................................................................
3. 3 OR.
(AREA) (DEAD) Interaction effect
(MALPRES) Effect Modifier
3.2) OR.
OR(MALPRES=0) =...............................................
OR(MALPRES=1) =...............................................
78
3.3) OR Interaction effect

( 3.3 )
3.3.1 Variance Covariance Matrix STATA

.logit dead area malpres a_m => Fit Model ( a_m Interaction term
area malpres)
.matrix V = get(VCE) => V Matrix (
STATA)
.matrix list V =>Variance-covariance Matrix
. logit dead area malpres a_m


LR chi2(3) = 52.05
Prob > chi2 = 0.0000
------------------------------------------------------------------------------
---------+--------------------------------------------------------------------
area | -.3988154 .3230824 -1.234 0.217 -1.032045 .2344146
malpres | .8903152 .8428469 1.056 0.291 -.7616343 2.542265
a_m | 2.362425 .9739987 2.425 0.015 .4534228 4.271427
_cons | -1.988928 .2091045 -9.512 0.000 -2.398765 -1.57909
------------------------------------------------------------------------------
. matrix V = get(VCE)
. matrix list V
symmetric V[4,4]
area malpres a_m _cons
area .10438226
malpres .0437247 .71039085
a_m -.10438226 -.71039085 .94867342 Variance-covariance Matrix
_cons -.0437247 -.0437247 .0437247 .0437247
3.3.2 OR.
. MALPRES = 0
95% CI. OR. = Exp[-0.399 1.960.1044]
= Exp(-1.032) Exp(0.234)
= 0.36 1.26
79
. MALPRES = 1
var (L) = bAREA + bA_MAL
= var(bAREA) + 2MALPRES cov(bAREA , bA_MAL )
+ (MALPRES)2var(bA_MAL)
= 0.1044 + [2(1)(-0.01044)] + [(1)2(0.9487)]
= 0.8443
95% CI. OR. = Exp[1.963 1.960.8443]

= Exp(0.162) Exp(3.764)
= 1.18 43.12
3.4) STATA OR 95%CI Interaction effect

3.3 ( lincom effmod )
lincom
. lincom area
( 1) area = 0.0
------------------------------------------------------------------------------
---------+--------------------------------------------------------------------
(1) | .6711146 .2168253 -1.234 0.217 .3562775 1.264168
------------------------------------------------------------------------------
. lincom area + a_m
( 1) area + a_m = 0.0
------------------------------------------------------------------------------
---------+--------------------------------------------------------------------
(1) | 7.125 6.546829 2.137 0.033 1.176673 43.14337
------------------------------------------------------------------------------
effmod
. effmod dead area, cov( malpres) int( a_m 0)
OR and 95% CI for a Logistic Regression Model with Interaction

--------------------------------------------------------------
Disease: dead
Exposure: area
Confounders: malpres
Interaction Terms and Stratum Values:
a_m: 0
Exposed-Unexposed= 1
l= -.39881537
Var(l)= .10438226
Odds Ratio (95% CI) for dead vs. area: 0.671 (0.356, 1.264)
80
. effmod dead area, cov( malpres) int( a_m 1)
OR and 95% CI for a Logistic Regression Model with Interaction

--------------------------------------------------------------
Disease: dead
Exposure: area
Confounders: malpres
Interaction Terms and Stratum Values:
a_m: 1
Exposed-Unexposed= 1
l= 1.9636097
Var(l)= .84429116
Odds Ratio (95% CI) for dead vs. area: 7.125 (1.177, 43.143)
3.5)
81
5
:
1. Model
2. Model
:
1. Model (Model fitting Strategies)
1.1) Model
1.2) Model
1.3) - Multicolinearity
- Multiple testing
- Outlier
- Non-linear relationship
2. Model
2.1) Initial Model
2.2) Model
1. 1
2.
3.
82

1. Model
Logistic
Regression
5.1

Model Model
Model Fitting Strategy
: (E)

BEST MODEL
Confounder Effect (D)
Modifier
(C) Confounder Effect
:
1. Initial Model Modifier
2. Final Model
3. Effect Modifier OR
4. Confounder
5. Model adequacy

Model

Final Model

Model

Model
1.
2.
3. Effect Modifier
4. Confounder
5.
1.1 Model
Model
2 Model
E D
Risk assessment goal
Model
D E
83
Risk Profile
Prediction goal

5.2

Cohort study

1. Model E D Risk assessment
2. Model D E Prediction
Model

Prediction goal
Prediction goal

Fit Model Backward Elimination Forward
Backward Stepwise method
Risk assessment goal Inclusion Backward Stepwise Method
Fit Model Risk Assessment Goal

Model

Model

Confounder Effect
Modifier

1.2 Model
Model 3
5.3

Model (Initial Model)
1. Initial Model
Effect
2. Effect Modifier
Modifier Effect Modifier

3. Confounder
precision
confounder

Model
84
Effect Modifier
Confounder
Precision
Precision

1.3 Model
5.4
Model
Multicolinearity
Multiple testing Outlier
Multicolinearity Non-linear relationship
Multiple testing (ordinal)
Outlier
Non-Linear relationship
(continuous)

1.3.1 Multicolinearity
Multicolinearity
5.5
Model
Multicolinearity Model
Model AGE
: AGEG Model

:
AGE () AGEG
Model AGE () ()
AGEG ()

:
(Unreliable Coefficient)
Model
Multicolinearity

Multicolinearity Fit model

Multicolinearity
Model
85

(STATA
Multicolinearity )
Model

1.3.2 Multiple Testing
Model
5.6

Multiple testing

Model
Model Model
Model

1.3.3 Outlier
Outlier
5.7
Record

Outlier
record

Outliner
....... . .
Logit P(x)
. .
. . outlier
. . ... .. outlier
.. . Model
. .. ..... . . ..
b
.
Age
Fit Model
outlier
Measure of influence
Hosmer and Lemeshow
(1989)
STATA ( Stata Corp, 1999
86
Volume 2 H-O 218 222 )

1.3.4 Non-linear Relationship

Model

Model
dummy variable
Model

Model
Model

Model
dummy variable
dummy
variable

5.8 dummy variable (
Non-Linear relationship dichotomous variable dummy
variable)
Logit P(x)
1

.. .. .. Mazumdar and Glassman (2000)
. ..
0.5 .... . . Linear relationship
... . . .
.
. . ...... . ... outlier
0
()
( 5.7) Non-linear
25 30 35 40 45 50
relationship
(Gestational age)

Logit P(X)
20 (Pre-
term) 36 (Post-
87
term)
(20-36 )
5.8
logit P(X)

Model

Logit P(X)
Risk profile Model

Model
Linear relationship
Crude analysis
1
Model

2. Model
Fit Model
5.9
Initial Model
1
Initial Model
Initial model :
( )
Crude analysis p-value < 0.25
Interaction term Tests of homogeneity of odds ratios Stratum p-
value < 0.25 Stratified analysis
:

(Review literature)

Crude analysis Stratified
analysis p-value < 0.25 (
88
1)
Initial model

Model Multicolinearity

Non-
linear relationship (
)
Initial
Model

5.10
Main effect Model
:
1. Dichotomous
Interaction term
2. Product term (
2.1) Main effect - Clinically or biologically or socially important
2.2) Interaction term

- Crude analysis p-value < 0.25 Second order term)
- Second order term (X1*X2) ( Third order term)
-
- Third order term (X1*X2* X3)
- Multicolinearity
3. Model
Heirarchically Well-formated Model (HWF) Interaction effect

Fit Initial Model computer
Second order term

Second
order term Multicolinearity

5.11 Model
Heirarchically Well-formatted
Model
Model Product term
Model Main effect
Product term
Model
Model
89
Heirarchically Well-
Heirarchically Well-formated Model (HWF) :
formatted Model
1. Logit P(X) = a + b1X1 + b2X2 + b3X3 + b4X1X3
HWF Model

2. Logit P(X) = a + b1X1 + b2X2 + b3X3X4
HWF Model Main effect X3 X4 Model
3. Logit P(X) = a + b1X1 + b2X2 + b3X3 + b4X4 + b5X3 X4 + b6X2X3 X4

HWF Model product term X2 X3 X2 X4
3. Model
Model
5.12

2
Model Backward elimination
Model Backward Elimination
Heirarchical
(Initial Model)
Principle Model
3 (Third order term)
Third order term
Model Third
2 (Second order term) order term Second
Main effect
order term Main
effect Model
5.13 Interaction term

Third order term Second order

term
Third Order term Second order term
Interaction term
Main effect

Product term Interaction term
Main effect

Confounder
5.14

Model

90
Model
Heirarchical Principle


Model
:
Initial Model : Logit P(X) = a + b1X1+ b2X2+ b3X3+ b4X1X2+ b5X1X3+ b6X2X3+ b7X1X2X3
1. X1X2X3 Model
2. X1X2X3 , X1X3 X2X3 Model
X1X2 X1 X2
X3
Model
Product term

dummy variable

Initial model
Logit P(X) = a + b1X1 + b2X2 + b3X3

+ b4X1X2 + b5X2X3
+ b6X1X3 + b7X1X2X3
1. X1X2X3
Model
2. X1X2X3 , X1X3
X2X3 Model
X1X2
X1 X2
X3
5.15 Model
Fit Model Initial model

2 (1) p-value
91
(Backward Elimination) Wald test Z

1: Fitting the initial model Output STATA (2) Log

Log Likelihood = -57.653633
y | Coefficient Std. Errer Z P-value [95%Conf. Interval]
Likelihood
x1 | 1.932839 1.307732 1.478 0.139 -.6302681 4.495946
x2
x3
|
|
.6309061
.8260566
.6477891
.7203189
0.974
1.147
0.330
0.251
-.6387371
-.5857424
1.900549
2.237856
Model
x1x3 | -1.481385 1.326425 -1.117 0.264 -4.081131 1.118361
_cons | -2.241951 .6269012 -3.576 0.000 -3.470654 -1.013247 p-value Wald test
Wald test
Log Likelihood Z = SE b , Z2 X2
Likelihood Ratio test (LR.)
LR. Z 2
(
LR . = 2 Loglikelihood Model Loglikelihood Model )
0
X X
Chi-square df = b 2 Model LR.
Model Fit

Wald test
Wald test

Log
Likelihood
Likelihood Ratio (LR)
Chi-square
Wald
test Fit Model Model
Log Likelihood Model
Model
Model
Log Likelihood Model
(-2) LR 2
degree of freedom
Model p-value

Model

Likelihood Ratio test (
Deviance G2)
5.16 Fit Initial Model
P-value Wald tests
Interaction term
term
term p-value
Fit Model Model term
92
2 Interaction term Log Likelihood

Higher order interaction term p-value (Least Significant Wald test) Log Likelihood Model
Fit Model term -2 LR
LR Chi Square df = 1 (
p-value ( X2 df=1 1 term)
Model 1
p value < 0.05 p value 0 .05
Higher order interaction term Higher order interaction term ) p-value LR test
Lower order Components p-value < 0.05

p-value Wald lest

p-value 0.05

p-
value Wald test

Model
Model
Final Model
5.17 Main effect
Backward Elimination
Model
Model (p0.05)
Initial Model
1

Fit Model
Polytomous Model Dummy variable
Backward Elimination
1

Fit Model
X1 D
5.18 X3 X4
D Interaction
Effect Initial Model logit
form Logit P(x) = a+b1X1 + b2X2 +
93
: Backward Elimination b3X3 + b4X4 + b5X1X3 + b6X1X4

1. Model 1 : Initial Model
y Coefficient Std. Errer Z P-value [95%Conf. Interval] Fit Model Initial
x1 | 1.932839 1.307732 1.478 0.139 -.6302681 4.495946
x2 | .6309061 .6477891 0.974 0.330 -.6387371 1.900549
Model
x3 | .8260566 .7203189 1.147 0.251 -.5857424 2.237856
x4 | -.3261456 .6569414 -0.496 0.620 -1.613727 .9614357
Model
x1x3 | -1.481385 1.326425 -1.117 0.264 -4.081131 1.118361 1
x1x4 | -.4069955 1.004148 -0.405 0.685 -2.375089 1.561098
_cons | -2.241951 .6269012 -3.576 0.000 -3.470654 -1.013247 p-value Wald test
X1X4 X1X4 p-value
(0.685) Fit Model
5.19 Log Likelihood

2. Model 2 : X1X4 Model Model
y Coefficient Std. Error Z P-value [95%Conf. Interval]
-2 LR 0.18
x1 | 1.839284 1.276507 1.441 0.150 -.6626245 4.341192 X2 degree of freedom (df)
x2 | .6436386 .6455916 0.997 0.319 -.6216976 1.908975
x3 | .8429361 .7207969 1.169 0.242 -.5697999 2.255672 1 ( b6 ) p-value =
x4 | -.5031502 .5043087 -0.998 0.318 -1.491577 .4852766
x1x3 | -1.553466 1.305413 -1.190 0.234 -4.112029 1.005097 0.6892 0.05
_cons | -2.207755 .6191707 -3.566 0.000 -3.421307 -.9942028
X1X4 Interaction term
LR = -2(-57.74 -(-57.65)) = 0.18
X2 df=1 p = 0.6892 0.05 X1X4 Model
X1X3

5.20 Second order
3. Model 3 : X1X3 term X1X3 Fit Model
X1X3 LR.
x1 | .5128482 .6508643 0.788 0.431 -.7628223 1.788519
x2 | .6767462 .6568664 1.030 0.303 -.6106883 1.964181
Model 2 p-
x3 | .4361177 .597445 0.730 0.465 -.7348529 1.607088 value < 0.05
x4 | -.5383285 .5042896 -1.067 0.286 -1.526718 .450061
_cons | -1.9106 .5103662 -3.744 0.000 -2.910899 -.9103008 Model
LR = -2(-59.84 -(-57.74)) = 4.2 X1
X2df=1 p = 0.04 0.05 X1X3
Model X1 X3 Heirarchical well-formated model X3 Model
X2 Heirarchical Principle
Model
Model 2 X1X3 Model
5.21
X2 X4

X2 p-value
94
4. Model 4 : X1X3 X2 (0.319) Fit Model

LR.
x1 | 2.290336 1.177093 1.946 0.052 -.016723 4.597395 Model 2 p-value > 0.05
x3 | 1.002244 .6995785 1.433 0.152 -.3689044 2.373393
x4 | -.5682332 .5001514 -1.136 0.256 -1.548512 .4120456 Model
x1x3 | -1.565421 1.286337 -1.217 0.224 -4.086594 .9557528
_cons | -2.149703 .6137187 -3.503 0.000 -3.35257 -.946837
LR = -2(-58.22 -(-57.74)) = 0.96 ( Log Likelihood Model 2)

X2 df=1 p = 0.3272 0.05 X2 X4
X4

Final Model
OR

5.22
5. Model 5 : X4
y Coefficient Std. Errer Z P-value [95%Conf. Interval] Model
x1 | 2.30336 1.157093 1.646 0.051 -.016423 4.567395
x3 | 1.012244 .6875785 1.413 0.142 -.3389044 2.313393

x1x3 | -1.365421 1.226337 -1.211 0.214 -4.186594 .9257528
_cons | -2.189703 .4137187 -3.501 0.000 -3.15257 -.926837
Model
LR = -2[-58.82 -(-58.22)] = 1.2
(Precision) OR
X2 = 1.2 df=1 p-value 0.05 X4

Logistic regression Model
P(X) = 1 p-value LR test
1 + e -(-2.190 + 2.303X1 + 1.012X3- 1.365X1X3) Logit Form
Logit P(X) = -2.190 + 2.303X1 + 1.012X3 - 1.365X1X3 STATA
()
4. Interaction Effect
Confounding Effect

Interaction term
Model Model (p-
5.23 value <0.05) Interaction Effect
p>0.05
Interaction
Effect
Effect Modifier Interaction Effect
Likelihood
95
Ratio test
Interaction
Statistical test

Con foumding precision Confounder
Statistical test
Validity
Control for Confounding
Validity
Random error Interaction Effect
( OR) confounder
Control Precision ( )
Precision
Precision
Confounding Effect
5.24 Confounding effect

Confounding effect Interaction effect
Initial Model Interaction effect ?
P(D)=X1+X2+X3+X1X2+X1X3+X2X3+X1X2X3 Interaction Effect

Interaction Effect Model
Full Model Subset1 Subset2 OR
X1+X2+X3 X1+X2 X1+X3 95%CI.OR. Main effect

ORF OR. OR1 OR2 effect modifier
Interaction term OR
Model Subset OR ORF
Model
OR

Model CI.OR. Final Model
(Potential confounder)
Model Gold standard
Model

Potential
Confounder ( Subset
Model) Fit Model
OR OR
Gold Standard Model Subset
OR Gold standard
OR
OR
Gold Standard Model
Model Final Model
96

Confounding effect
(Subset) Initial
Model Confounder
Model

5.25 Fit Model
Model OR
Confounding assessment Interaction effect Model (Gold
OR Model
Model OR OR Full Model (Gold Standard) standard) precision
Model CI
OR Model
Validity Precision Model Final Model
Validity
Best Model Precise
Model Subset Full
Model

Full Model
Best Model

Model Subset

5.26
Interaction Interaction
Full Model :
Logit P(X) = a+b1X1+b2X2+b3X3+b4X4
Model Main
Model Subset OR 95%CI effect X1, X 2, X3 X4
1. X1,X2 ,X3,X44.3 1.9-6.4
2. X1,X2 ,X3, 4.0 3.1-5.0
3. X1,X3 ,X4 4.6 1.7-5.8
4. X1,X2 ,X4 2.6 0.9-4.5 Confounder Best Model
Model : 1, 2, 3 (n
Model : 2
Final Model : Logit P(X) = a+b1X1+b2X2+b3X3 ) Fit Model OR
95% CI OR Model
Model 1 Full Model OR
Gold Standard Model
Subset 4 Model
97
Valid OR
Gold standard
Model
Precision Final Model
5.27 Interaction effect

Confounding Interaction term Model
Initial Model
Interaction assessment
Interaction Interaction term
Model Heirarchical principle
Interaction
Model
Interaction term
term


- Model
- Confounding assessment

5.28
Fit Model Confounding assesment

Confounding assessment
-

- (Subjective)

Confounder Model

Potential Confounder
Confounding factors Precision
Validity
Precision

98
Confounding effect
Interaction
OR Model Subset
Full Model OR Gold
standard

Kleinbaum, 1994 203-218
5. Conditional Logistic Regression
Unconditional Logistic Regression
5.29
Conditional Unconditional Logistic Regression Logistic

Mathematical Model 2 Regression
1. Maximum Likelihood (ML) estimation Conditional
2. Least square (LS) estimation
Unconditional
Logistic Model (b)
ML

ML 2
1. Unconditional method
Mathematical Model
2. Conditional Method
2 Maximum Likelihood (ML.)
Least Square (LS.) Model
(Coefficient)
b Logistic
Regression ML.

Unconditional method
-
- : SAS (LOGIST) BMDP
GLIM SPSS EGRET SPIDA
S-PLUS STATA
Unconditional
Conditional Method
-
- : SAS (DECAN) SAS (PHREG)

5.30 EGRET SPIDA S+ STATA Conditional
OR
(Overestimate Odds Ratio)
99

Unconditional method
-
- : SAS (LOGIST) BMDP
GLIM SPSS EGRET SPIDA
S-PLUS STATA
Conditional Method
-
- : SAS (DECAN) SAS (PHREG)
EGRET SPIDA S+ STATA

5.31
Unconditional
Matched study

Conditional Unconditional Matched study
Unconditional :- Matched study
- Matched design Conditional
-
Conditional :- Matched study
- Matched study Conditional Matched
-
Outcome ( ) data (Dummy variable)
Matched
1

5.32 Model
?
: Hsieh (1989) Hsieh et al. (1998) Logistic
Rule of thumb: regression
Harrel et al. (1984): 1 Outcome 10
Concato et al. (1993): 1 Outcome 10 Hsieh (1989) Hsieh et al.
Feinstein (1996): 1 Outcome 20
(1998) Harrel et al.
Safe rule :- Outcome
Model
(1984): Concato et al. (1993)
Conditional
Conditional
1 Outcome
Memory 10
5
Model
50
5

100
10,000 Feinstein (1996)

1
Outcome 20
Outcome
Model Unconditional
ML. Over fitting
OR

Outcome
Model

Conditional ML.
Conditional ML.

(RAM)

5
Concato, J., Feinstein, A.R., and Holford, T.R., (1993). The risk of determining risk in
multivariable models. Annals of Internal Medicine. 118:201-210.
Feinstein, A.R. (1996). Multivariable analysis: an introduction. Yale university Press: New
Haven.
Harrell, F.E., Lee, K.L., Califf, R.M., Pryor, D.B., and Rosati, R.A. (1984). Rgression modelling
strategies for improve prognostic modelling. Statistics in Medicine. 3:143-152.
Hsieh, F. Y. (1989). Sample size tables for logistic regression. Stat Med 8, 795-802.
Hsieh, F. Y., Bloch, D. A., & Larsen, M. D. (1998). A simple method of sample size calculation
for linear and logistic regression. Stat Med 17, 1623-34.
101
Hosmer, D.W., and Lemeshow, S. (1989). Applied Logistic Regression. New York: John Wiley
& Sons.
Mazumdar, M., and Glassman, J. R. (2000). Categorizing a prognostic variable: review of

methods, code for easy implementation and applications to decision-making about cancer
treatments. Stat Med 19, 113-32.
Corporation.
102
5

1. (Model fitting strategies)
1 4 ( EXAMPLE.DTA
1 4 Polytomous
variable) 2 3

ID 1 465
DEAD 28 0= 1=
AREA 0= 1=
MALPRES 0= 1=
BWT ()
MAGE ()
PLACE 0= 1=
2= 3=()
"AREA" "DEAD" ( MALPRES

BWT MAGE PLACE) Risk assessment goal exposure of interest AREA
STATA

1 Exploring the data and univariate analysis

"list"
. list dead area malpres bwt mage place
dead area malpres bwt mage place

1. 1 1 0 2600 30 0
2. 1 1 0 2900 29 1
3. 1 1 0 3100 25 0
--- 460 records ---

464. 0 1 0 3500 30 0
465. 0 1 0 3200 22 1
103
"summarize"
. summarize
Variable | Obs Mean Std. Dev. Min Max
---------+-----------------------------------------------------
dead | 465 .1397849 .3471372 0 1
area | 465 .5182796 .5002039 0 1
malpres | 465 .0752688 .2641087 0 1
bwt | 465 3010.695 437.7349 1850 4000
mage | 465 25.52473 5.362298 17 42
place | 465 .2408602 .5273217 0 3
"tab"
. tab dead
dead | Freq. Percent Cum.

------------+-----------------------------------
0 | 400 86.02 86.02
1 | 65 13.98 100.00
------------+-----------------------------------
Total | 465 100.00
"ci"
. ci dead
Variable | Obs Mean Std. Err. [95% Conf. Interval]

---------+-------------------------------------------------------------
dead | 465 .1397849 .0160981 .1081507 .1714192
" 465 65
(neonatal dead rate) 14.0% (95%CI: 10.8% 17.1%)".
2 Bivariate (crude) analysis
2.1 Crude effect of AREA on DEAD

. cs dead area, or
| area |
| Exposed Unexposed | Total
-----------------+------------------------+----------
Cases | 37 28 | 65
Noncases | 204 196 | 400
-----------------+------------------------+----------
Total | 241 224 | 465
| |
Risk | .153527 .125 | .1397849
| |
|------------------------+----------------------
Risk difference | .028527 | -.0342996 .0913535
Risk ratio | 1.228216 | .778466 1.937803
Attr. frac. ex. | .1858108 | -.2845776 .4839517
Attr. frac. pop | .1057692 |
+-----------------------------------------------
chi2(1) = 0.79 Pr>chi2 = 0.3754
104
" 241
15.4% 224
12.5%
1.26 (95%CI: 0.8 2.1)
(p-value = 0.375).
2.2 Crude effect of MALPRES on DEAD

. cs dead malpres, or
| malpres |
-----------------+------------------------+----------
Cases | 21 44 | 65
Noncases | 14 386 | 400
-----------------+------------------------+----------
Total | 35 430 | 465
| |
Risk | .6 .1023256 | .1397849
| |
|------------------------+----------------------
Risk difference | .4976744 | .3328653 .6624835
Risk ratio | 5.863636 | 3.972854 8.654289
Attr. frac. ex. | .8294574 | .7482918 .8844504
Attr. frac. pop | .2679785 |
Odds ratio | 13.15909 | 6.309044 27.44195 (Cornfield)
+-----------------------------------------------
chi2(1) = 66.67 Pr>chi2 = 0.0000
2.3 Crude effect of BWT on DEAD
. gen bwtg = .
. replace bwtg = 2 if bwt >= 2500 & bwt <= 3000
. replace bwtg = 3 if bwt > 3000
. tab bwtg dead, row chi2 exact
| dead
bwtg | 0 1 | Total
-----------+----------------------+----------
1 | 27 12 | 39
| 69.23 30.77 | 100.00
-----------+----------------------+----------
2 | 175 38 | 213
| 82.16 17.84 | 100.00
-----------+----------------------+----------
3 | 198 15 | 213
| 92.96 7.04 | 100.00
-----------+----------------------+----------
Total | 400 65 | 465
| 86.02 13.98 | 100.00
Pearson chi2(2) = 20.3082 Pr = 0.000

Fisher's exact = 0.000
OR 2500
105
. csi 38 12 175 27, or

-----------------+------------------------+----------
Cases | 38 12 | 50
Noncases | 175 27 | 202
-----------------+------------------------+----------
Total | 213 39 | 252
| |
Risk | .1784038 .3076923 | .1984127
| |
|------------------------+----------------------
Risk difference | -.1292886 | -.2829945 .0244174
Risk ratio | .5798122 | .3338618 1.00695
Prev. frac. ex. | .4201878 | -.00695 .6661382
Prev. frac. pop | .3551587 |
Odds ratio | .4885714 | .2294889 1.037412 (Cornfield)
+-----------------------------------------------
chi2(1) = 3.46 Pr>chi2 = 0.0627
. csi 15 12 198 27, or

-----------------+------------------------+----------
Cases | 15 12 | 27
Noncases | 198 27 | 225
-----------------+------------------------+----------
Total | 213 39 | 252
| |
Risk | .0704225 .3076923 | .1071429
| |
|------------------------+----------------------
Risk difference | -.2372698 | -.386141 -.0883985
Risk ratio | .2288732 | .1161831 .4508654
Prev. frac. ex. | .7711268 | .5491346 .8838169
Prev. frac. pop | .6517857 |
Odds ratio | .1704545 | .0730813 .3964905 (Cornfield)
+-----------------------------------------------
chi2(1) = 19.40 Pr>chi2 = 0.0000
"lintrend"
Model
. lintrend dead bwt, groups(12) plot(log) xlab ylab
The proportion and log odds of dead by categories of bwt
(Note: 12 bwt categories of equal sample size;

Uses mean bwt value for each category)
bwt min max d total dead logodds

2162.8 1850 2400 12 39 0.31 -0.81
2544.1 2500 2600 14 62 0.23 -1.23
2695.3 2650 2700 5 32 0.16 -1.69
2858.1 2750 2900 8 43 0.19 -1.48
2998.0 2950 3000 11 76 0.14 -1.78
3099.1 3060 3100 3 46 0.07 -2.66
3196.9 3150 3200 4 32 0.12 -1.95
3293.5 3250 3300 1 23 0.04 -3.09
3473.7 3380 3500 6 73 0.08 -2.41
3761.5 3600 4000 1 39 0.03 -3.64
106
0.00
-1.00
Log odds of dead
-2.00
-3.00
-4.00
2000.0 2500.0 3000.0 3500.0 4000.0
Mean of bwt categories
Assessing Linearity Assumption -- Log Odds
Linear relationship
Linear relationship
. replace bwtg = .
(465 real changes made, 465 to missing)

. replace bwtg = 0 if bwt >= 2500

1 = Low birth weight 0 = Normal birth weight Crude effect

. cs dead bwtg, or
| bwtg |
-----------------+------------------------+----------
Cases | 12 53 | 65
Noncases | 27 373 | 400
-----------------+------------------------+----------
Total | 39 426 | 465
| |
Risk | .3076923 .1244131 | .1397849
| |
|------------------------+----------------------
Risk difference | .1832792 | .0350754 .3314829
Risk ratio | 2.473149 | 1.449993 4.218275
Attr. frac. ex. | .5956573 | .3103413 .7629363
Attr. frac. pop | .1099675 |
+-----------------------------------------------
chi2(1) = 9.98 Pr>chi2 = 0.0016
107
2.4 Crude effect of MAGE on DEAD

MAGE continuous variable DEAD
BWT dichotomize teenage pregnancy
. gen mageg = .
. replace mageg = 1 if mage < 20

. replace mageg = 0 if mage >= 20

. cs dead mageg, or
| mageg |
-----------------+------------------------+----------
Cases | 7 58 | 65
Noncases | 39 361 | 400
-----------------+------------------------+----------
Total | 46 419 | 465
| |
Risk | .1521739 .1384248 | .1397849
| |
|------------------------+----------------------
Risk difference | .0137491 | -.0951896 .1226878
Risk ratio | 1.099325 | .5336421 2.264657
Attr. frac. ex. | .0903512 | -.8739152 .558432
Attr. frac. pop | .0097301 |
+-----------------------------------------------
chi2(1) = 0.07 Pr>chi2 = 0.7985
2.5 Crude effect of PLACE on DEAD

PLACE polytomous variable

. tab place dead, row chi2 exact
| dead
place | 0 1 | Total
-----------+----------------------+----------
0 | 337 38 | 375
| 89.87 10.13 | 100.00
-----------+----------------------+----------
1 | 47 21 | 68
| 69.12 30.88 | 100.00
-----------+----------------------+----------
2 | 11 4 | 15
| 73.33 26.67 | 100.00
-----------+----------------------+----------
3 | 5 2 | 7
| 71.43 28.57 | 100.00
-----------+----------------------+----------
Total | 400 65 | 465
| 86.02 13.98 | 100.00
Pearson chi2(3) = 24.0179 Pr = 0.000

Model
. replace place = 2 if place == 3

108
. tab place dead, row chi2 exact
| dead
place | 0 1 | Total
-----------+----------------------+----------
0 | 337 38 | 375
| 89.87 10.13 | 100.00
-----------+----------------------+----------
1 | 47 21 | 68
| 69.12 30.88 | 100.00
-----------+----------------------+----------
2 | 16 6 | 22
| 72.73 27.27 | 100.00
-----------+----------------------+----------
Total | 400 65 | 465
| 86.02 13.98 | 100.00
Pearson chi2(2) = 24.0035 Pr = 0.000


OR
. csi 21 38 47 337, or

-----------------+------------------------+----------
Cases | 21 38 | 59
Noncases | 47 337 | 384
-----------------+------------------------+----------
Total | 68 375 | 443
| |
Risk | .3088235 .1013333 | .1331828
| |
|------------------------+----------------------
Risk difference | .2074902 | .0935114 .321469
Risk ratio | 3.047601 | 1.912134 4.857333
Attr. frac. ex. | .671873 | .477024 .7941257
Attr. frac. pop | .2391412 |
+-----------------------------------------------
chi2(1) = 21.47 Pr>chi2 = 0.0000
. csi 6 38 16 337, or

-----------------+------------------------+----------
Cases | 6 38 | 44
Noncases | 16 337 | 353
-----------------+------------------------+----------
Total | 22 375 | 397
| |
Risk | .2727273 .1013333 | .1108312
| |
|------------------------+----------------------
Risk difference | .1713939 | -.0171971 .359985
Risk ratio | 2.691388 | 1.276449 5.67478
Attr. frac. ex. | .6284444 | .2165766 .8237817
Attr. frac. pop | .085697 |
+-----------------------------------------------
chi2(1) = 6.19 Pr>chi2 = 0.0128
(
) OR 95%CI p-value p-value Model
109
3 Stratified analysis
3.1 Effect of MALPRES on the association between AREA and

DEAD
. cc dead area, by(malpres)
malpres | OR [95% Conf. Interval] M-H Weight

-----------------+-------------------------------------------------
0 | .6711146 .3590862 1.254787 11.85116 (Cornfield)
1 | 7.125 1.297704 37.58284 .4571429 (Cornfield)
-----------------+-------------------------------------------------
Crude | 1.269608 .7512221 2.145309 (Cornfield)
M-H combined | .9108184 .5136778 1.615001
-----------------+-------------------------------------------------

Pr>chi2 = 0.7453
MALPRES Effect modifier

. tab area dead if malpres == 0, row chi2 exact
| dead
area | 0 1 | Total
-----------+----------------------+----------
0 | 190 26 | 216
| 87.96 12.04 | 100.00
-----------+----------------------+----------
1 | 196 18 | 214
| 91.59 8.41 | 100.00
-----------+----------------------+----------
Total | 386 44 | 430
| 89.77 10.23 | 100.00
Pearson chi2(1) = 1.5385 Pr = 0.215

1-sided Fisher's exact = 0.140
. tab area dead if malpres == 1, row chi2 exact
| dead
area | 0 1 | Total
-----------+----------------------+----------
0 | 6 2 | 8
| 75.00 25.00 | 100.00
-----------+----------------------+----------
1 | 8 19 | 27
| 29.63 70.37 | 100.00
-----------+----------------------+----------
Total | 14 21 | 35
| 40.00 60.00 | 100.00
Pearson chi2(1) = 5.2932 Pr = 0.021

1-sided Fisher's exact = 0.030
110
3.2 Effect of BWTG on the association between AREA and DEAD

. cc dead area, by(bwtg)
bwtg | OR [95% Conf. Interval] M-H Weight

-----------------+-------------------------------------------------
0 | 1.339792 .7542532 2.379341 9.934272 (Cornfield)
1 | .49 .1209808 1.95487 2.564103 (Cornfield)
-----------------+-------------------------------------------------
Crude | 1.269608 .7512221 2.145309 (Cornfield)
M-H combined | 1.165453 .6827702 1.989367
-----------------+-------------------------------------------------

Pr>chi2 = 0.5728
3.3 Effect of MAGEG on the association between AREA and DEAD

. cc dead area, by(mageg)
mageg | OR [95% Conf. Interval] M-H Weight

-----------------+-------------------------------------------------
0 | 1.599555 .9133475 2.800384 9.661098 (Cornfield)
1 | .1571429 .0305953 .8318563 3.043478 (Cornfield)
-----------------+-------------------------------------------------
Crude | 1.269608 .7512221 2.145309 (Cornfield)
M-H combined | 1.254014 .7442425 2.112957
-----------------+-------------------------------------------------

Pr>chi2 = 0.3867
3.4 Effect of PLACE on the association between AREA and DEAD

. cc dead area, by(place)
place | OR [95% Conf. Interval] M-H Weight

-----------------+-------------------------------------------------
0 | .7952381 .4090156 1.546609 9.52 (Cornfield)
1 | 3.74 1.13241 12.16321 1.470588 (Cornfield)
2 | .7777778 .1316856 4.564086 1.227273 (Cornfield)
-----------------+-------------------------------------------------
Crude | 1.269608 .7512221 2.145309 (Cornfield)
M-H combined | 1.147927 .6675961 1.973853
-----------------+-------------------------------------------------

Pr>chi2 = 0.6185
4 Multivariable analysis : Logistic regression
Crude stratified analysis 2 3

Neonatal dead Candidate Initial model
Interaction term
111
. gen a_mal = area * malpres

. gen a_mageg = area * mageg
. gen a_place = area * place
4.1. The initial model the full model

. xi: logit dead area malpres bwtg mageg i.place a_mal a_mageg i.a_place
i.place Iplace_0-2 (naturally coded; Iplace_0 omitted)
i.a_place Ia_pla_0-2 (naturally coded; Ia_pla_0 omitted)


LR chi2(10) = 74.63
Prob > chi2 = 0.0000
------------------------------------------------------------------------------
---------+--------------------------------------------------------------------
area | -.5413629 .4338548 -1.248 0.212 -1.391703 .3089768
malpres | .8913886 .9323986 0.956 0.339 -.9360792 2.718856
bwtg | 1.117437 .4577921 2.441 0.015 .2201811 2.014693
mageg | 1.439287 .6143028 2.343 0.019 .2352758 2.643299
Iplace_1 | .5058782 .6178105 0.819 0.413 -.7050082 1.716765
Iplace_2 | 1.306483 .7715727 1.693 0.090 -.2057713 2.818738
a_mal | 2.086607 1.073441 1.944 0.052 -.0172996 4.190513
a_mageg | -1.630821 1.032344 -1.580 0.114 -3.654178 .3925359
Ia_pla_1 | .8395218 .8137985 1.032 0.302 -.7554939 2.434537
Ia_pla_2 | .2971595 1.080756 0.275 0.783 -1.821084 2.415403
_cons | -2.38564 .2742555 -8.699 0.000 -2.923171 -1.848109
------------------------------------------------------------------------------
Log-likelihood Model 0
. lrtest, saving(0)
xi logit STATA polytomous variables

model i. polytomous variable STATA dummy
variables ( "logit" StataCorp (1999);
228-239 Volumn 2 : H-O)
interaction terms () AREA*PLACE () Model

p-value dummy variables
hierarchical well-formatted model
4.2. Model without AREA*PLACE

. xi: logit dead area malpres bwtg mageg i.place a_mal a_mageg
112


LR chi2(8) = 73.52
Prob > chi2 = 0.0000
------------------------------------------------------------------------------
---------+--------------------------------------------------------------------
area | -.310655 .355062 -0.875 0.382 -1.006564 .3852538
malpres | .9825991 .9336054 1.052 0.293 -.8472338 2.812432
bwtg | 1.040474 .4492353 2.316 0.021 .159989 1.920959
mageg | 1.55312 .6067453 2.560 0.010 .3639209 2.742319
Iplace_1 | .9748812 .3862543 2.524 0.012 .2178366 1.731926
Iplace_2 | 1.452425 .539014 2.695 0.007 .3959774 2.508873
a_mal | 2.045493 1.077159 1.899 0.058 -.0657009 4.156686
a_mageg | -1.861715 1.004119 -1.854 0.064 -3.829751 .1063217
_cons | -2.487954 .2633255 -9.448 0.000 -3.004063 -1.971846
------------------------------------------------------------------------------
p-value Likelihood Ratio test Model

. lrtest, using(0)
Logit: likelihood-ratio test chi2(2) = 1.11
Prob > chi2 = 0.5752
Log-likelihood Model Model 1

. lrtest, saving(1)
LR test AREA*PLACE Model (p-value = 0.575)

Model AREA*MAGEG Model
4.3. Model without AREA*MAGE

. xi: logit dead area malpres bwtg mageg i.place a_mal


LR chi2(7) = 69.74
Prob > chi2 = 0.0000
------------------------------------------------------------------------------
---------+--------------------------------------------------------------------
area | -.5590873 .3350725 -1.669 0.095 -1.215817 .0976429
malpres | .8722993 .9317147 0.936 0.349 -.9538279 2.698427
bwtg | 1.047556 .4440794 2.359 0.018 .1771763 1.917935
mageg | .7140317 .4804309 1.486 0.137 -.2275954 1.655659
Iplace_1 | .9866509 .3859063 2.557 0.011 .2302884 1.743013
Iplace_2 | 1.478023 .540374 2.735 0.006 .4189098 2.537137
a_mal | 2.246689 1.073616 2.093 0.036 .1424403 4.350939
_cons | -2.382853 .2488897 -9.574 0.000 -2.870668 -1.895038
------------------------------------------------------------------------------
. lrtest, using(1)
Prob > chi2 = 0.0518
. lrtest, saving(2)
113
AREA*MAGE Model (p-value = 0.052)

AREA*MALPRES Model (p-value = 0.036)
Main effect p-value MALPRES
Interaction term MAGEG
4.4. Model without MAGEG

. xi: logit dead area malpres bwtg i.place a_mal


LR chi2(6) = 67.73
Prob > chi2 = 0.0000
------------------------------------------------------------------------------
---------+--------------------------------------------------------------------
area | -.5157685 .3326557 -1.550 0.121 -1.167762 .1362246
malpres | .7955996 .925203 0.860 0.390 -1.017765 2.608964
bwtg | 1.093564 .4429316 2.469 0.014 .2254335 1.961694
Iplace_1 | .8849724 .376117 2.353 0.019 .1477966 1.622148
Iplace_2 | 1.365092 .5319488 2.566 0.010 .3224913 2.407692
a_mal | 2.266141 1.069409 2.119 0.034 .170138 4.362143
_cons | -2.295464 .2367904 -9.694 0.000 -2.759565 -1.831363
------------------------------------------------------------------------------
. lrtest, using(2)
Prob > chi2 = 0.1565
MAGEG (p-value = 0.156) Model

significant predictors DEAD Model Final model.
5 Assessing model adequacy: test for goodness of fit of the model

. lfit
Logistic model for dead, goodness-of-fit test
number of observations = 465

number of covariate patterns = 16
Pearson chi2(9) = 17.32
Prob > chi2 = 0.0440
lfit Pearson Hosmer-Lemeshow goodness-of-fit tests

Hosmer-Lemeshow test Pearson test
Model ( StataCorp (1999); 209-211
Volumn 2 : H-O) p-value = 0.044 Model
114
Fit Model BWT MAGE p-value =

0.465 Model OR
Model Model
Model assessment Hosmer and

Lemeshow (1989) influence observations
OR Model
STATA ( StataCorp, 1999 Volume 2,
200-222).
6 Obtaining measure of associations from the model

Odds ratios p-value Model logistic
BWTG PLACE ()
. xi: logistic dead area malpres bwtg i.place a_mal

LR chi2(6) = 67.73
Prob > chi2 = 0.0000
------------------------------------------------------------------------------
---------+--------------------------------------------------------------------
area | .5970416 .1986093 -1.550 0.121 .3110624 1.145939
malpres | 2.215769 2.050036 0.860 0.390 .3614018 13.58497
bwtg | 2.984892 1.322103 2.469 0.014 1.252866 7.11136
Iplace_1 | 2.422917 .9113004 2.353 0.019 1.159277 5.063957
Iplace_2 | 3.916082 2.083155 2.566 0.010 1.380563 11.1083
a_mal | 9.642116 10.31136 2.119 0.034 1.185468 78.42503
------------------------------------------------------------------------------
Interaction AREA MALPRES AREA DEAD

MALPRES AREA MALPRES = 0 Output
area AREA MALPRES = 1
. lincom area + a_mal
( 1) area + a_mal = 0.0
------------------------------------------------------------------------------
---------+--------------------------------------------------------------------
(1) | 5.756744 5.836508 1.726 0.084 .7891896 41.99257
------------------------------------------------------------------------------
7 Summarize findings
465 65 28 14.0%
(95%CI: 10.8% 17.1%) 1
115

. 28

(p-value = 0.034)

28 1.7 . (95%CI:
0.9 3.2) .
28 5.8
(95%CI: 0.8 42.0)
1 Crude adjusted odds ratio
Crude Adjusted OR 95%CI for p-value

Factors (%) OR adjusted OR
1. .

0.034
1.1
27 70 7.1 5.8 0.8 to 42.0
8 25 1.0 1.0
1.2
214 8 0.7 0.6 0.3 to 1.1
216 12 1.0 1.0
2. 0.014
2,500 39 31 3.1 3.0 1.2 to 7.1
2,500 426 12 1.0 1.0
3. 0.010
375 10 1.0 1.0
68 31 4.0 2.4 1.2 to 5.1
22 27 3.3 3.9 1.4 to 11.1
****************
116
2.

< 40 577 34
682 57
40 - 59 164 4
245 74
2.1)
2.2) 2.1
2.3) Confounder Effect Modifier
2.4) 2.3

2.5)
3. (Esophageal cancer)
case-control study

case
1 31 2531 Control case
117
1 2 ESOPH_CA.DTA

1-3 ID 1 = case
4 CASE 1 = case
0 = control
5 AlC1 1 =
2 =
6 ALC2 1 =
2 =
7 SMK 1 =
2 =
8 PARA 1 =
2 =
9 CIGA 0 =
1 = 1-9 /
2 = 10-19 /
3 = 20+ /

118

. (2541). .
. 3(3) :20-25.
Concato, J., Feinstein, A.R., and Holford, T.R., (1993). The risk of determining risk in
multivariable models. Annals of Internal Medicine. 118:201-210.
Feinstein, A.R. (1996). Multivariable analysis: an introduction. Yale university Press: New
Haven.
Fleiss, J.L. (1981). Statistical methods for rates and proportions. 2nd edition. New York: John
Willey & Sons.
Guyatt, G., Jaeschke, R., Heddle, N., Cook, D., Shannon, H., and Walter S. (1995). Interpreting
study results: confidence intervals. Canadian Medical Association Journal. 152:169-173.
Harrell, F.E., Lee, K.L., Califf, R.M., Pryor, D.B., and Rosati, R.A. (1984). Rgression modelling
strategies for improve prognostic modelling. Statistics in Medicine. 3:143-152.
Hosmer, D.W., and Lemeshow, S. (1989). Applied Logistic Regression. New York: John Wiley
& Sons.
Hsieh, F. Y. (1989). Sample size tables for logistic regression. Stat Med 8, 795-802.
Hsieh, F. Y., Bloch, D. A., & Larsen, M. D. (1998). A simple method of sample size calculation
for linear and logistic regression. Stat Med 17, 1623-34.
Jaeschke, R., Guyatt, G., Shannon, H., Walter, S. Cook, D. Heddle, N. (1995). Assessing the
effects of treatment: measures of association . Canadian Medical Association Journal. 152:
351-357
Kleinbaum, D.G., Kupper, L.L., and Morgenstern, H. (1982). Epidemiologic research: principles
and qualitative methods. London: Lifetime Learning Publications.
Lang, TA., Secic, M. (1997). How to report statistics in medicine: annotated guidelines for
authors, editors, and reviewers. Philadelphia: American College of Physician.
Mazumdar, M., and Glassman, J. R. (2000). Categorizing a prognostic variable: review of
methods, code for easy implementation and applications to decision-making about cancer
treatments. Stat Med 19, 113-32.
Corporation.
119
1

1
1
1.2.5 400 records
2
2.1
STATA
EXERCISE+ EXERCISE- exc smk chd n
CHD+ CHD- Total CHD+ CHD- Total 1 1 1 50
SMK+ 50 50 100 SMK+ 25 10 35
SMK- 50 50 100 SMK- 25 40 65 1 1 0 50
Total 100 100 200 Total 50 50 100 1 0 1 50
1 0 0 50
2 1 1 25
2 1 0 10
EXC 1=Always, 2= Not always 2 0 1 25
SMK 0=No, 1=Yes 2 0 0 40
CHD 0=No, 1=Yes
001
300

1. EXC [ ]
[ ]1. [ ]2.
2. SMK [ ]
[ ]0. [ ]1.
3. CHD [ ]
[ ]0. [ ]1.
120
2.3 .cc chd smk, by(exc)
2.5 .logistic chd smk exc
3.
3.1) Dichotomous DEAD AREA MALPRES
3.2) Continuous BWT MAGE DCHILD
3.3) (D) DEAD
3.4) (E) AREA
3.5) (C) MALPRES BWT MAGE DCHILD
3.6)
1.

1. 28 DEAD[ 1 ]
[X]1. [ ]0.
2. AREA[ 1 ]
[X]1. [ ]0.
3. MALPRES[ 0 ]
[ ]1. [X]0.
4. ..........2600....... BWT[2][6 ][ 0 ][ 0 ]
5. .................30.................... AGE[ 3 ][ 0 ]
6.
....0...... DCHILD[ 0 ]
121
3.7) 465
3.8.1 ORC = 1.27
3.9.1.1 OR1 = 0.67

OR2 = 7.13
3.9.1.3 OR1 = 0.67

OR2 = 7.13
ORC = 1.27
ORMH = 0.91
Woolfs test p-value = 0.015
3.9.1.4
Stratified analysis DEAD AREA Interaction
effect MALPRES Effect Modifier
28

28
1.49 (95%CI: 0.80 2.79)
28
7.13 (95%CI: 0.93 67.28)
: 1. (95%CI.)
2. OR 1
OR 1
1/OR 1/0.69 = 1.49
OR 1
(protective effect) 1 (risk
effect)
3.9.2.1 OR1 = 0.80

OR2 = 2.44
122
3.9.2.3 OR1 = 0.80

OR2 = 2.44
ORC = 1.27
ORMH = 1.15
Woolfs test p-value = 0.067
Woolfs test for heterogeneity of Odds Ratios p-

value = 0.057 ==> OR1OR2 Interaction
effect ORMH = 1.15 ORC
ORMH ORC
Confounding effect DCHILD Effect modifier Confounder
DEAD AREA
3.9.2.4

28
3.9.3.3 ORC = 1.27

OR1 = 0.49
OR2 = 2.1
OR3 = 0.8
Woolfs test p-value = 0.154 Interaction effect
ORMH = 1.09 ORC =1.27 Confounding effect
3.9.3.4 BWTG Effect modifier Confounder
DEAD AREA
3.10 AREA DEAD

Bivariate analysis stratified
analysis MALPRES effect modifier DCHILD BWT Effect
modifier Confounder DEAD AREA
multivariable analysis
Model MALPRES Model Interaction
term AREA () DCHILD BWT
Model (joint effect) AREA MALPRES DCHILD
BWT DEAD
123

2
1.
1.1) Logistic Function :
1
f (z ) =
1 + e z
1.2) Logistic Model :

1
P (X ) =
1 + e ( a + bi X i )
1.3) Logit transformation :
P (X )
ln = a + b i x i
1 P (X )
Logit P(X) = a + biXi
P(X) Model (X ) P(X)

Model 1.2 P(X) Model (X ) Odds
2.
2.1) OR Logistic Model
Cohort study
Case-control study
Cross-sectional Study
2.2) OR
(i) ORx1,Xo = Exp{[bi(X1i- X0i)]}
(ii) X1 AREA=1
X0 AREA=0
124
(iii) ORx1,Xo= Exp{[-1.946 + 0.239(1)] -[-1.946 + 0.239(0)]}

= Exp[0 + 0.239)]
= Exp(0.239)
= e(0.239)
= 1.27
(iv) 28 1.27

(.) 28
1.27

2.3) 2 x 2
DEAD
1 0
1 37 204
AREA
0 28 196 OR = (37 x 196) / (204 x 28) = 1.27
2.4) Logistic Model 2 x 2

- Logit P(X) = a + b1AREA
- Logit P(X) = -1.94591 + .2387081(AREA)
3
3.2) OR
(ii) DCHILD
X1 (AREA=1, DCHILD )
DCHILD X0
X0 (AREA=0, DCHILD )
125
(iii) ORx1,Xo = Exp{[-2.255301 (0 - 0) + 0.1419709 (1 - 0)

+ 1.321847(0 - 0)]}
= Exp(0.1419709)
= 1.15
(iv)
.
28 1.15

3.3) Logistic Model Stratified analysis 1 3.9.2.3

Logit P(X) = -2.255301 + 0.1419709(AREA) + 1.321847 (DCHILD)
4.
Logit P(X) = a + b1AREA + b2MALPRES
( 3 2 (2.1)
126

3
1.
1.1 BWTG = 2 (Reference group)
(Dummy Variable)
BWTD1 BWTD3
BWTG = 1 1 0
BWTG = 2 0 0
BWTG = 3 0 1
1.3.1) OR

(ii)
X1 (BWTD3=1, )

X0 (BWTD1=0, )
(iii) 3.2 (iii) 2
ORx1,Xo = Exp(0.6092406)
= 1.84
1.3.2) OR

(ii)
X1 (BWTD1=1, )

X0 (BWTD1=0, )
(iii) 3.2 (iii) 2
ORx1,Xo = Exp(-0.8628492)
= 0.42
127
2.
2.1) Model Logit transformation
Logit P(X) = a + b1AREA + b2MALPRES + b3AREA*MALPRES
2.3) MALPRES = 0, OR(AREA1,0) = 0.67

MALPRES = 1, OR(AREA1,0) = 7.12
2.4) OR Stratified analysis
2.5) OR Exponential Coefficient

Interaction effect
3.1) Term Third order term

3.2)
Logit P(X) = a + b1AREA + b2MALPRES + b3MAGE + b4AREA*MALPRES
+ b5AREA*MAGE + b6MALPRES*MAGE + b7AREA*MALPRES*MAGE
128

4
1.
1.1.1) OR. 95%
DEAD
1 0
1 37 204
AREA
0 28 196 OR. = (37 x 196) / (204 x 28) = 1.27
1 1 1 1
95%CI .OR.=1.27 EXP 1.96 + + +
37 204 28 196
= 0.75 - 2.15
: STATA .cc area dead <ENTER>

1.1.2 STATA
. use logistic.dta

LR chi2(1) = 0.79
Prob > chi2 = 0.3745
------------------------------------------------------------------------------
---------+--------------------------------------------------------------------
area | 1.269608 .342429 0.885 0.376 .7483246 2.154017
------------------------------------------------------------------------------
1.2.3 :
(.)
28 1.27
1.2) Logistic Regression Model 1.1 Logit

129
transformation
Logit P(X) = -1.946 + 0.239AREA
1.2.1)
OR. = Exp(0.239) = 1.27
95% CI OR. = Exp[0.239 + 1.96(0.27)]
Standard Error (SE.) = 0.27 STATA
.logit dead area
= Exp(-0.29) Exp(0.77)
= 0.75 2.16
1.2.2) STATA
.logistic dead area
OR. = 1.27
95% CI OR. = 0.75 - 2.15
1.3) 1.1 1.2
2.
.logit dead mage

-----------------------------------------------------------------
dead | Coef. Std. Err. z P>|z|
[95% Conf. Interval]
------+----------------------------------------------------------
mage | .0170007 .0244332 0.696 0.487 -.0308874
.0648888
_cons | -2.254025 .64633 -3.487 0.000 -3.520808 -
.9872413
-----------------------------------------------------------------
2.2) OR MAGE30,20 = eL
L = b(MAGE30 - MAGE20)
130
OR. = Exp[(30-20)(0.017)]
= Exp(0.17)
= 1.19
95% CI
95% CI OR. = exp [L 1.96 var (L)]
L = 10(bMAGE)
Var (L) = var[10(bMAGE)]
Var (L) = 102 var(bMAGE)
var (L) = 102 var(bMAGE)
var (L) = 10 x var(bMAGE)
= 10 x SE.(bMAGE)
= 10 x 0.024 ....>(var = SE. SE.(bMAGE) 2.1)
= 0.24
95% CI OR. = Exp[(0.17) + 1.96 x 0.24]
= Exp(-0.3) Exp(0.64)
= 0.74 1.90
: 30 28
1.19 20 (95%CI: 0.74 1.90)
3.

------------------------------------------------------------------
------+-----------------------------------------------------------
area | -.3988155 .3230824 -1.234 0.217 -1.032045 .2344144
malpres | .8903152 .8428469 1.056 0.291 -.7616343 2.542265
a_mal | 2.362425 .9739987 2.425 0.015 .453423 4.271427
_cons | -1.988927 .2091045 -9.512 0.000 -2.398765 -1.57909
------------------------------------------------------------------
131
3.2) OR.
OR(MALPRES=0) = Exp(-0.399)
= 0.67
OR(MALPRES=1) = Exp(-0.399 + 2.362)
= 7.12
3.5)
. 28

28 1.49 .
(95%CI: 0.79 2.78)
. 28 7.13
(95%CI: 1.18 43.14)
: OR 1
1
OR=1.49 1 / 0.67 95%CI: 0.79 2.81 1/ 1.26 1/0.36
132
1.

50 () .
.
. 40002
Download http://web.kku.ac.th/~bandit/data/
2. STATA
STATA

Stata Coorporation
702 University Drive East
College Station, TX 77840 USA.
Fax. 409-696-4601
http://www.stata.com
:
.

. . 40002
e-Mail : karawa@kku.ac.th

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ANALYSIS OF DATA IN HEALTH SCIENCE RESEARCH USING

ANALYSIS OF DATA IN HEALTH SCIENCE RESEARCH USING

4. Confounding effect Interaction effect

2. Bivariate analysis Logistic Regression

3. Stratified analysis Logistic Regression : Confounding Interaction effect

1.4 Logistic regression

Dichotomous outcome Logistic regression

Polytomous outcome Multinomial logistic regression

Ordinal outcome Ordinal logistic regression

1.7 (Risk assessment)

(Grand totals is fixed )

P = a + b ! cN+! ad! !b !ac+! dc! ! b + d !

2.2 Stratified analysis

2.2.1 Confounding Effect

2.2.2. Interaction effect

1.19 Interaction effect

1.25 Crude analysis Logistic

Logit estimates Number of obs = 400 ORC = 5.4 ( CHD

1.26 Stratified analysis

SEX | OR [95% Conf. Interval] M-H Weight

Test that combined OR = 1:

1.27 Multiple logistic regression

1. Edit icon 2. 3. Double click

1.2.4 1 record ( n ) 1 record

1.2.6 Save save <ENTER>

1.3 1.24 1.27

CHD+ CHD- Total CHD+ CHD- Total

2.2 STATA EXAMPLE2.DTA

2.5 Logistic regression 2.3

ID DEAD AREA MALPRES BWT MAGE DCHILD

3.8 3.9 ( Odds Ratio

3.9 Stratified analysis

Woolfs test for heterogeneity of Odds Ratios

p-value = 0.015 ( Computer output 3.9.1.2)

. cc dead area, by(malpres)

malpres | OR [95% Conf. Interval] M-H Weight

Test that combined OR = 1:

3.9.2 Stratified analysis DCHILD Stratified variable DCHILD

OR1 = OR2 = . ORC = 1.27

. replace dchild = 1 if dchild > 1 & dchild ~= .

. cc dead area, by( dchild)

dchild | OR [95% Conf. Interval] M-H Weight

Test that combined OR = 1:

3.9.3 Stratified analysis BWT Stratified variable

bwtg | OR [95% Conf. Interval] M-H Weight

Test that combined OR = 1:

3.10 Multivariable analysis

2. Simple Linear Regression Logistic Regression

4. Odds Ratio (OR) Logistic Model

2. Logistic Regression Model

1 function f(z) = 1/(1+e-z)

2.5 Logistic Model Logistic

Natural Log Odds (ln

2.11 ( 10) Odds Ratio

1.2) Logistic Model :

1.3) Logit transformation :

2. Odds Ratio (OR) Bivariate model

Iteration 0: log likelihood = -188.1264

Logit estimates Number of obs = 465

. logistic dead area

Logit estimates Number of obs = 465

2.4) Logistic Model 2 x 2

2.5) Logistic Model Logit transformation

predicted = -17.70177 + .0833837maleteen -1.117091south + .0229224educ + .0581834police59

3. Model Interaction term AREAMALPRESSMAGE