Logistic regression had superior performance compared with regression trees for predicting in-hospital mortality in patients hospitalized with heart failure

被引:39
作者
Austin, Peter C. [1 ,3 ]
Tu, Jack V. [1 ,2 ,3 ,4 ,5 ]
Lee, Douglas S. [1 ,5 ,6 ]
机构
[1] Inst Clin Evaluat Sci, Toronto, ON M4N 3M5, Canada
[2] Univ Toronto, Dalla Lana Sch Publ Hlth, Toronto, ON, Canada
[3] Univ Toronto, Dept Hlth Management Policy & Evaluat, Toronto, ON, Canada
[4] Sunnybrook Hlth Sci Ctr, Schulich Heart Ctr, Toronto, ON M4N 3M5, Canada
[5] Univ Toronto, Fac Med, Dept Med, Toronto, ON, Canada
[6] Univ Hlth Network, Div Cardiol, Toronto, ON, Canada
基金
加拿大健康研究院;
关键词
Logistic regression; Regression trees; Classification trees; Predictive model; Validation; Recursive partitioning; Congestive heart failure; ACUTE MYOCARDIAL-INFARCTION; RISK SCORE; CLASSIFICATION; VALIDATION; MODELS; CARE;
D O I
10.1016/j.jclinepi.2009.12.004
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Objective: To compare the predictive accuracy of regression trees with that of logistic regression models for predicting in-hospital mortality in patients hospitalized with heart failure. Study Design and Setting: Models were developed in 8,236 patients hospitalized with heart failure between April 1999 and March 2001. Models included the Enhanced Feedback for Effective Cardiac Treatment and Acute Decompensated Heart Failure National Registry (ADHERE) regression models and tree. Predictive accuracy was assessed using 7,608 patients hospitalized between April 2004 and March 2005. Results: The area under the receiver operating characteristic curve for five different logistic regression models ranged from 0.747 to 0.775, whereas the corresponding values for three different regression trees ranged from 0.620 to 0.651. For the regression trees grown in 1,000 random samples drawn from the derivation sample, the number of terminal nodes ranged from 1 to 6, whereas the number of variables used in specific trees ranged from 0 to 5. Three different variables (blood urea nitrogen, dementia, and systolic blood pressure) were used for defining the first binary split when growing regression trees. Conclusion: Logistic regression predicted in-hospital mortality in patients hospitalized with heart failure more accurately than did the regression trees. Regression trees grown in random samples from the same data set can differ substantially from one another. (C) 2010 Elsevier Inc. All rights reserved.
引用
收藏
页码:1145 / 1155
页数:11
相关论文
共 29 条
[1]   Predictors of in-hospital mortality in patients hospitalized for heart failure - Insights from the Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure (OPTIMIZE-HF) [J].
Abraham, William T. ;
Fonarow, Gregg C. ;
Albert, Nancy M. ;
Stough, Wendy Gattis ;
Gheorghiade, Mihai ;
Greenberg, Barry H. ;
O'Connor, Christopher M. ;
Sun, Jie Lena ;
Yancy, Clyde W. ;
Young, James B. .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2008, 52 (05) :347-356
[2]  
[Anonymous], 1984, OLSHEN STONE CLASSIF, DOI 10.2307/2530946
[3]  
[Anonymous], 2005, R LANG ENV STAT COMP
[4]   Automated variable selection methods for logistic regression produced unstable models for predicting acute myocardial infarction mortality [J].
Austin, PC ;
Tu, JV .
JOURNAL OF CLINICAL EPIDEMIOLOGY, 2004, 57 (11) :1138-1146
[5]   A comparison of regression trees, logistic regression, generalized additive models, and multivariate adaptive regression splines for predicting AMI mortality [J].
Austin, Peter C. .
STATISTICS IN MEDICINE, 2007, 26 (15) :2937-2957
[6]   The large-sample performance of backwards variable elimination [J].
Austin, Peter C. .
JOURNAL OF APPLIED STATISTICS, 2008, 35 (11-12) :1355-1370
[7]   A multivariate model for predicting mortality in patients with heart failure and systolic dysfunction [J].
Brophy, JM ;
Dagenais, GR ;
McSherry, F ;
Williford, W ;
Yusuf, S .
AMERICAN JOURNAL OF MEDICINE, 2004, 116 (05) :300-304
[8]  
Clark L.A., 1993, Statistical Models in S, P377
[9]   DEMAND FOR AUTOMOBILES [J].
CRAGG, JG ;
UHLER, RS .
CANADIAN JOURNAL OF ECONOMICS, 1970, 3 (03) :386-406
[10]   BACKWARD, FORWARD AND STEPWISE AUTOMATED SUBSET-SELECTION ALGORITHMS - FREQUENCY OF OBTAINING AUTHENTIC AND NOISE VARIABLES [J].
DERKSEN, S ;
KESELMAN, HJ .
BRITISH JOURNAL OF MATHEMATICAL & STATISTICAL PSYCHOLOGY, 1992, 45 :265-282