Modeling longitudinal data with ordinal response by varying coefficients

This paper presents a smooth regression model for ordinal data with longitudinal dependence structure. A marginal model with cumulative logit link is applied to cope with the ordinal scale and the main and covariate effects in the model are allowed to vary with time. Local fitting is pursued and asymptotic properties of the estimates are discussed. In a second step, the longitudinal dependence of the observations is considered. Cumulative log odds ratios are fitted locally, which allows investigation of how the longitudinal dependence of the ordinal observations changes with time.     

GOLDmineR: improving models for classifying patients with chest pain

The laboratory is dealing with reporting tests as information needed to make clinical decisions. The traditional statistical quality control measures which assigns reference ranges based on 95 percent confidence intervals is insufficient for diagnostic tests that assign risk. We construct a basis for risk assignment by a method that builds on the 2 x 2 contingency table used to calculate the C2 goodness-of-fit and Bayesian estimates. The widely used logistic regression is a subset of the regression method, as it only considers dichotomous outcome choices. We use examples of multivalued predictor(s) and a multivalued as well as dichotomous outcome. Outcomes analyses are quite easy using the ordinal logit regression model.     

Logit model in prospective coronary heart disease (CHD) risk factors prediction in Saudi population

Analysis through logistic regression explored to investigate the relationship between binary or multivariable ordinal response probability and in one or more explanatory variables. The main objectives of this study to investigate advanced prediction risk factor of Coronary Heart Disease (CHD) using a logit model. Attempts made to reduce risk factors, increase public or professional awareness. Logit model used to evaluate the probability of a person develop CHD, considering any factors such as age, gender, high low-density lipoprotein (LDL) cholesterol, low high-density lipoprotein (HDL) cholesterol, high blood pressure, family history of CHD younger than 45, diabetes, smoking, being post-menopausal for women and being older than 45 for men. Logit concept of brief statistics described with slight modification to estimate the parameters testing for the significance of the coefficients, confidence interval fits the simple, multiple logit models. Besides, interpretation of the fitted logit regression model introduced. Variables showing best results within the scientific context, good explanation data assessed to fit an estimated logit model containing chosen variables, this present experiment used the statistical inference procedure; chi-square distribution, likelihood ratio, Score, or Wald test and goodness-of-fit. Health promotion started with increased public or professional awareness improved for early detection of CHD, to reduce the risk of mortality, aimed to be Saudi vision by 2030.     

Use of ordinal categorical variables in skeletal assessment of sex from the cranium

In anthropological studies, visual indicators of sex are traditionally scored on an ordinal categorical scale. Logistic and probit regression models are commonly used statistical tools for the analysis of ordinal categorical data. These models provide unbiased estimates of the posterior probabilities of sex conditional on observed indicators, but they do so only under certain conditions. We suggest a more general method for sexing using a multivariate cumulative probit model and examine both single indicator and multivariate indicator models on a sample of 138 crania from a Late Mississippian site in middle Tennessee. The crania were scored for five common sex indicators: superciliary arch form, chin form, size of mastoid process, shape of the supraorbital margin, and nuchal cresting. Independent assessment of sex for each individual is based on pubic indicators. The traditional logistic regressions are cumbersome because of limitations imposed by missing data. The logistic regression correctly classified 66/74 males and 46/64 females, with an overall correct classification of 81%. The cumulative probit model classified 64/74 males correctly and 51/64 females correctly for an overall correct classification rate of 83%. Finally, we apply parameters estimated from the logit and probit models to find posterior probabilities of sex assignment for 296 additional crania for which pubic indicators were absent or ambiguous. Am J Phys Anthropol 107:97–112, 1998. © 1998 Wiley-Liss, Inc.     

Calculating Ordinal Regression Models in SAS and S‐Plus

Although a number of regression models for ordinal responses have been proposed, these models are not widely known and applied in epidemiology and biomedical research. Overviews of these models are either highly technical or consider only a small part of this class of models so that it is difficult to understand the features of the models and to recognize important relations between them. In this paper we give an overview of logistic regression models for ordinal data based upon cumulative and conditional probabilities. We show how the most popular ordinal regression models, namely the proportional odds model and the continuation ratio model, are embedded in the framework of generalized linear models. We describe the characteristics and interpretations of these models and show how the calculations can be performed by means of SAS and S‐Plus. We illustrate and compare the methods by applying them to data of a study investigating the effect of several risk factors on diabetic retinopathy. A special aspect is the violation of the usual assumption of equal slopes which makes the correct application of standard models impossible. We show how to use extensions of the standard models to work adequately with this situation.     

Sequential ordinal modeling with applications to survival data

This paper considers the class of sequential ordinal models in relation to other models for ordinal response data. Markov chain Monte Carlo (MCMC) algorithms, based on the approach of Albert and Chib (1993, Journal of the American Statistical Association 88, 669-679), are developed for the fitting of these models. The ideas and methods are illustrated in detail with a real data example on the length of hospital stay for patients undergoing heart surgery. A notable aspect of this analysis is the comparison, based on marginal likelihoods and training sample priors, of several nonnested models, such as the sequential model, the cumulative ordinal model, and Weibull and log-logistic models.     

A new nonparametric approach for baseline covariate adjustment for two-group comparative studies

SUMMARY: We consider two-armed clinical trials in which the response and/or the covariates are observed on either a binary, ordinal, or continuous scale. A new general nonparametric (NP) approach for covariate adjustment is presented using the notion of a relative effect to describe treatment effects. The relative effect is defined by the probability of observing a higher response in the experimental than in the control arm. The notion is invariant under monotone transformations of the data and is therefore especially suitable for ordinal data. For a normal or binary distributed response the relative effect is the transformed effect size or the difference of response probability, respectively. An unbiased and consistent NP estimator for the relative effect is presented. Further, we suggest a NP procedure for correcting the relative effect for covariate imbalance and random covariate imbalance, yielding a consistent estimator for the adjusted relative effect. Asymptotic theory has been developed to derive test statistics and confidence intervals. The test statistic is based on the joint behavior of the estimated relative effect for the response and the covariates. It is shown that the test statistic can be used to evaluate the treatment effect in the presence of (random) covariate imbalance. Approximations for small sample sizes are considered as well. The sampling behavior of the estimator of the adjusted relative effect is examined. We also compare the probability of a type I error and the power of our approach to standard covariate adjustment methods by means of a simulation study. Finally, our approach is illustrated on three studies involving ordinal responses and covariates.     

Trimmed logit method for estimating the ED50 in quantal bioassay

Trimmed nonparametric procedures such as the trimmed Spearman-Karber method have been proposed in the literature for overcoming the deficiencies of the probit and logit models in the analysis of quantal bioassay data. However, there are situations where the median effective dose (ED50) is not calculable with the trimmed Spearman-Karber method, but is estimable with a parametric model. Also, it is helpful to have a parametric model for estimating percentiles of the dose-response curve such as the ED10 and ED25. A trimmed logit method that combines the advantages of a parametric model with that of trimming in dealing with heavy-tailed distributions is presented here. These advantages are substantiated with examples of actual bioassay data. Simulation results are presented to support the validity of the trimmed logit method, which has been found to work well in our experience with over 200 data sets. A computer program for computing the ED50 and associated 95% asymptotic confidence interval, based on the trimmed logit method, can be obtained from the authors.     

Bayesian mapping of genomewide interacting quantitative trait loci for ordinal traits

Development of statistical methods and software for mapping interacting QTL has been the focus of much recent research. We previously developed a Bayesian model selection framework, based on the composite model space approach, for mapping multiple epistatic QTL affecting continuous traits. In this study we extend the composite model space approach to complex ordinal traits in experimental crosses. We jointly model main and epistatic effects of QTL and environmental factors on the basis of the ordinal probit model (also called threshold model) that assumes a latent continuous trait underlies the generation of the ordinal phenotypes through a set of unknown thresholds. A data augmentation approach is developed to jointly generate the latent data and the thresholds. The proposed ordinal probit model, combined with the composite model space framework for continuous traits, offers a convenient way for genomewide interacting QTL analysis of ordinal traits. We illustrate the proposed method by detecting new QTL and epistatic effects for an ordinal trait, dead fetuses, in a F(2) intercross of mice. Utility and flexibility of the method are also demonstrated using a simulated data set. Our method has been implemented in the freely available package R/qtlbim, which greatly facilitates the general usage of the Bayesian methodology for genomewide interacting QTL analysis for continuous, binary, and ordinal traits in experimental crosses.     

Power analysis for trend in ordinal cover classes: implications for long‐term vegetation monitoring

Question: We provide a method to calculate the power of ordinal regression models for detecting temporal trends in plant abundance measured as ordinal cover classes. Does power depend on the shape of the unobserved (latent) distribution of percentage cover? How do cover class schemes that differ in the number of categories affect power? Methods: We simulated cover class data by “cutting‐up” a continuous logit‐beta distributed variable using 7‐point and 15‐point cover classification schemes. We used Monte Carlo simulation to estimate power for detecting trends with two ordinal models, proportional odds logistic regression (POM) and logistic regression with cover classes re‐binned into two categories, a model we term an assessment point model (APM). We include a model fit to the logit‐transformed percentage cover data for comparison, which is a latent model. Results: The POM had equal or higher power compared to the APM and latent model, but power varied in complex ways as a function of the assumed latent beta distribution. We discovered that if the latent distribution is skewed, a cover class scheme with more categories might yield higher power to detect trend. Conclusions: Our power analysis method maintains the connection between the observed ordinal cover classes and the unmeasured (latent) percentage cover variable, allowing for a biologically meaningful trend to be defined on the percentage cover scale. Both the shape of the latent beta distribution and the alternative hypothesis should be considered carefully when determining sample size requirements for long‐term vegetation monitoring using cover class measurements.     

Multiple censored data in dentistry: A new statistical model for analyzing lesion size in randomized controlled trials

Caries infiltration is a novel treatment option for proximal caries lesions. The idea is to build a diffusion barrier inside the lesion to slow down or stop the caries progression. If a lesion still reaches a critical size, restorative treatment is required. Clinical trials investigating caries infiltration thus produce multiple censored ordinal data. Standard statistical models do not take into account this censoring, and we therefore propose the Multiple Ordered Tobit (MOT) model. The model is implemented in R and compared with standard approaches. Simulation studies demonstrate that for all sample sizes and scenarios the MOT model has the largest statistical power among all methods compared, and it is robust against heteroscedasticity to some extent. Finally, a comparison with dichotomous and ordinal scaled models shows that the use of metric data for the lesion size reduces the required sample size considerably.     

Maximum Likelihood Estimates for Binary Data with Random Effects

The purpose of this paper is to present a procedure for obtaining approximate maximum likelihood estimates for compound binary response models. The extra binomial variation is incorporated into the model by adding random effects to the fixed effects on the probit (or logit) scale. Numerical integration techniques are used to arrive at a solution of the likelihood equations. The paper also presents an illustrating numerical example based on a large toxicological data set. The computations are carried out within the GLIM statistical package.     

Empirical likelihood for cumulative hazard ratio estimation with covariate adjustment

In medical studies, it is often of scientific interest to evaluate the treatment effect via the ratio of cumulative hazards, especially when those hazards may be nonproportional. To deal with nonproportionality in the Cox regression model, investigators usually assume that the treatment effect has some functional form. However, to do so may create a model misspecification problem because it is generally difficult to justify the specific parametric form chosen for the treatment effect. In this article, we employ empirical likelihood (EL) to develop a nonparametric estimator of the cumulative hazard ratio with covariate adjustment under two nonproportional hazard models, one that is stratified, as well as a less restrictive framework involving group-specific treatment adjustment. The asymptotic properties of the EL ratio statistic are derived in each situation and the finite-sample properties of EL-based estimators are assessed via simulation studies. Simultaneous confidence bands for all values of the adjusted cumulative hazard ratio in a fixed interval of interest are also developed. The proposed methods are illustrated using two different datasets concerning the survival experience of patients with non-Hodgkin's lymphoma or ovarian cancer.     

Applications of proportional odds ordinal logistic regression models and continuation ratio models in examining the association of physical inactivity with erectile dysfunction among type 2 diabetic patients

[Purpose]Many studies have observed a high prevalence of erectile dysfunction among individuals performing physical activity in less leisure-time. However, this relationship in patients with type 2 diabetic patients is not well studied. In exposure outcome studies with ordinal outcome variables, investigators often try to make the outcome variable dichotomous and lose information by collapsing categories. Several statistical models have been developed to make full use of all information in ordinal response data, but they have not been widely used in public health research. In this paper, we discuss the application of two statistical models to determine the association of physical inactivity with erectile dysfunction among patients with type 2 diabetes.[Methods]A total of 204 married men aged 20-60 years with a diagnosis of type 2 diabetes at the outpatient unit of the Department of Endocrinology at PSG hospitals during the months of May and June 2019 were studied. We examined the association between physical inactivity and erectile dysfunction using proportional odds ordinal logistic regression models and continuation ratio models.[Results]The proportional odds model revealed that patients with diabetes who perform leisure time physical activity for over 40 minutes per day have reduced odds of erectile dysfunction (odds ratio=0.38) across the severity categories of erectile dysfunction after adjusting for age and duration of diabetes.[Conclusion]The present study suggests that physical inactivity has a negative impact on erectile function. We observed that the simple logistic regression model had only 75% efficiency compared to the proportional odds model used here; hence, more valid estimates were obtained here.     

Regression modeling of ordinal data with nonzero baselines

This paper develops regression models for ordinal data with nonzero control response probabilities. The models are especially useful in dose-response studies where the spontaneous or natural response rate is nonnegligible and the dosage is logarithmic. These models generalize Abbott's formula, which has been commonly used to model binary data with nonzero background observations. We describe a biologically plausible latent structure and develop an EM algorithm for fitting the models. The EM algorithm can be implemented using standard software for ordinal regression. A toxicology data set where the proposed model fits the data but a more conventional model fails is used to illustrate the methodology.     

UGMDR: a unified conceptual framework for detection of multifactor interactions underlying complex traits

Biological outcomes are governed by multiple genetic and environmental factors that act in concert. Determining multifactor interactions is the primary topic of interest in recent genetics studies but presents enormous statistical and mathematical challenges. The computationally efficient multifactor dimensionality reduction (MDR) approach has emerged as a promising tool for meeting these challenges. On the other hand, complex traits are expressed in various forms and have different data generation mechanisms that cannot be appropriately modeled by a dichotomous model; the subjects in a study may be recruited according to its own analytical goals, research strategies and resources available, not only consisting of homogeneous unrelated individuals. Although several modifications and extensions of MDR have in part addressed the practical problems, they are still limited in statistical analyses of diverse phenotypes, multivariate phenotypes and correlated observations, correcting for potential population stratification and unifying both unrelated and family samples into a more powerful analysis. I propose a comprehensive statistical framework, referred as to unified generalized MDR (UGMDR), for systematic extension of MDR. The proposed approach is quite versatile, not only allowing for covariate adjustment, being suitable for analyzing almost any trait type, for example, binary, count, continuous, polytomous, ordinal, time-to-onset, multivariate and others, as well as combinations of those, but also being applicable to various study designs, including homogeneous and admixed unrelated-subject and family as well as mixtures of them. The proposed UGMDR offers an important addition to the arsenal of analytical tools for identifying nonlinear multifactor interactions and unraveling the genetic architecture of complex traits.     

Maximally Selected Rank Statistics for Dose‐Response Problems

We consider the bivariate situation of some quantitative, ordinal, binary or censored response variable and some quantitative or ordinal exposure variable (dose) with a hypothetical effect on the response. Data can either be the outcome of a planned dose‐response experiment with only few dose levels or of an observational study where, for example, both exposure and response variable are observed within each individual. We are interested in testing the null hypothesis of no effect of the dose variable vs. a dose‐response function depending on an unknown ‘threshold’ parameter. The variety of dose‐response functions considered ranges from no observed effect level (NOEL) models to umbrella alternatives. Here we discuss generalizations of the method of Lausen & Schumacher (Biometrics, 1992, 48, 73–85)which are based on combinations of two‐sample rank statistics and rank statistics for trend. Our approach may be seen as a generalization of a proposal for change‐point problems. Using the approach of Davies (Biometrika, 1987, 74, 33–43)we derive and approximate the asymptotic null distribution for a large number of thresholds considered. We use an improved Bonferroni inequality as approximation for a small number of thresholds considered. Moreover, we analyse the small sample behaviour by means of a Monte‐Carlo study. Our paper is illustrated by examples from clinical research and epidemiology.     

Polytomous disease mapping to detect uncommon risk factors for related diseases

A statistical model for jointly analysing the spatial variation of incidences of three (or more) diseases, with common and uncommon risk factors, is introduced. Deaths for different diseases are described by a logit model for multinomial responses (multinomial logit or polytomous logit model). For each area and confounding strata population (i.e. age-class, sex, race) the probabilities of death for each cause (the response probabilities) are estimated. A specic disease, the one having a common risk factor only, acts as the baseline category. The log odds are decomposed additively into shared (common to diseases different by the reference disease) and specic structured spatial variability terms, unstructured unshared spatial terms and confounders terms (such as age, race and sex) to adjust the crude observed data for their effects. Disease specic spatially structured effects are estimated; these are considered as latent variables denoting disease-specic risk factors. The model is presented with reference to a specic application. We considered the mortality data (from 1990 to 1994) relative to oral cavity, larynx and lung cancers in 13 age groups of males, in the 287 municipalities of Region of Tuscany (Italy). All these pathologies share smoking as a common risk factor; furthermore, two of them (oral cavity and larynx cancer) share alcohol consumption as a risk factor. All studies suggest that smoking and alcohol consumption are the major known risk factors for oral cavity and larynx cancers; nevertheless, in this paper, we investigate the possibility of other different risk factors for these diseases, or even the presence of an interaction effect (between smoking and alcohol risk factors) but with different spatial patterns for oral and larynx cancer. For each municipality and age-class the probabilities of death for each cause (the response probabilities) are estimated. Lung cancer acts as the baseline category. The log odds are decomposed additively into shared (common to oral cavity and larynx diseases) and specic structured spatial variability terms, unstructured unshared spatial terms and an age-group term. It turns out that oral cavity and larynx cancer have different spatial patterns for residual risk factors which are not the typical ones such as smoking habits and alcohol consumption. But, possibly, these patterns are due to different spatial interactions between smoking habits and alcohol consumption for the first and the second disease.     

An Efficient Hierarchical Generalized Linear Mixed Model for Mapping QTL of Ordinal Traits in Crop Cultivars

Many important phenotypic traits in plants are ordinal. However, relatively little is known about the methodologies for ordinal trait association studies. In this study, we proposed a hierarchical generalized linear mixed model for mapping quantitative trait locus (QTL) of ordinal traits in crop cultivars. In this model, all the main-effect QTL and QTL-by-environment interaction were treated as random, while population mean, environmental effect and population structure were fixed. In the estimation of parameters, the pseudo data normal approximation of likelihood function and empirical Bayes approach were adopted. A series of Monte Carlo simulation experiments were performed to confirm the reliability of new method. The result showed that new method works well with satisfactory statistical power and precision. The new method was also adopted to dissect the genetic basis of soybean alkaline-salt tolerance in 257 soybean cultivars obtained, by stratified random sampling, from 6 geographic ecotypes in China. As a result, 6 main-effect QTL and 3 QTL-by-environment interactions were identified.     

A Hybrid Pairwise Likelihood Method

A modification to the pairwise likelihood method is proposed,which aims to improve the estimation of the marginal distributionparameters. This is achieved by replacing the pairwise likelihoodscore equations, for estimating such parameters, by the optimallinear combinations of the marginal score functions. A furtheradvantage of the proposed estimator of marginal parameters,over pairwise likelihood, is that it is robust to misspecificationof the bivariate distributions as long as the univariate marginaldistributions are correctly specified. While alternating logisticregression can be seen as a special case of the proposed method,it is shown that an existing generalization of alternating logisticregression applicable to ordinal data is not the same as andis inferior to the proposed method because it replaces certainconditional densities by pseudodensities that assume workingindependence. The fitting of the multivariate negative binomialdistribution is another scenario involving intractable likelihoodthat calls for the use of pairwise likelihood methods, and thesuperiority of the modified method is demonstrated in a simulationstudy. Two examples, based on the analyses of salamander matingand patient-controlled analgesia data, demonstrate the usefulnessof the proposed method. The possibility of combining optimallythe pairwise, rather than marginal, scores is also consideredand its difficulty and potential are discussed.