Validation of models for predicting the use of health technologies.
Validation must be carried out before a model can be used confidently as a tool of managerial decision making in health care. The authors describe a bootstrap approach to validating models for predicting the utilization of four technologies used in neonatal care: measurement of blood gases (gasometry), the oxygen hood, continuous positive airway pressure (CPAP), and mechanical ventilation. These models were fitted by stepwise multiple linear regression from 20 prognostic covariates of 193 neonates. One hundred bootstrap samples were generated to validate the choices of covariates in the models based on their frequencies of selection. This approach validated the models for the oxygen hood and CPAP. The regression coefficients and standard deviations for the CPAP and oxygen hood models were estimated using 200 additional bootstrap samples. A close agreement between stepwise and bootstrap estimates was observed for both models. These results suggest that bootstrap can be useful for validating models for predicting the utilization of health technologies.
Departamento de Engenharia Biomédica, Fundação de Ensino Superior de São João del-Rey, Brazil.
J D
JD
Scalon
S M
SM
Freire
T A
TA
Cunha
D001784:Blood Gas Analysis / Q000706:statistics & numerical data*; D001938:Brazil; D003661:Decision Support Techniques; D005260:Female; D005544:Forecasting; D006301:Health Services Needs and Demand / Q000639:trends*; D006801:Humans; D007231:Infant, Newborn; D015931:Intensive Care, Neonatal / Q000639:trends*; D016014:Linear Models; D008297:Male; D010102:Oxygen Inhalation Therapy / Q000706:statistics & numerical data*; D011175:Positive-Pressure Respiration / Q000706:statistics & numerical data*; D011379:Prognosis; D015203:Reproducibility of Results; D012121:Respiration, Artificial / Q000706:statistics & numerical data*; D012189:Retrospective Studies