A comparison of model-building strategies for lower respiratory tract infection in long-term care.
Five strategies for creating predictive models of lower respiratory tract infection in residents of long-term care facilities were compared. A linear judgment model was derived by administering clinical vignettes to physicians who indicated the risk of infection based on the presence or absence of five predictor variables. A model based on physician consensus was created using the same variables. Three models based on empirical data (logistic regression, proportional hazards, and recursive partitioning) were created from a "derivation" sample of data from a cohort study of lower respiratory tract infections in nursing homes using the five predictor variables. All models were applied to a validation set and compared using receiver operating characteristic (ROC) curves. The data-derived and consensus models showed the highest discriminative ability while the linear judgment model showed inferior performance.
Loeb
M
M
Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada. loebm@fhs.mcmaster.ca
Walter
S D
SD
McGeer
A
A
Simor
A E
AE
McArthur
M A
MA
Norman
G
G
D002170:Canada / Q000453:epidemiology; D015331:Cohort Studies; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008134:Long-Term Care; D009735:Nursing Homes; D011379:Prognosis; D016016:Proportional Hazards Models; D012372:ROC Curve; D012141:Respiratory Tract Infections / Q000175:diagnosis* / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors