Generalized Modeling Approaches to Risk Adjustment of Skewed Outcomes Data

There are two broad classes of models used to address the econometric problems caused by skewness in data commonly encountered in health care applications: (1) transformation to deal with skewness (e.g., OLS on ln(y)); and (2) alternative weighting approaches based on exponential conditional models (ECM) and generalized linear model (GLM) approaches. In this paper, we encompass these two classes of models using the three parameter generalized gamma (GGM) distribution, which includes several of the standard alternatives as special cases OLS with a normal error, OLS for the log normal, the standard gamma and exponential with a log link, and the Weibull. Using simulation methods, we find the tests of identifying distributions to be robust. The GGM also provides a potentially more robust alternative estimator to the standard alternatives. An example using inpatient expenditures is also analyzed.

Conditional symmetry model as a better alternative to Symmetry Model for rater agreement measure

In almost all life or social science researches, subjects are classified into categories by raters, interviewers or observers. Many approaches have been proposed by various authors for analyzing the data or the results obtained from these raters. Symmetry and conditional symmetry models are models designed for square tables like the one arising from the raters results. Conditional symmetry model which possessed an extra parameter for the off-diagonal cells is a special case to symmetry. In this research work, we examined the effect of the extra parameter introduced by conditional symmetry model over that of symmetry on structure of agreement as well as their fittings. Generalized linear model (GLM) approach was used to model the loglinear model forms of these models with empirical examples. We observed that conditional symmetry based on it extra parameter gave a tremendous improvement to the significant level of the test statistics over that of its symmetry model counterpart, hence conditional symmetry model is better for raters agreement modelling which require symmetric table

A flexible regression model for count data

Poisson regression is a popular tool for modeling count data and is applied in a vast array of applications from the social to the physical sciences and beyond. Real data, however, are often over- or under-dispersed and, thus, not conducive to Poisson regression. We propose a regression model based on the Conway--Maxwell-Poisson (COM-Poisson) distribution to address this problem. The COM-Poisson regression generalizes the well-known Poisson and logistic regression models, and is suitable for fitting count data with a wide range of dispersion levels. With a GLM approach that takes advantage of exponential family properties, we discuss model estimation, inference, diagnostics, and interpretation, and present a test for determining the need for a COM-Poisson regression over a standard Poisson regression. We compare the COM-Poisson to several alternatives and illustrate its advantages and usefulness using three data sets with varying dispersion.Comment: Published in at http://dx.doi.org/10.1214/09-AOAS306 the Annals of Applied Statistics (http://www.imstat.org/aoas/) by the Institute of Mathematical Statistics (http://www.imstat.org

Disease Mapping via Negative Binomial Regression M-quantiles

We introduce a semi-parametric approach to ecological regression for disease mapping, based on modelling the regression M-quantiles of a Negative Binomial variable. The proposed method is robust to outliers in the model covariates, including those due to measurement error, and can account for both spatial heterogeneity and spatial clustering. A simulation experiment based on the well-known Scottish lip cancer data set is used to compare the M-quantile modelling approach and a random effects modelling approach for disease mapping. This suggests that the M-quantile approach leads to predicted relative risks with smaller root mean square error than standard disease mapping methods. The paper concludes with an illustrative application of the M-quantile approach, mapping low birth weight incidence data for English Local Authority Districts for the years 2005-2010.Comment: 23 pages, 7 figure