IDEAS home Printed from https://ideas.repec.org/a/csb/stintr/v16y2015i2p203-222.html
   My bibliography  Save this article

Multinomial logistic regression approach for the evaluation of binary diagnostic test in medical research

Author

Listed:
  • Angel M. Morales
  • Patrick Tarwater
  • Indika Mallawaarachchi
  • Alok Kumar Dwivedi
  • Juan B. Figueroa-Casas

Abstract

Evaluating the effect of variables on diagnostic measures (sensitivity, specificity, positive, and negative predictive values) is often of interest to clinical researchers. Logistic regression (LR) models can be used to predict diagnostic measures of a screening test. A marginal model framework using generalized estimating equation (GEE) with logit/log link can be used to compare the diagnostic measures between two or more screening tests. These individual modeling approaches to each diagnostic measure ignore the dependency among these measures that might affect the association of covariates with each diagnostic measure. The diagnostic measures are computed using joint distribution of screening test result and reference test result which generates a multinomial response data. Thus, multinomial logistic regression (MLR) is a more appropriate approach to modeling these diagnostic measures. In this study, the validity of LR and GEE approaches as compared to MLR model was assessed for modeling diagnostic measures. All methods provided unbiased estimates of diagnostic measures in the absence of any covariate. LR and GEE methods produced more biased estimates as compared to MLR approach especially for small sample size studies. No bias was obtained in predicting sensitivity measure using MLR method for one screening test. Our proposed MLR method is robust for modeling diagnostic measures of a screening test as opposed to LR method. MLR method and GEE method produced similar estimates of diagnostic measures for comparing two screening tests in large sample size studies. The proposed MLR model for diagnostic measures is simple, and available in common statistical software. Our study demonstrates that MLR method should be preferred as an alternative for modeling diagnostic measures.

Suggested Citation

  • Angel M. Morales & Patrick Tarwater & Indika Mallawaarachchi & Alok Kumar Dwivedi & Juan B. Figueroa-Casas, 2015. "Multinomial logistic regression approach for the evaluation of binary diagnostic test in medical research," Statistics in Transition new series, Główny Urząd Statystyczny (Polska), vol. 16(2), pages 203-222, June.
    • Handle: RePEc:csb:stintr:v:16:y:2015:i:2:p:203-222
    as

    Download full text from publisher

    File URL: http://index.stat.gov.pl/repec/files/csb/stintr/csb_stintr_v16_2015_i2_n4.pdf
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Bergtold, Jason S. & Yeager, Elizabeth A. & Featherstone, Allen M., 2011. "Sample Size and Robustness of Inferences from Logistic Regression in the Presence of Nonlinearity and Multicollinearity," 2011 Annual Meeting, July 24-26, 2011, Pittsburgh, Pennsylvania 103771, Agricultural and Applied Economics Association.
    2. Vaclav Fidler & Nico Nagelkerke, 2013. "The Mantel-Haenszel Procedure Revisited: Models and Generalizations," PLOS ONE, Public Library of Science, vol. 8(3), pages 1-4, March.
    3. A. Cecile J. W. Janssens & Yazhong Deng & Gerard J. J. M. Borsboom & Marinus J. C. Eijkemans & J. Dik. F. Habbema & Ewout W. Steyerberg, 2005. "A New Logistic Regression Approach for the Evaluation of Diagnostic Test Results," Medical Decision Making, , vol. 25(2), pages 168-177, March.
    4. King, Gary & Zeng, Langche, 2001. "Logistic Regression in Rare Events Data," Political Analysis, Cambridge University Press, vol. 9(2), pages 137-163, January.
    5. Wendy Leisenring & Todd Alono & Margaret Sullivan Pepe, 2000. "Comparisons of Predictive Values of Binary Medical Diagnostic Tests for Paired Designs," Biometrics, The International Biometric Society, vol. 56(2), pages 345-351, June.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Alok Kumar Dwivedi & Indika Mallawaarachchi & Juan B. Figueroa-Casas & Angel M. Morales & Patrick Tarwater, 2015. "Multinomial Logistic Regression Approach For The Evaluation Of Binary Diagnostic Test In Medical Research," Statistics in Transition New Series, Polish Statistical Association, vol. 16(2), pages 203-222, June.
    2. Dwivedi Alok Kumar & Mallawaarachchi Indika & Figueroa-Casas Juan B. & Morales Angel M. & Tarwater Patrick, 2015. "Multinomial Logistic Regression Approach for the Evaluation of Binary Diagnostic Test in Medical Research," Statistics in Transition New Series, Statistics Poland, vol. 16(2), pages 203-222, June.
    3. F. Gauthier & D. Germain & B. Hétu, 2017. "Logistic models as a forecasting tool for snow avalanches in a cold maritime climate: northern Gaspésie, Québec, Canada," Natural Hazards: Journal of the International Society for the Prevention and Mitigation of Natural Hazards, Springer;International Society for the Prevention and Mitigation of Natural Hazards, vol. 89(1), pages 201-232, October.
    4. Douglas Cumming & Lars Hornuf & Moein Karami & Denis Schweizer, 2023. "Disentangling Crowdfunding from Fraudfunding," Journal of Business Ethics, Springer, vol. 182(4), pages 1103-1128, February.
    5. Eunae Yoo & Elliot Rabinovich & Bin Gu, 2020. "The Growth of Follower Networks on Social Media Platforms for Humanitarian Operations," Production and Operations Management, Production and Operations Management Society, vol. 29(12), pages 2696-2715, December.
    6. Cemal Eren Arbatlı & Quamrul H. Ashraf & Oded Galor & Marc Klemp, 2020. "Diversity and Conflict," Econometrica, Econometric Society, vol. 88(2), pages 727-797, March.
    7. Lo Turco, Alessia & Maggioni, Daniela, 2018. "Effects of Islamic religiosity on bilateral trust in trade: The case of Turkish exports," Journal of Comparative Economics, Elsevier, vol. 46(4), pages 947-965.
    8. Matija Kovacic & Claudio Zoli, 2021. "Ethnic distribution, effective power and conflict," Social Choice and Welfare, Springer;The Society for Social Choice and Welfare, vol. 57(2), pages 257-299, August.
    9. Blackman, Allen & Guerrero, Santiago, 2012. "What drives voluntary eco-certification in Mexico?," Journal of Comparative Economics, Elsevier, vol. 40(2), pages 256-268.
    10. Jacob Ausderan, 2018. "Reassessing the democratic advantage in interstate wars using k-adic datasets," Conflict Management and Peace Science, Peace Science Society (International), vol. 35(5), pages 451-473, September.
    11. Alessandra Iannamorelli & Stefano Nobili & Antonio Scalia & Luana Zaccaria, 2024. "Asymmetric Information and Corporate Lending: Evidence from SME Bond Markets," Review of Finance, European Finance Association, vol. 28(1), pages 163-201.
    12. Paul Poast, 2013. "Issue linkage and international cooperation: An empirical investigation," Conflict Management and Peace Science, Peace Science Society (International), vol. 30(3), pages 286-303, July.
    13. Yerko Rojas, 2017. "Evictions and short-term all-cause mortality: a 3-year follow-up study of a middle-aged Swedish population," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 62(3), pages 343-351, April.
    14. Mehrez Ben Slama & Dhafer Saidane & Hassouna Fedhila, 2012. "How to identify targets in the M&A banking operations? Case of cross-border strategies in Europe by line of activity," Review of Quantitative Finance and Accounting, Springer, vol. 38(2), pages 209-240, February.
    15. Marcin Chlebus, 2014. "One-day prediction of state of turbulence for financial instrument based on models for binary dependent variable," Ekonomia journal, Faculty of Economic Sciences, University of Warsaw, vol. 37.
    16. Lorenzo Cassi & Anne Plunket, 2014. "Proximity, network formation and inventive performance: in search of the proximity paradox," The Annals of Regional Science, Springer;Western Regional Science Association, vol. 53(2), pages 395-422, September.
    17. Trent Geisler & Herman Ray & Ying Xie, 2023. "Finding the Proverbial Needle: Improving Minority Class Identification Under Extreme Class Imbalance," Journal of Classification, Springer;The Classification Society, vol. 40(1), pages 192-212, April.
    18. Wegenast, Tim, 2013. "The Impact of Fuel Ownership on Intrastate Violence," GIGA Working Papers 225, GIGA German Institute of Global and Area Studies.
    19. Xinfu Xing & Chenglong Wu & Jinhui Li & Xueyou Li & Limin Zhang & Rongjie He, 2021. "Susceptibility assessment for rainfall-induced landslides using a revised logistic regression method," Natural Hazards: Journal of the International Society for the Prevention and Mitigation of Natural Hazards, Springer;International Society for the Prevention and Mitigation of Natural Hazards, vol. 106(1), pages 97-117, March.
    20. Hwang, Seokyoun & Sarath, Bharat & Han, Seung-youb, 2022. "Auditor independence: The effect of auditors’ quality control efforts and corporate governance," Journal of International Accounting, Auditing and Taxation, Elsevier, vol. 47(C).

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:csb:stintr:v:16:y:2015:i:2:p:203-222. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Beata Witek (email available below). General contact details of provider: https://edirc.repec.org/data/gusgvpl.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.