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Statistical Models for Prognostication
Author Bio
Introduction
Predictions: Statistical Models
Insight: Statistical Models
Ingredients: Statistical Models
Theoretical Aspects
Central Concepts
Currently selected section: Regression Models
Problems: Regression
Practical Advice
Example 1
Example 2
Chapter 8: Statistical Models for Prognostication: Development of Regression Models
        

Alternatives to Stepwise Selection

Given the problems with stepwise selection methods, alternatives have been considered (Harrell et al., 1985). The most obvious selection strategy is to fit a fixed selection of pre-defined predictors, in other words, based on firm clinical knowledge and information from other studies.

As an intermediate option between fitting a full model and stepwise selection with the standard significance level (alpha=0.05), we may consider applying stepwise selection with a high alpha for selection. We may, for example, exclude covariables with p-values exceeding 0.50, arguing that these probably contribute more noise than predictive information to the model (Steyerberg et al., 2000a).

We may also apply Akaike's Information Criterion (AIC). Application of AIC is equivalent to a p-value of 0.157 when covariables with 1 df are considered, and corresponds closely to application of Mellow's cp for selection with all subsets regression. Note that AIC was originally intended to compare pre-specified models of different complexity (as indicated by the degrees of freedom of the predictors). AIC was never intended specifically for stepwise procedures, where many models are being compared sequentially. So, instead of 0.157 one might also argue for a p-value of 0.20 or 0.50.

With higher p-values, the stability of the selection increases and the power for inclusion of true predictors increases. The increase in power is associated with a risk of including noise variables, which may however be less severe then omission of true predictors. Further, a higher p-value for selecting variables reduces the biases in the estimation of variances, p-values, and regression coefficients (Steyerberg et al., 1999).

QUESTION 7.4

In smaller medical data sets, better predictions are generally obtained by selecting variables:

Selection AWith stepwise selection and alpha=0.05.
Selection BWith stepwise selection and alpha=0.50.
Selection CWith stepwise selection and alpha=1.0 (equivalent to selection of all covariables).


Selection of Interaction Terms

The selection of covariables concentrates usually on "main effects," which means that the covariables are entered in the regression formula without interaction terms. Interaction terms may be considered as a check of the additivity assumption. A complicating factor is, however, that the number of potential interaction terms explodes when a substantial number of covariables is included in the model. Some pre-selection is therefore desirable, e.g. on clinical grounds (Harrell et al., 1996).

In small data sets, the statistical power will be too limited to allow for a reasonable assessment of interaction terms. We may then rely on a predictive model with main effects only, which implies that average effects of predictor variables, over all other covariables, are modeled (Brenner and Blettner, 1997).

 

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