Biostatistics in Practice
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Transcript of Biostatistics in Practice
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Biostatistics in Practice
Peter D. ChristensonBiostatistician
http://gcrc.LABioMed.org/Biostat
Session 5: Associations and Confounding
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Session 5 Preparation #1
1. We often hear news reports of "seasonally adjusted unemployment rates". Can you think of a logical way that this adjustment could be made?
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Session 5 Preparation #2
Unadjusted
Adjusted
What does “adjusted” mean?
How is it done?
From Table 3
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Goal One of Session 5Earlier: Compare means for a single measure among groups.
Use t-test, ANOVA.
Session 5: Relate two or more measures.
Use correlation or regression.
Qu et al(2005), JCEM 90:1563-1569.
ΔΔY/ΔX
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Goal Two of Session 5
Try to isolate the effects of different characteristics on an outcome.
Previous slide:
Gender
BMI
GH Peak
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CorrelationVisualize Y (vertical) by X (horizontal) scatter plot.
Pearson correlation, r, is used to measure association between two measures X and Y
Ranges from -1 (perfect inverse association) to 1 (perfect direct association)
Value of r does not depend on:
scales (units) of X and Ywhich role X and Y assume, as in a X-Y plot
Value of r does depend on: the ranges of X and Yvalues chosen for X, if X is fixed & Y is measured
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Graphs and Values of Correlations
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Logic for Value of Correlation
Σ (X-Xmean) (Y-Ymean)
√Σ(X-Xmean)2 Σ(Y-Ymean)2
r =
+
+-
-
Statistical software gives r.
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Correlation Depends on Ranges of X & Y
Graph B contains only the graph A points in the ellipse.
Correlation is reduced in graph B.
Thus: correlations for the same quantities X and Y may be quite different in different study populations.
BA
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Regression
Again: Y (vertical) by X (horizontal) scatterplot, as with correlation. See next slide.
X and Y now assume unique roles: Y is an outcome, response, output, dependent
variable. X is an input, predictor, independent variable. Regression analysis is used to:
Measure X-Y association, as with correlation. Fit a straight line through the scatter plot, for:
Prediction of Y from X. Estimation of Δ in Y for a unit change in X (slope = “effect” of X on Y).
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Regression Example
ei
MinimizesΣei
2
Range for Individuals
Range for mean
Statistical software gives all this info.
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X-Y Association
If slope=0 then X and Y are not associated.
But the slope measured from a sample will never be 0. How different from 0 does a measured slope need to be in order to claim X and Y are associated?
[ Side note: It turns out that slope=0 is equivalent to correlation r = 0. ]
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X-Y AssociationTest slope=0 vs. slope≠0, with the rule:
Claim association (slope≠0) if
tc=|slope/SE(slope)| > t ≈ 2.
There is a 5% chance of claiming an X-Y association that really does not exist.
Note similarity to t-test for means:
tc=|mean/ SE(mean)|
Formula for SE(slope) is in statistics books.
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Example Software OutputThe regression equation is: Y = 81.6 + 2.16 X
Predictor Coeff StdErr T PConstant 81.64 11.47 7.12 <0.0001X 2.1557 0.1122 19.21 <0.0001
S = 21.72 R-Sq = 79.0%
Predicted Values:
X: 100Fit: 297.21SE(Fit): 2.1795% CI: 292.89 - 301.5295% PI: 253.89 - 340.52
Predicted y = 81.6 + 2.16(100)
Range of Ys with 95% assurance for:
Mean of all subjects with x=100.
Individual with x=100.
19.21=2.16/0.112 should be between ~ -2 and 2 if “true” slope=0.
Refers to Intercept
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Goal Two of Session 5
Try to isolate the effects of different characteristics on an outcome.
Ethnicity
Age
Outcome
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Another Study
J Clin Endocrin Metab 2006 Nov; 91(11):4424-32.
Potential doping test for athletes.
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Study Goals: Outcomes are IGF-1 and Collagen Markers
Determine the relative and combined explanatory power of age, gender, BMI, ethnicity, and sport type on the markers.
*
* for age, gender, and BMI.
Figure 2.One conclusion is lack of differences between ethnic IGF-1 means, after adjustment for age, gender, and BMI (Fig 2).
How are these adjustments made?
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Adjustment: For a Single Continuous Characteristic
We simulate data for Caucasians and Africans only for simplicity, to demonstrate attenuation of a 155-140=15 μg/L ethnic difference to a 160-157=3 μg/L ethnic difference.
158155
160140
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Adjustment: For a Single Continuous Characteristic
Problem:
Want to compare groups on IGF-1.
Groups to be compared (ethnicities) have different mean ages, and IGF-1 tends to decrease with age.
Solution:
Make groups appear to have the same mean age.
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Adjustment: For a Single Continuous Characteristic
Solution: Make groups appear to have the same mean age.
To do this,
Find regression line predicting IGF-1 from age.
Move each subject parallel to the regression line to the mean age. This is the expected IGF-1 if this subject had been at the mean age.
Adjusted means are means of these adjusted individual values.
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250
200
150
100
Age (Years)
IGF
1 (
ug
/L)
IGF1 Adjustment for Age - Simulated Data
(Mean)
140
155
15 = Diff
160157
Diff = 3
Unadjusted 22.2 Adjusted
CaucasianAfrican
15 30
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Adjustment: For a Single Continuous Characteristic
We have just described a special case of multiple regression, in which an outcome is estimated by multiple predictors.
Simple Regression:
Estimated IGF-1 = intercept +slope(age)
Multiple Regression:
Estimated IGF-1 = intercept +slope(age) + diff(indicator)
Indicator = 0 if African, 1 if Caucasian.
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Adjustment: For a Single Continuous Characteristic
Software:
Select Regression or Analysis of Covariance.
Usually menu such as
Output: Values of b0,b1,b2 for
IGF1=b0+b1(age)+b2(indicator)
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Multiple Regression: Geometric View
LHCY is the Y (homocysteine) to be predicted from the two X’s: LCLC (folate) and LB12 (B12).
LHCY = b0 + b1LCLC + b2LB12 is the equation of the plane
Multiple predictors may be continuous.
Geometrically, this is fitting a slanted plane to a cloud of points:
www.StatisticalPractice.com
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How Are Coefficients Interpreted?
LHCY = b0 + b1LCLC + b2LB12
OutcomePredictors
LHCY
LCLC
LB12
LB12 may have both an independent and an indirect (via LCLC) association with LHCY
Correlation
b1 ?
b2 ?
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Coefficients: Meaning of their Values
LHCY = b0 + b1LCLC + b2LB12
OutcomePredictors
LHCY increases by b2 for a 1-unit increase in LB12
… if other factors (LCLC) remain constant, or
… adjusting for other factors in the model (LCLC)
May be physiologically impossible to maintain one predictor constant while changing the other by 1 unit.
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Another Example: HDL Cholesterol Std Coefficient Error t Pr > |t|
Intercept 1.16448 0.28804 4.04 <.0001 AGE -0.00092 0.00125 -0.74 0.4602 BMI -0.01205 0.00295 -4.08 <.0001BLC 0.05055 0.02215 2.28 0.0239PRSSY -0.00041 0.00044 -0.95 0.3436DIAST 0.00255 0.00103 2.47 0.0147GLUM -0.00046 0.00018 -2.50 0.0135SKINF 0.00147 0.00183 0.81 0.4221LCHOL 0.31109 0.10936 2.84 0.0051
The predictors of log(HDL) are age, body mass index, blood vitamin C, systolic and diastolic blood pressures, skinfold thickness, and the log of total cholesterol. The equation is:
Log(HDL) = 1.16 - 0.00092(Age) +…+ 0.311(LCHOL)
www.
Statistical
Practice
.com
Output:
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HDL Example: Coefficients
Interpretation of coefficients on previous slide:
1. Need to use entire equation for making predictions.
2. Each coefficient measures the difference in expected LHDL between 2 subjects if the factor differs by 1 unit between the two subjects, and if all other factors are the same. E.g., expected LHDL is 0.012 lower in a subject whose BMI is 1 unit greater, but is the same as the other subject on other factors.
Continued …
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HDL Example: Coefficients
Interpretation of coefficients two slides back:
3. P-values measure the association of a factor with Log(HDL) , if other factors do not change.
This is sometimes expressed as “after accounting for other factors” or “adjusting for other factors”, and called its independent association.
SKINF is probably is associated. Its p=0.42 says that it has no additional info to predict LogHDL, after accounting for other factors such as BMI.