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Article overview
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Bayesian variable selection using cost-adjusted BIC, with application to cost-effective measurement of quality of health care | D. Fouskakis
; I. Ntzoufras
; D. Draper
; | Date: |
17 Aug 2009 | Abstract: | In the field of quality of health care measurement, one approach to assessing
patient sickness at admission involves a logistic regression of mortality
within 30 days of admission on a fairly large number of sickness indicators (on
the order of 100) to construct a sickness scale, employing classical variable
selection methods to find an ’’optimal’’ subset of 10--20 indicators. Such
’’benefit-only’’ methods ignore the considerable differences among the sickness
indicators in cost of data collection, an issue that is crucial when admission
sickness is used to drive programs (now implemented or under consideration in
several countries, including the U.S. and U.K.) that attempt to identify
substandard hospitals by comparing observed and expected mortality rates (given
admission sickness). When both data-collection cost and accuracy of prediction
of 30-day mortality are considered, a large variable-selection problem arises
in which costly variables that do not predict well enough should be omitted
from the final scale. In this paper (a) we develop a method for solving this
problem based on posterior model odds, arising from a prior distribution that
(1) accounts for the cost of each variable and (2) results in a set of
posterior model probabilities that corresponds to a generalized cost-adjusted
version of the Bayesian information criterion (BIC), and (b) we compare this
method with a decision-theoretic cost-benefit approach based on maximizing
expected utility. We use reversible-jump Markov chain Monte Carlo (RJMCMC)
methods to search the model space, and we check the stability of our findings
with two variants of the MCMC model composition ($mathit{MC}^3$) algorithm. | Source: | arXiv, 0908.2313 | Services: | Forum | Review | PDF | Favorites |
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