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Development of health risk appraisal functions in the presence of multiple indicators: The Framingham Study nursing home institutionalization model
Author(s) -
D'Agostino Ralph B.,
Belanger Albert J.,
Markson Elizabeth W.,
KellyHayes Maggie,
Wolf Philip A.
Publication year - 1995
Publication title -
statistics in medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.996
H-Index - 183
eISSN - 1097-0258
pISSN - 0277-6715
DOI - 10.1002/sim.4780141605
Subject(s) - proportional hazards model , framingham heart study , framingham risk score , hazard , risk factor , regression analysis , ranking (information retrieval) , medicine , institutionalisation , actuarial science , econometrics , disease , gerontology , statistics , computer science , mathematics , business , surgery , chemistry , organic chemistry , machine learning , psychiatry
A health risk appraisal function is a mathematical model designed to estimate the risk or probability of a person's mortality or morbidity for various diseases based upon risk factors such as age, medical history and smoking behaviour. The Framingham Study has contributed substantially to the development and use of these for endpoints such as mortality and incidence of coronary heart disease and other cardiovascular diseases. This paper discusses a methodology for the development of health risk appraisal functions when the number of potential risk factors is large and illustrates it with sex specific functions for nursing home institutionalization. The methodology involves grouping variables substantively into sets, applying principal component factor analysis and variable clustering to obtain substantively meaningful composite scores, ranking these in order of substantive importance, and then entering these with a hierarchical ordering into a Cox proportional hazard regression.