Hi Tzippy,
Yes, interesting. If we think of Admission Days as being a surrogate for “how bad is this case?” then a really bad case could be represented by a really low number (acute illness, the patient died) or a really high number (took many days/weeks until release). Perhaps you need to present/ model figures for deaths and live releases separately. Or if you have to present/model them together then redefine the endpoint as live release and set deaths to a very large number (in place of infinity).
Regards, Barry
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The best way to analyze this type of data is with survival analysis (a brief overview is here: https://en.wikipedia.org/wiki/Survival_analysis). This allows you to take into account the information on those that died as censored observations. Within survival analysis are techniques for analyzing competing risks (death vs. discharge to another facility vs. discharge to home, etc.) which may give even more insight to your questions.
Survival analysis is often a full semester graduate level course, so if you are not already familiar with it, you should probably involve a statistician that is familiar with it to help you (or take the class). This is not something that most people can spend an hour reading up on and then know enough to expand from regular regression models (you can learn the commands in the software in that time, but really understanding what you are doing, the assumptions being made, the possible pitfalls, etc. takes some real effort).
From: meds...@googlegroups.com <meds...@googlegroups.com>
On Behalf Of Tzippy Shochat
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Subject: {MEDSTATS} Hoping this forum is still active
External Sender: Be aware! Read with care! |
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Hello all.
I hope this forum is still active.
I am a practical medical statistician with a recurring problem.
I am frequently asked to analyze Admission Days (Days from Admission to Release from hospitalization) as a dependent variable.
The problem is that a non-ignorable number of patients, who died, also have short admission days.
I tried convincing the researchers not to use Admission Days as an endpoint.
Is there a good way to analyze this?
Thanks
Tzippy Shochat
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