基于生存分析法的医疗电子病历系统采纳与扩散研究

医疗电子病历系统作为中国医疗信息化建设的核心,关注其采纳与扩散机理,对推进医疗卫生信息化建设,以及实现有意义地使用具有重要的理论和实践意义。基于云南省222家医院信息化建设的调研数据,运用半参数生存分析法即Cox回归模型探讨医院采纳电子病历系统的影响因素及扩散机理。研究表明,教学状态、医院规模和建院时间均为有利因素,即这三个因素积极促进医院采纳电子病历系统;时间×规模为不利因素,即它对医院采纳电子病历系统有负向影响;地理位置在分层和删减样本的模型分析中均表现为不利因素;医院等级影响并不明显。     

Influence Diagnostics in log-Birnbaum-Saunders Regression Models

In this paper we present various diagnostic methods for a linear regression model under a logarithmic Birnbaum-Saunders distribution for the errors, which may be applied for accelerated life testing or to compare the median lives of several populations. Some influence methods, such as the local influence, total local influence of an individual and generalized leverage are derived, analysed and discussed. We also present a connection between the local influence and generalized leverage methods. A discussion of the computation of the likelihood displacement as well as the normal curvature in the local influence method are presented. Finally, an example with real data is given for illustration.     

Influence diagnostics in a multivariate normal regression model with general parameterization

Patriota and Lemonte [24] introduced a quite general multivariate normal regression model. This model considers that the mean vector and the covariance matrix share the same vector of parameters. In this paper we present some influence assessment for this model, such as the local influence, total local influence of an individual and generalized leverage which are discussed. Additionally, the normal curvatures for local influence studies are derived under some perturbation schemes.     

基于等级差异的公立医院效率及其影响因素分析

使用2010年江苏省261家公立医院的数据,对不同等级的公立医院效率及其影响因素进行比较与分析.基于随机前沿方法,利用柯布—道格拉斯生产函数和成本函数分别计算了江苏省不同等级不同类别公立医院的技术效率与成本效率.在此基础上,使用Tobit回归方法分析影响医院效率的因素,回归结果显示,不同级别公立医院效率影响因素差异较大,一级和三级公立医院可以通过降低人均门诊费用、增加人均住院费用的方式提高效率,而二级公立医院主要通过增加职业医师比例来提高效率.     

Influence diagnostics for polyhazard models in the presence of covariates

In this paper, we present various diagnostic methods for polyhazard models. Polyhazard models are a flexible family for fitting lifetime data. Their main advantage over the single hazard models, such as the Weibull and the log-logistic models, is to include a large amount of nonmonotone hazard shapes, as bathtub and multimodal curves. Some influence methods, such as the local influence and total local influence of an individual are derived, analyzed and discussed. A discussion of the computation of the likelihood displacement as well as the normal curvature in the local influence method are presented. Finally, an example with real data is given for illustration.     

Local Influence Diagnostics in the Modified Ridge Regression

Calculations of local influence curvatures have been well developed when the ordinary least squares method is applied. In this article, we discuss the assessment of local influence under the modified ridge regression. Using a pseudo-likelihood function, we express the normal curvatures of local influence for three useful perturbation schemes in interpretable forms. Two illustrative examples are analyzed by the methodology developed in the article.     

Influence diagnostic analysis in the possibly heteroskedastic linear model with exact restrictions

The local influence method has proven to be a useful and powerful tool for detecting influential observations on the estimation of model parameters. This method has been widely applied in different studies related to econometric and statistical modelling. We propose a methodology based on the Lagrange multiplier method with a linear penalty function to assess local influence in the possibly heteroskedastic linear regression model with exact restrictions. The restricted maximum likelihood estimators and information matrices are presented for the postulated model. Several perturbation schemes for the local influence method are investigated to identify potentially influential observations. Three real-world examples are included to illustrate and validate our methodology.     

An application of the local influence approach to ridge regression

In this study, the method of local influence, which was introduced by Cook as a general tool for assessing the influence of local departures from the underlying assumptions, is applied to ridge regression, by defining the maximum pseudo-likelihood ridge estimator obtained using the augmentation approach, because this method is suitable for likelihood-based models. In addition, an alternative local influence approach suggested by Billor and Loynes is applied to ridge regression. A comparison of these approaches and an example are given.     

Local Influence Under Parameter Constraints

Calculations of local influence curvatures and leverage have been well developed when the parameters are unrestricted. In this article, we discuss the assessment of local influence and leverage under linear equality parameter constraints with extensions to inequality constraints. Using a penalized quadratic function we express the normal curvature of local influence for arbitrary perturbation schemes and the generalized leverage matrix in interpretable forms, which depend on restricted and unrestricted components. The results are quite general and can be applied in various statistical models. In particular, we derive the normal curvature under three useful perturbation schemes for generalized linear models. Four illustrative examples are analyzed by the methodology developed in the article.     

Outlier Detection in Time Series Models Using Local Influence Method

We propose a new procedure for detecting a patch of outliers or influential observations for autoregressive integrated moving average (ARIMA) model using local influence analysis. It is shown that the dependency aspects of time series data gives rise to masking or smearing effects when the local influence analysis is performed using current perturbation schemes. We suggest a new perturbation scheme to take into account the dependent structure of time series data, and employ the stepwise local influence method to give a diagnostic procedure. We show that the new perturbation scheme can avoid the smearing effects, and the stepwise technique of local influence can successfully deal with masking effects. Various simulation studies are performed to show the efficiency of proposed methodology and a real example is used for illustrations.     

Influential observations in GARCH models

This paper examines local influence assessment in generalized autoregressive conditional heteroscesdasticity models with Gaussian and Student-t errors, where influence is examined via the likelihood displacement. The analysis of local influence is discussed under three perturbation schemes: data perturbation, innovative model perturbation and additive model perturbation. For each case, expressions for slope and curvature diagnostics are derived. Monte Carlo experiments are presented to determine the threshold values for locating influential observations. The empirical study of daily returns of the New York Stock Exchange composite index shows that local influence analysis is a useful technique for detecting influential observations; most of the observations detected as influential are associated with historical shocks in the market. Finally, based on this empirical study and the analysis of simulated data, some advice is given on how to use the discussed methodology.     

Local influence on bandwidth estimation for kernel smoothing

This paper examines the problem of assessing local influence on the optimal bandwidth estimation in kernel smoothing based on cross validation. The bandwidth for kernel smoothing plays an important role in the model fitting and is often estimated using the cross-validation criterion. Following the argument of the second-order approach to local influence suggested by Wu and Luo (1993), we develop a new diagnostic statistic to examine the local influence of the observations on the estimation of the optimal bandwidth, where the perturbation may belong to one of three schemes. These are the response perturbation, the perturbation in the explanatory variable, and the case-weight

perturbation. The proposed diagnostic is nonparametric and is capable of identifying influential observations with strong influence on the bandwidth estimation. An example is presented to illustrate the application of the proposed diagnostic, and the usefulness of the nonparametric approach is illustrated in comparison with some other approaches to the assessment of local influence     

On influence diagnostics in elliptical multivariate regression models with equicorrelated random errors

In this paper we discuss estimation and diagnostic procedures in elliptical multivariate regression models with equicorrelated random errors. Two procedures are proposed for the parameter estimation and the local influence curvatures are derived under some usual perturbation schemes to assess the sensitivity of the maximum likelihood estimates (MLEs). Two motivating examples preliminarily analyzed under normal errors are reanalyzed considering appropriate elliptical distributions. The local influence approach is used to compare the sensitivity of the model estimates.     

On influence diagnostic in univariate elliptical linear regression models

We discuss in this paper the assessment of local influence in univariate elliptical linear regression models. This class includes all symmetric continuous distributions, such as normal, Student-t, Pearson VII, exponential power and logistic, among others. We derive the appropriate matrices for assessing the local influence on the parameter estimates and on predictions by considering as influence measures the likelihood displacement and a distance based on the Pearson residual. Two examples with real data are given for illustration.     

Diagnostics for Autocorrelated Regression Models

This paper discusses the local influence approach to the linear regression model with AR(1) errors. Diagnostics for the autocorrelation models and for the autocorrelation coefficient only are proposed and developed respectively, when simultaneous perturbations of the response vector are allowed. Furthermore, the direction of maximum curvature of local influence analysis is shown to be exactly the same as that in Tsai & Wu (1992) when only the autocorrelation coefficient is of special interest.     

Multivariate Birnbaum–Saunders regression model

In this paper, we propose a multivariate log-linear Birnbaum–Saunders regression model. We discuss maximum-likelihood estimation of the model parameters and provide closed-form expressions for the score function and for Fisher's information matrix. Hypothesis testing is performed using approximations obtained from the asymptotic normality of the maximum-likelihood estimator. Some influence methods, such as the local influence and generalized leverage are discussed and the normal curvatures for studying local influence are derived under some perturbation schemes. Further, a test for the homogeneity of the shape parameter of the multivariate regression model is investigated. A real data set is presented for illustrative purposes.     

Local influence in binary regression models,and its correspondence with global influence

We develop local influence diagnostics for a general binary regression model,and apply these methods to case-weight perturbations in four examples. In addition, we illustrate the correspondence between case-deletion diagnostics and local case-weight perturbation slopes and curvatures. We demonstrate that local influence diagnostics can provide a more computationally efficient means for obtaining analogous information to that yielded by case-deletion diagnostics, which can be thought of as global influence perturbations. We also assess the global consistency of patterns of local influence using these data examples.     

Local influence in ridge semiparametric models

ABSTRACT

Ridge penalized least-squares estimators has been suggested as an alternative to the minimum penalized sum of squares estimates in the presence of collinearity among the explanatory variables in semiparametric regression models (SPRMs). This paper studies the local influence of minor perturbations on the ridge estimates in the SPRM. The diagnostics under the perturbation of ridge penalized sum of squares, response variable, explanatory variables and ridge parameter are considered. Some local influence diagnostics are given. A Monte Carlo simulation study and a real example are used to illustrate the proposed perturbations.     

Local Influence in Generalized Estimating Equations

Abstract.  We investigate the influence of subjects or observations on regression coefficients of generalized estimating equations (GEEs) using local influence. The GEE approach does not require the full multivariate distribution of the response vector. We extend the likelihood displacement to a quasi-likelihood displacement, and propose local influence diagnostics under several perturbation schemes. An illustrative example in GEEs is given and we compare the results using the local influence and deletion methods.