Comparison of logistic regression and neural networks to predict rehospitalization in patients with stroke

Kenneth J. Ottenbacher, Pam M. Smith, Sandra B. Illig, Richard T. Linn, Roger C. Fiedler, Carl V. Granger

Research output: Contribution to journalArticle

65 Scopus citations

Abstract

Context: Rehospitalization following inpatient medical rehabilitation has important health and economic implications for patients who have experienced a stroke. Objective: Compare logistic regression and neural networks in predicting rehospitalization at 3-6-month follow-up for patients with stroke discharged from medical rehabilitation. Design: The study was retrospective using information from a national database representative of medical rehabilitation patients across the US. Setting: Information submitted to the Uniform Data System for Medical Rehabilitation from 1997 and 1998 by 167 hospital and rehabilitation facilities from 40 states was examined. Participants: 9584 patient records were included in the sample. The mean age was 70.74 years (SD = 12.87). The sample included 51.6% females and was 77.6% non-Hispanic White with an average length of stay of 21.47 days (SD = 15.47). Main Outcome Measures: Hospital readmission from 80 to 180 days following discharge. Results: Statistically significant variables (P < .05) in the logistic model included sphincter control, self-care ability, age, marital status, ethnicity and length of stay. Area under the ROC curves were 0.68 and 0.74 for logistic regression and neural network analysis, respectively. The Hosmer-Lemeshow goodness-of-fit chi-square was 11.32 (df = 8, P = 0.22) for neural network analysis and 16.33 (df = 8, P = 0.11) for logistic regression. Calibration curves indicated a slightly better fit for the neural network model. Conclusion: There was no statistically significant or practical advantage in predicting hospital readmission using neural network analysis in comparison to logistic regression for persons who experienced a stroke and received medical rehabilitation during the period of the study.

Original languageEnglish (US)
Pages (from-to)1159-1165
Number of pages7
JournalJournal of Clinical Epidemiology
Volume54
Issue number11
DOIs
StatePublished - Nov 15 2001

Keywords

  • Logistic regression
  • Neural networks
  • Stroke

ASJC Scopus subject areas

  • Medicine(all)
  • Public Health, Environmental and Occupational Health
  • Epidemiology

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