PHN TCH HI QUI LOGISTIC A THC

M hnh hi qui logistic nh thc (binary logistic) xem xt mi quan h gia bin ph thuc l bin nh phn (v d: sng/cht) v bin c lp c th l bin s (nh lng) hoc bin nh tnh v phng trnh lin h c dng: Log( )= + 1x1+ 2x2+.... (trong x1 , x2,...l cc bin c 1
lp). = 1 (p l xc sut t vong,1-p l xc sut cn sng)

20.1 M hnh hi qui logistic a thc

M hnh hi qui logistic a thc (Multinomial logistic regression) tng t nh m hnh hi qui logistic nh thc nhng bin ph thuc l bin nh tnh c nhiu hn 2 trng thi (hoc mc). V d (khi bnh, khi vi d chng, t vong) hoc (tt, trung bnh, xu). M hnh hi qui logistic a thc pht biu: Log( )= + ijx1+ ijx2+....+ ij Gi: p0 l xc sut khi bnh p1 l xc sut khi vi d chng p2 xc sut t vong Ta c 3 phng trnh sau:
1 Log( 0 2 Log( 0 2 Log( 1

)= 10+ 10x1+ 10x2+.... (1) )= 20+20x1+ 20x2+.... (2) )= 21+21x1+ 21x2+.... (3)

20.2 Phn tch hi qui logistic a thc trong SPSS Tm s lin h gia cn nng, triu chng thiu mu ca cc b m mang thai v tr sinh ra nh cn. Bin ph thuc (kt cc) sinh nh cn l bin nh tnh, c chia lm 3 mc: bnh thng (>2500g), nh cn trung bnh (1500 -2500g) v nh cn nng (< 1500).

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Bng 20.1 S liu 30 b m sinh con

Mabn Canme Thieumau Nhecan
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 44 46 48 50 52 54 56 58 60 62 47 48 51 50 53 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1

Mabn Canme
16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 52 55 54 55 60 50 47 56 49 55 51 45 53 47 46

Thieumau Nhecan
0 1 1 1 1 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1 2 2 2 2 2 2 2 2 2 2

Ct 1: m BN Ct 2: Cn nng ca m (bin s) Ct 3: Triu chng thiu mu ca m (bin nh phn 0 v 1) Ct 4 : Bin kt cc sinh nh cn c 3 mc (0: bnh thng; 1: nh cn trung bnh; 2: nh cn mc nng) Vo menu: Analyze> Regression>Multinomial Logistic

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Vo mn hnh Multinomial Logistic Regression

Nhp chuyn bin nhecan vo bin ph thuc (Dependent), bin thieumau(bin nh phn) vo Factor(s) v bin cannang vo Covariate Nhn vo hp thoi Reference Category, chn mc tham kho l First Category, c m nhecan=0 (cn nng bnh thng) nh hnh sau:

Nhp Continue, nhn OK cho kt qu sau:

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Cc bng trn m t s ph hp ca m hnh , ni chung tr s -2 Log likelihood cng nh s ph hp m hnh cng ln. Cn tr pseudo- R2 gn tng t nh R2 trong m hnh hi qui tuyn tnh. Bng 20.2 Kt qu so snh gia nhm nh cn nng (hoc trung bnh) so vi nhm s sinh cn nng bnh thng (reference category: 0)

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Bng kt qu gm 2 hng 9 ct. Hng c s 1 (nh cn trung bnh) cc bin d on (cn nng m, thiu mu) c so snh vi mc tham kho l 0 (cn bnh thng) Hng c s 2 (nh cn mc nng) cc bin d on (cn nng m, thiu mu) c so snh vi mc tham kho l 0 (cn bnh thng) Ct 1: gm cc bin d on (cn nng m v thiu mu) Ct 2 : B l h s hi qui Ct 3: Sai s chun Ct 4: Tr ca Wald test tng t 2(chi square) trong m hnh hi qui tuyn tnh. Ct 5: df (bc t do) Ct 6: Sig. ( ngha thng k) Ct 7: Exponent ca h s hi qui B ct 2 (eB) chnh l odds ratio Ct 8-9: khong tin cy 95% ca OR Din dch kt qu trn nh sau: Nu gi p0 l xc sut tr c cn nng bnh thng p1 l xc sut tr nh cn trung bnh Log (

)= 6,77 - 0,10x Cannangme - 1.56x Thieumau

Nu m khng b thiu mu th log(odds) gim c 1,56 hoc gim c 79% nguy c sinh nh cn trung bnh (OR=0,21; KTC 95%:0,01-2,49), tuy nhin s khc bit ny khng c ngha thng k (p=0,21). Nu m c cn nng bnh thng th log(odds) gim c 0,10 hoc gim c 11% nguy c sinh nh cn trung bnh (OR=0,89; KTC95%: 0,70 - 1,14), tuy nhin s khc bit ny cng khng c ngha thng k (p=0,38). Nh vy, m c cn nng thp v thiu mu cha phi l yu t nguy c sinh con nh cn mc trung bnh (1500-2500g).
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Nu gi p0 l xc sut tr c cn nng bnh thng p2 l xc sut tr nh cn nng Log ( ) =19,1 - 0,32 x Cannangme - 3,68 x Thieumau Nu m khng b thiu mu th log(odds) gim c 3,68 hoc gim c 99,5% nguy c sinh nh cn mc nng (OR=0,025; KTC 95%: 0,001-0,456; p=0,013). Nu m c cn nng bnh thng th log(odds) gim c 0,32 hoc gim c 28% nguy c sinh nh cn mc nng (OR=0,719; KTC95%: 0,53 - 0,97; p=0,031). Nh vy, m nh cn v thiu mu l yu t nguy c sinh con nh cn mc nng (<1500g). so snh cc yu t nguy c dn n sinh nh cn nng vi nh cn trung bnh, ta khai loi tham kho (reference category) l 1 trong SPSS. Bng 20.3 Kt qu so snh gia sinh nh cn nng vi nh cn trung bnh (reference category: 1)

Log ( ) =12,3 - 0,22 x Cannangme - 2,12 x Thieumau

So snh gia nhm tr s sinh nh cn nng vi tr s sinh nh cn trung bnh, th s khc bit v cn nng m (p=0,091) v thiu mu (p=0,075) cha c ngha thng k.

Tm li m c thiu mu (p=0,013) v cn nng thp (p=0,03) lm tng nguy c sinh con nh cn mc nng.
Ti liu tham kho: Germn Rodrguez. The Multinomial Logit Model, Princeton University, website: http://data.princeton.edu/, truy cp 02/2010

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