XY DNG M HNH (MODELLING)

L Tn Phng *

t vn :
Trong thng k, bi ton thng gp nht l tm mi lin quan gia yu t m ta nghin cu (thng gi l bin ph thuc) vi mt hay nhiu yu t khc (thng gi l bin c lp). V d, tm hiu mi lin quan gia bo ph (bin ph thuc) vi mc vn ng, ch n, gii tnh (cc bin c lp). Trng hp n gin nht khi ch c mt bin ph thuc v mt bin c lp. Phn tch ny c gi l phn tch nh bin (bivariate analysis). V d, mi lin quan gia tng huyt p (HA) (bin ph thuc) v ht thuc l (bin c lp); mi lin quan gia ung th v (bin ph thuc) v s dng thuc trnh thai (bin c lp). Thc t, rt him c trng hp ch c mt yu t duy nht tc ng ln yu t ta ang nghin cu. Ung th gan c th do tc ng ca vim gan siu vi, tip xc vi thuc tr su, yu t di truyn v.v Tng HA c th b nh hng bi gii tnh, ch n mn, tha cn/bo ph, yu t di truyn v.v Trrng hp phn tch mi lin quan gia yu t nghin cu (bin ph thuc) vi nhiu yu t khc (bin c lp), ngi ta gi l phn tch a bin (multivariate analysis). Vn l trong s rt nhiu bin c lp nhn bit c, th c bao nhiu bin l c ngha thng k v mc tc ng (nh hng) ca tng bin c lp i vi bin ph thuc l nh th no? V d, trong s 5 yu t nh hng n tng HA bao gm: gii tnh, tui, ch n mn, tha cn/bo ph, yu t di truyn th yu t no c ngha thng k tc ng n tng HA? Mc tc ng ca tui i vi HA ra sao, nhiu hn hay t hn so vi tc ng ca gii tnh, ch n mn, tha cn/bo ph, di truyn? din t mi lin quan ny, ngi ta dng m hnh ton hc nhm lng ha mi tng quan gia cc bin c lp vi mt bin ph thuc. Thut ng thng k gi cng vic ny l xy dng m hnh (modelling).

Mc ch ca modelling
Mc ch ca modelling l tm mt m hnh tt nht (best model) sao cho khng c qu nhiu bin c lp m khng b st cc bin c ngha thng k, ng thi gip ch cho kh nng suy rng ra cho qun th. Tng s lng bin c lp cho mt m hnh s lm cho tnh ph hp i vi mu (sample) tt hn nhng li lm gim kh nng suy on cho qun th v ngc li.
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Bc s, thc s Y t cng cng. Email: letanphung@yahoo.com

Cc phng php modelling s gip gii quyt vn ny. Modelling nhm gii quyt nhng vn c th sau y: Phn tch khm ph (exploratory analysis): Tm hiu mt mi tng quan no gia cc bin. Xc nh gi thuyt: Xc nhn v mt thng k mt gi thuyt no cho rng c mi lin quan gia mt s bin s vi nhau Tin on (predictive modelling): i vi nhng m hnh thc nghim hoc mt l thuyt no c khng nh.

Cc phng php modelling

C 3 phng php (strategy) modelling, i t thp n cao nh sau: Phng php t ng hoc kinh nghim (heuristic or empirical approach): Phng php ny da vo my tnh. Cc phn mm thng k s t ng tnh ton cho ra m hnh. C th k cc phng php backward, forward, stepwise Phng php hi quy theo nhm (Hierarchical regression approach): Cc bin c lp c phn nhm trc khi hi quy. Phng php trc tip (Enter method): Da trn nhng hiu bit v vn nghin cu cng nh hiu bit v thng k hc ca nh nghin cu. y l phng php ti u nht nhng cng i hi s ng no nhiu nht.

1. Phng php t ng
Phng php ny da vo mt phn mm thng k no , v phn mm ny s t dng chn nhng bin no a vo m hnh. Mt phng php rt hay c s dng l phng php stepwise, bao gm 3 cch: forward, stepwise v backward. 1.1 Forward Tnh h s tng quan (correlation) ca y (bin ph thuc) vi tng xi (cc bin c lp). Tm cc h s tng quan c ngha thng k gia y v tng bin xi. Chn bin c h s tng quan vi y cao nht (tng quan c ngha thng k), v d bin x1. Tnh phn d (residual) ca m hnh y = x1, ta c y1 Tip tc tnh h s tng quan ca y1 vi cc bin xi cn li. Tm bin c h s tng quan vi y1 cao nht ri a vo m hnh. V d tm c x2. Ta c m hnh y1 = x1 + x2. Tnh phn d ca m hnh y1 = x1 + x2. Ta c y3. C tip tc nh th cho n khi no khng cn h s tng quan no c ngha thng k na.

1.2 Backward Bt u bng a ton b cc bin vo m hnh, sau loi dn dn t nhng bin yu nht. 2

Tiu chun cho nhng bin yu nht c th da vo ch s F, gi tr p, hoc Wald score.

1.3 Stepwise Tng t nh Forward, nhng khi bt u a bin th ba vo th xem xt tr li xem c bin no khng cn ngha thng k hay khng (cng da vo mt s tiu chun nh F, gi tr p hoc Wald score). C th xem stepwise ging nh va l forward, va lm backward, c v von nh t dng hybrid.

2. Phng php hi quy theo nhm (Hierarchical approach)

Phng php ny c th xem nh trung gian gia phng php t ng v phng php trc tip. Cc bin c lp c gp li theo nhm (thematic blocks). V d, nhm c im v dn s hc (tui, gii), nhm c im v lm sng (HA, mch, nhit ), nhm v tin s bnh tt v.v Mi nhm sau s chy hi quy vi bin ph thuc, tng nhm mt theo th t do nh nghin cu xc nh, s dng phng php trc tip hoc t ng (stepwise) cho tng nhm. Mt v d v phng php hi quy theo nhm: Mt nghin cu bnh chng v tm thn phn lit. Cc bin c lp c chia thnh 3 nhm: o Yu t di truyn (c hay khng s hin din ca gen SNP) o Cc yu t v dn s hc o Tin s dng thuc V d cu hi nghin cu ch yu l tm hiu mi lin quan gia bnh tm thn phn lit v tin s dng thuc. Do , yu t di truyn v cc yu t dn s hc s ln lt c chy hi quy trc. Cui cng, chy hi quy tin s dng thuc tm hiu mi lin quan gia tm thn phn lit v tin s dng thuc. S khc bit c ngha ca R2 sau khi a bin tin s dng thuc vo m hnh s tr li cu hi nghin cu.

3. Phng php trc tip

y s ni v phng php chn la c ch ch (purposeful selection of covariates). y l phng php c xem l tt nht, p dng cho tt c c m hnh, bao gm c phn tch hi quy v phn tch sng cn (survival analysis). Cc bc ca phng php ny nh sau: a) Chy phn tch nh bin gia bin ph thuc vi tng bin c lp. b) Chn tt c nhng bin c lp c p value < 0.2 t phn tch nh bin trn a vo m hnh a bin u tin. c) Chy phn tch a bin m hnh ny. Loi ra nhng bin c lp khng c ngha thng k (p < 0.05).

d) Ln lt a vo tng bin mt phn tch a bin cc bin c lp b loi bc c) xem bin ny tr nn c ngha thng k hay khng hoc l confounder (c ngha l s >20%). e) Thc hin nh bc d), nhng ln ny th ln lt thm vo cc bin b loi phn tch nh bin bc a) v b), xem c bin no tr nn c ngha hoc l confounder. f) Kim tra xem c tc ng tng tc (interaction) trong m hnh khng. g) Kim tra ln cui s ph hp ca m hnh (model adequacy), bao gm: M hnh c ngha hay khng? Gii thch R2 Tnh gi tr ca m hnh (model validity): Nu cc gi nh ca m hnh.

Tham kho: Tham kho ch yu t bi ging ca lp Phng php nghin cu nh lng nng cao (Advanced Qualitative Research Methods), k hiu HLN706, Queensland University of Technology, Australia.