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Misuse of multinomial logistic regression in stroke related health research: A systematic review of methodology.

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Title: Misuse of multinomial logistic regression in stroke related health research: A systematic review of methodology.
Authors: Fitzhugh, Nicholas (AUTHOR), Rasmussen, Line Ryberg (AUTHOR), Simoni, Amalie Helme (AUTHOR), Valentin, Jan Brink (AUTHOR)
Source: European Journal of Neuroscience. Aug2023, Vol. 58 Issue 4, p3116-3131. 16p. 1 Diagram, 3 Charts, 2 Graphs.
Subjects: Public health research, Stroke patients, Model validation, Logistic regression analysis, Odds ratio, Time management
Abstract: Multinomial logistic regression (MLR) is often used to model the association between a nominal outcome variable and one or more covariates. The results of MLR are interpreted as relative risk ratios (RRR) and warrant a more coherent interpretation than ordinary logistic regression. Some authors compare the results of MLR to ordinal logistic regression (OLR), irrespective of the fact that these estimate different quantities. We aim to investigate the time trends in the use and misuse of MLR in studies including stroke patients, specifically the extent to which (1) the results are denoted as anything other than RRR, (2) comparisons are made of results with results of OLR and (3) results have been interpreted coherently. Secondarily, we examine the use of model validation techniques in studies with predictive aims. We searched EMBASE and PubMed for articles using MLR on populations of stroke patients. Identified studies were screened, and information pertaining to our aims was extracted. A total of 285 articles were identified through a systematic literature search, and 68 of these were included in the review. Of these, 60 articles (88%) did not denote exponentiated coefficients of MLR as relative risk ratios but rather some other measure. Additionally, 63 articles (93%) interpreted the results of MLR in a non‐coherent manner. Two articles attempted to compare MLR results with those of OLR. Nine studies attempted to use MLR for predictive means, and three used relevant validation techniques. From these findings, it is clear that the interpretation of MLR is often suboptimal. [ABSTRACT FROM AUTHOR]
Copyright of European Journal of Neuroscience is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Label: Title
  Group: Ti
  Data: Misuse of multinomial logistic regression in stroke related health research: A systematic review of methodology.
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  Data: <searchLink fieldCode="AR" term="%22Fitzhugh%2C+Nicholas%22">Fitzhugh, Nicholas</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Rasmussen%2C+Line+Ryberg%22">Rasmussen, Line Ryberg</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Simoni%2C+Amalie+Helme%22">Simoni, Amalie Helme</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Valentin%2C+Jan+Brink%22">Valentin, Jan Brink</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22European+Journal+of+Neuroscience%22">European Journal of Neuroscience</searchLink>. Aug2023, Vol. 58 Issue 4, p3116-3131. 16p. 1 Diagram, 3 Charts, 2 Graphs.
– Name: Subject
  Label: Subjects
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22Public+health+research%22">Public health research</searchLink><br /><searchLink fieldCode="DE" term="%22Stroke+patients%22">Stroke patients</searchLink><br /><searchLink fieldCode="DE" term="%22Model+validation%22">Model validation</searchLink><br /><searchLink fieldCode="DE" term="%22Logistic+regression+analysis%22">Logistic regression analysis</searchLink><br /><searchLink fieldCode="DE" term="%22Odds+ratio%22">Odds ratio</searchLink><br /><searchLink fieldCode="DE" term="%22Time+management%22">Time management</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Multinomial logistic regression (MLR) is often used to model the association between a nominal outcome variable and one or more covariates. The results of MLR are interpreted as relative risk ratios (RRR) and warrant a more coherent interpretation than ordinary logistic regression. Some authors compare the results of MLR to ordinal logistic regression (OLR), irrespective of the fact that these estimate different quantities. We aim to investigate the time trends in the use and misuse of MLR in studies including stroke patients, specifically the extent to which (1) the results are denoted as anything other than RRR, (2) comparisons are made of results with results of OLR and (3) results have been interpreted coherently. Secondarily, we examine the use of model validation techniques in studies with predictive aims. We searched EMBASE and PubMed for articles using MLR on populations of stroke patients. Identified studies were screened, and information pertaining to our aims was extracted. A total of 285 articles were identified through a systematic literature search, and 68 of these were included in the review. Of these, 60 articles (88%) did not denote exponentiated coefficients of MLR as relative risk ratios but rather some other measure. Additionally, 63 articles (93%) interpreted the results of MLR in a non‐coherent manner. Two articles attempted to compare MLR results with those of OLR. Nine studies attempted to use MLR for predictive means, and three used relevant validation techniques. From these findings, it is clear that the interpretation of MLR is often suboptimal. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
  Group: Ab
  Data: <i>Copyright of European Journal of Neuroscience is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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RecordInfo BibRecord:
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        Value: 10.1111/ejn.16084
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        Text: English
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      – SubjectFull: Public health research
        Type: general
      – SubjectFull: Stroke patients
        Type: general
      – SubjectFull: Model validation
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      – SubjectFull: Logistic regression analysis
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      – SubjectFull: Odds ratio
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      – SubjectFull: Time management
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      – TitleFull: Misuse of multinomial logistic regression in stroke related health research: A systematic review of methodology.
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            NameFull: Rasmussen, Line Ryberg
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            NameFull: Simoni, Amalie Helme
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            – D: 15
              M: 08
              Text: Aug2023
              Type: published
              Y: 2023
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