Recursive partitioning: Difference between revisions

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Examples are available of using recursive partitioning in research of diagnostic tests.<ref name="pmid15687312">{{cite journal |author=Fonarow GC, Adams KF, Abraham WT, Yancy CW, Boscardin WJ |title=Risk stratification for in-hospital mortality in acutely decompensated heart failure: classification and regression tree analysis |journal=JAMA |volume=293 |issue=5 |pages=572-80 |year=2005 |id=PMID 15687312 |doi=10.1001/jama.293.5.572}}</ref><ref name="pmid11597285">{{cite journal |author=Stiell IG, Wells GA, Vandemheen KL, ''et al'' |title=The Canadian C-spine rule for radiography in alert and stable trauma patients |journal=JAMA |volume=286 |issue=15 |pages=1841-8 |year=2001 |id=PMID 11597285 |doi=}}</ref><ref name="pmid10891517">{{cite journal |author=Haydel MJ, Preston CA, Mills TJ, Luber S, Blaudeau E, DeBlieux PM |title=Indications for computed tomography in patients with minor head injury |journal=N. Engl. J. Med. |volume=343 |issue=2 |pages=100-5 |year=2000 |id=PMID 10891517 |doi=}}</ref><ref name="pmid8594242">{{cite journal |author=Stiell IG, Greenberg GH, Wells GA, ''et al'' |title=Prospective validation of a decision rule for the use of radiography in acute knee injuries |journal=JAMA |volume=275 |issue=8 |pages=611-5 |year=1996 |id=PMID 8594242 |doi=}}</ref><ref name="pmid7110205">{{cite journal |author=Goldman L, Weinberg M, Weisberg M, ''et al'' |title=A computer-derived protocol to aid in the diagnosis of emergency room patients with acute chest pain |journal=N. Engl. J. Med. |volume=307 |issue=10 |pages=588-96 |year=1982 |id=PMID 7110205 |doi=}}</ref> Goldman used recursive partitioning to prioritize [[sensitivity (tests)|sensitivity]] in the diagnosis of [[myocardial infarction]] among patients with chest pain in the emergency room.<ref name="pmid7110205"/>
Examples are available of using recursive partitioning in research of diagnostic tests.<ref name="pmid15687312">{{cite journal |author=Fonarow GC, Adams KF, Abraham WT, Yancy CW, Boscardin WJ |title=Risk stratification for in-hospital mortality in acutely decompensated heart failure: classification and regression tree analysis |journal=JAMA |volume=293 |issue=5 |pages=572-80 |year=2005 |id=PMID 15687312 |doi=10.1001/jama.293.5.572}}</ref><ref name="pmid11597285">{{cite journal |author=Stiell IG, Wells GA, Vandemheen KL, ''et al'' |title=The Canadian C-spine rule for radiography in alert and stable trauma patients |journal=JAMA |volume=286 |issue=15 |pages=1841-8 |year=2001 |id=PMID 11597285 |doi=}}</ref><ref name="pmid10891517">{{cite journal |author=Haydel MJ, Preston CA, Mills TJ, Luber S, Blaudeau E, DeBlieux PM |title=Indications for computed tomography in patients with minor head injury |journal=N. Engl. J. Med. |volume=343 |issue=2 |pages=100-5 |year=2000 |id=PMID 10891517 |doi=}}</ref><ref name="pmid8594242">{{cite journal |author=Stiell IG, Greenberg GH, Wells GA, ''et al'' |title=Prospective validation of a decision rule for the use of radiography in acute knee injuries |journal=JAMA |volume=275 |issue=8 |pages=611-5 |year=1996 |id=PMID 8594242 |doi=}}</ref><ref name="pmid7110205">{{cite journal |author=Goldman L, Weinberg M, Weisberg M, ''et al'' |title=A computer-derived protocol to aid in the diagnosis of emergency room patients with acute chest pain |journal=N. Engl. J. Med. |volume=307 |issue=10 |pages=588-96 |year=1982 |id=PMID 7110205 |doi=}}</ref> Goldman used recursive partitioning to prioritize [[sensitivity (tests)|sensitivity]] in the diagnosis of [[myocardial infarction]] among patients with chest pain in the emergency room.<ref name="pmid7110205"/>
==Calculations==
An 'Initial misclassification rate' is calculated by assigning all cases to a single class. For example, in trying to diagnose 100 patients who have a disease of interest among a  sample of 1000 patients, arbitrarily classifying all patients as normal yields:
Initial misclassification rate = total
:<math>\mbox{Initial misclassification rate} =\left (\frac{\mbox{Total with disease}}{\mbox{Total sample size}}\right)</math>


==References==
==References==

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Recursive partitioning is a statistical method for the multivariable analysis of diagnostic tests.[1][2][3]. Recursive partitioning creates a decision tree that strives to correctly classify members of the population based on a dichotomous dependent variable. Compared to other multivariable methods, recursive partitioning:

  • Advantages are:
    • Generates clinically more intuitive models that do not require the user to perform calculations.[4]
    • Allows "adjustable misclassification penalties" or misclassification costs in order to create a decision rule that has more sensitivity or specificity. This has also been called the "dispersity index" which is the sum of the false-negatives and false-positives. Either the false-negatives and false-positives can be weighted in order to preferentially reduce their occurrence.[5]
    • May be more accurate.[6]
  • Disadvantages are:
    • Does not work well for continuous variables[7]
    • May overfit data.

A variation is 'Cox linear recursive partitioning'.[5]

Examples are available of using recursive partitioning in research of diagnostic tests.[8][9][10][11][12] Goldman used recursive partitioning to prioritize sensitivity in the diagnosis of myocardial infarction among patients with chest pain in the emergency room.[12]

Calculations

An 'Initial misclassification rate' is calculated by assigning all cases to a single class. For example, in trying to diagnose 100 patients who have a disease of interest among a sample of 1000 patients, arbitrarily classifying all patients as normal yields: Initial misclassification rate = total

References

  1. ↑ Breiman, Leo (1984). Classification and Regression Trees. Boca Raton: Chapman & Hall/CRC. ISBN 0-412-04841-8. 
  2. ↑ Lewis RJ (2000). An introduction to classification and regression tree (CART) analysis. Accessed March 12, 2008
  3. ↑ Yohannes Y, Hoddinott J (1999). Classification and regression trees: an introduction. Accessed March 12, 2008
  4. ↑ James KE, White RF, Kraemer HC (2005). "Repeated split sample validation to assess logistic regression and recursive partitioning: an application to the prediction of cognitive impairment". Statistics in medicine 24 (19): 3019-35. DOI:10.1002/sim.2154. PMID 16149128. Research Blogging.
  5. ↑ 5.0 5.1 Cook EF, Goldman L (1984). "Empiric comparison of multivariate analytic techniques: advantages and disadvantages of recursive partitioning analysis". Journal of chronic diseases 37 (9-10): 721-31. PMID 6501544. [e]
  6. ↑ Kattan MW, Hess KR, Beck JR (1998). "Experiments to determine whether recursive partitioning (CART) or an artificial neural network overcomes theoretical limitations of Cox proportional hazards regression". Comput. Biomed. Res. 31 (5): 363-73. PMID 9790741. [e]
  7. ↑ Lee JW, Um SH, Lee JB, Mun J, Cho H (2006). "Scoring and staging systems using cox linear regression modeling and recursive partitioning". Methods of information in medicine 45 (1): 37-43. PMID 16482368. [e]
  8. ↑ Fonarow GC, Adams KF, Abraham WT, Yancy CW, Boscardin WJ (2005). "Risk stratification for in-hospital mortality in acutely decompensated heart failure: classification and regression tree analysis". JAMA 293 (5): 572-80. DOI:10.1001/jama.293.5.572. PMID 15687312. Research Blogging.
  9. ↑ Stiell IG, Wells GA, Vandemheen KL, et al (2001). "The Canadian C-spine rule for radiography in alert and stable trauma patients". JAMA 286 (15): 1841-8. PMID 11597285. [e]
  10. ↑ Haydel MJ, Preston CA, Mills TJ, Luber S, Blaudeau E, DeBlieux PM (2000). "Indications for computed tomography in patients with minor head injury". N. Engl. J. Med. 343 (2): 100-5. PMID 10891517. [e]
  11. ↑ Stiell IG, Greenberg GH, Wells GA, et al (1996). "Prospective validation of a decision rule for the use of radiography in acute knee injuries". JAMA 275 (8): 611-5. PMID 8594242. [e]
  12. ↑ 12.0 12.1 Goldman L, Weinberg M, Weisberg M, et al (1982). "A computer-derived protocol to aid in the diagnosis of emergency room patients with acute chest pain". N. Engl. J. Med. 307 (10): 588-96. PMID 7110205. [e]

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