4.4 Article

Alternative statistical modeling for radical prostatectomy data

Journal

JOURNAL OF APPLIED STATISTICS
Volume -, Issue -, Pages -

Publisher

TAYLOR & FRANCIS LTD
DOI: 10.1080/02664763.2023.2229973

Keywords

Cubic smoothing splines; local anesthetic; Marshall-Olkin family; prostate cancer; quantile residuals

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In recent years, several statistical models, including semiparametric regression, have been proposed. Linear regression is not practical for statistical modeling in medicine when there is a nonlinear relationship between explanatory variables and the response variable. Another common situation is when the response variable does not have a unimodal shape. In this study, a semiparametric heteroskedastic regression based on an extension of the normal distribution is proposed to analyze the cost of prostate cancer surgery. The model considers predictor variables, including different treatment groups and other relevant variables, with a nonlinear effect on the cost.
Several statistical models have been proposed in recent years, among them is the semiparametric regression. In medicine, there are several situations in which it is impracticable to consider a linear regression for statistical modeling, especially when the data contain explanatory variables that present a nonlinear relationship with the response variable. Another common situation is when the response variable does not have a unimodal shape, and it is not possible to adopt distributions belonging to the symmetric or asymmetric classes. In this context, a semiparametric heteroskedastic regression is proposed based on an extension of the normal distribution. Then, we show the usefulness of this model to analyze the cost of prostate cancer surgery. The predictor variables refer to two groups of patients such that one group receives a multimodal local anesthetic solution (Preemptive Target Anesthetic Solution) and the second group is treated with neuraxial blockade (spinal anesthesia/traditional standard). The other relevant predictor variables are also evaluated, thus allowing for the in-depth interpretation of the predictor variables with a nonlinear effect on the dependent variable cost. The penalized maximum likelihood method is adopted to estimate the model parameters. The new regression is a useful statistical tool for analyzing medical data.

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