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Reliability of logP predictions based on calculated molecular descriptors: a critical review.

Correct QSAR analysis requires reliable measured or calculated logP values, being logP the most frequently utilized and most important physico-chemical parameter in such studies. Since the publication of theoretical fundamentals of logP prediction, many commercial software solutions are available. These programs are all based on experimental data of huge databases therefore the predicted logP values are mostly acceptable - especially for known structures and their derivatives. In this study we critically reviewed the published methods and compared the predictive power of commercial softwares (CLOGP, KOWWIN, SciLogP/ULTRA) to each other and to our recently developed automatic QS(P)AR program. We have selected a very diverse set of 625 known drugs (98%) and drug-like molecules with experimentally validated logP values. We have collected 78 reported "outliers" as well, which could not be predicted by the "traditional" methods. We used these data in the model building and validation. Finally, we used an external validation set of compounds missing from public databases. We emphasized the importance of data quality, descriptor calculation and selection, and presented a general, reliable descriptor selection and validation technique for such kind of studies. Our method is based on the strictest mathematical and statistical rules, fully automatic and after the initial settings there is no option for user intervention. Three approaches were applied: multiple linear regression, partial least squares analysis and artificial neural network. LogP predictions with a multiple linear regression model showed acceptable accuracy for new compounds therefore it can be used for "in-silico-screening" and/or planning virtual/combinatorial libraries.

Combinatorial Chemistry Techniques↗

Noninvasive carbon dioxide monitoring during neurosurgical procedures in adults: end-tidal versus transcutaneous techniques.

BACKGROUND: We prospectively compared transcutaneous (TC) versus end-tidal (ET) carbon dioxide monitoring during neurosurgical procedures in adults. METHODS: After calibration and an equilibration time for the TC-CO2 monitor, arterial blood gas (ABG) values were obtained as clinically indicated. The PaCO2 values were compared with the values recorded by the noninvasive monitors (TC and ET). RESULTS: The ET-CO2 to PaCO2 difference was 6.1 +/- 5.6 mm Hg, and the TC-CO2 to PaCO2 difference was 3.7 +/- 2.9 mm Hg. The difference between the PaCO2 and ET-CO2 was 3 mm Hg or less in 17 of 57 values, while the difference between the PaCO2 and TC-CO2 was 3 mm Hg or less in 35 of 57 values. Linear regression analysis of ET-CO2 versus PaCO2 revealed a slope of 0.381 +/- 0.007. Linear regression analysis of TC-CO2 versus PaCO2 revealed a slope of 1.17 +/- 0.008. CONCLUSION: Transcutaneous CO2 monitoring provides a more accurate estimate of PaCO2 than ET-CO2 monitoring during neurosurgical procedures.

Adolescent↗

Reference centile chart for fetal liver length of Thai fetuses.

OBJECTIVE: To create a reference centile chart for fetal liver length of Thai fetuses. DESIGN: Prospective, cross-sectional study. SETTING: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University. MATERIAL AND METHOD: A total of 752 pregnant women, who attended the antenatal clinic at Siriraj Hospital, Mahidol University, Bangkok, were recruited between 13-40 weeks of gestation. Each fetus was measured only once for the purpose of this study. Using real-time ultrasound with a 3.5 MHz convex transducer; the authors measured fetal liver length. The mean and standard deviation (SD) were estimated at each week of gestation using linear regression modeling. RESULTS: A total of 750 fetuses were measured for fetal liver length. Linear regression models were fitted to estimate the mean and 95% confidence interval for liver length at each gestation age. The centile chart of liver length was also presented CONCLUSION: A reference centile chart for fetal liver length of Thai fetuses has been created.

Cross-Sectional Studies↗

Age-related bone loss in women evaluated by the single and dual photon technique.

Bone mass and density were measured at two forearm sites (proximal and distal BMC/BMD) and in the spine (spinal BMC/BMD) by respectively single and dual photon absorptiometry in 141 healthy women aged 20-80 years. The proximal forearm site contains approximately 15% trabecular bone and the distal site equal amounts of trabecular and cortical bone. At all three sites linear regression analysis on pre- and postmenopausal women separately revealed accelerated decline in bone density after the menopause. Polynomial regressions in BMC and BMD versus menopause-adjusted age fitted the changes better than a linear regression in the peripheral skeleton, but not in the spine. In both the forearms and the spine the age-related reduction in bone could be described by a combined model, assuming a linear decrease before the menopause and an exponential one thereafter. According to this model, the premenopausal annual changes were 0.067% (proximal site), 0.187% (distal site) and 0.098% (spine). The annual changes during the first postmenopausal year were 3.7, 3.7 and 4.6%. No matter which model was applied to the data, the reduction in the oldest women was lowest in the spine. These data indicate that there are some small differences in the age-related changes in cortical and trabecular bone, but that the reduction of both types of bone accelerates after the menopause.

Adult↗

Noninvasive intraoperative monitoring of carbon dioxide in children: endtidal versus transcutaneous techniques.

BACKGROUND: The current study prospectively compares the accuracy of the intraoperative use of transcutaneous (Tc) and endtidal (PE) CO2 monitoring during surgical procedures in 30 paediatric patients, ranging in age from 6 months to 15 years (6.15 +/- 4.35 years) and in weight from 4.7 to 73 kg (24.9 +/- 18.2 kg). METHODS: Following calibration and an equilibration time for the TcCO2 monitor, arterial blood gas samples were obtained as clinically indicated. A total of 64 sample sets (PaCO2, PECO2 and TcCO2) were obtained from the 30 patients. RESULTS: The PECO2 to PaCO2 difference was 0.6-0.9 kPa (4.4 +/- 7.1 mmHg) while the TcCO2 to PaCO2 difference was 0.36-0.38 kPa (2.8 +/- 2.9 mmHg) (P=NS). The difference between the PaCO2 and PECO2 was 0.4 kPa (3 mmHg) or less in 37 of 64 sample sets while the difference between the PaCO2 and TcCO2 was 0.4 kPa (3 mmHg) or less in 49 of 64 sample sets (P=0.038). Linear regression analysis of PECO2 vs. PaCO2 revealed a slope of 0.434, r=0.8761, r2=0.7676. Linear regression analysis of TcCO2 vs. PaCO2 revealed a slope of 0.914, r=0.9472, r2=0.8972. CONCLUSIONS: Although in most circumstances, both noninvasive monitors of PCO2 provided a clinically acceptable estimate of PaCO2, TCCO2 provided a slightly more accurate estimate of PaCO2 during intraoperative anaesthetic care in children.

Anesthesia, General↗

Relationship between haemoglobin and haematocrit in the definition of anaemia.

INTRODUCTION: Anaemia is the most frequent haematological disorder in childhood. The notion that defines naemia does not change throughout life, although parameters used for its evaluation show significant variations during childhood. Haematocrit (Hct) (%) is usually defined as three times the value of haemoglobin (Hgb) (g/dl), while the clinical definition of anaemia is related to either an abnormal Hct or Hgb value. OBJECTIVE: To evaluate the agreement between Hgb and Hct values in the definition of anaemia, the relationship between these two parameters and their age-dependence. METHODS: The Hct and Hgb paired values from children aged 2-18 months from Ifakara (Tanzania) and children aged 1-4 years from Manhiça (Mozambique) were analysed. Haematological determinations of the Manhiça samples were done using a KX-21N cell counter (Kobe, Japan) and Ifakara samples were analysed in a semiautomatic cell counter (Sysmex F800 microcell counter, TOA Medical Electronics, Kobe, Japan). The kappa-statistic was used to calculate the agreement between anaemia definitions in each group. Crude and multivariate relationship between Hct and Hgb levels were analysed by linear regression model estimation. The age-dependence of the crude ratio (Hct/Hgb) was analysed using linear regression models and fractional polynomials. RESULTS: The prevalences of mild and moderate anaemia as defined by Hgb levels in the Manhiça group were 61% and 6%, respectively, and 41% and 2% by Hct. In the Ifakara group these were 74% and 10%, respectively, by Hgb and 42% and 3% by Hct, respectively. Agreement between mild and moderate anaemia definitions made up from Hgb or from Hct levels were from fair to moderate. Hct levels decreased with age for high Hgb levels, whereas they increased for low Hgb levels. The classification of cases is improved when higher age-related cut-off values for Hct are used. The crude relationship between Hct and Hgb levels was significantly different from 3, and this was modified by age. The evaluation of the age-dependence ratio (Hct/Hgb) showed a non-linear relationship with an asymptotic trend to 3. CONCLUSIONS: Measurement of haematocrit count is easy and can be performed in most rural health care centres. However, the corresponding Hgb levels cannot be derived with an acceptable accuracy using the value 3 as a conversion factor. Furthermore, the commonly assumed 'equivalent' cut-off points for anaemia definitions need to be re-evaluated.

Age Distribution↗

Change in body mass index from adolescence to young adulthood and increased carotid intima-media thickness at 28 years of age: the Atherosclerosis Risk in Young Adults study.

UNLABELLED: Obesity has become a major health problem in Western societies by increasing the risk of atherosclerosis and cardiovascular disease. Although data on tracking of body mass index (BMI) are available, little is known about the impact of weight change over time on the development of vascular damage. OBJECTIVE: To evaluate the relationship between adolescent BMI as well as change in BMI from adolescence into young adulthood and cardiovascular risk, as estimated by common carotid intima-media thickness (CIMT). DESIGN: Cohort study. SUBJECTS: A total of 750 healthy young adults, aged 27-30 y, who attended secondary school in Utrecht, the Netherlands. MEASUREMENTS: Data on adolescent weight, height, blood pressure and puberty stage were available from the original school health records of the Municipal Health Service. At young adulthood, a questionnaire on cardiovascular risk factors was completed and fasting blood sample was drawn and common CIMT was measured. RESULTS: One standard deviation (s.d.) increase in adolescent BMI was associated with 2.3 microm [95% confidence interval (CI): 1.3; 3.3] increase in mean common CIMT in young adults after adjustment for gender, adolescent age, adolescent blood pressure, puberty stage and lumen diameter. Further adjustment for adult cardiovascular risk factors did not change the relationship (linear regression coefficient=2.1 microm/s.d.; 95% CI: 1.0; 3.1). Adjustment for adult BMI attenuated the association (linear regression coefficient=0.9 microm/s.d.; 95% CI: -0.3; 2.2) as the majority of overweight and obese adolescents remained overweight or became obese young adults. Subjects who remained in the upper BMI distribution from adolescence into young adulthood had a significantly higher common CIMT compared to those who showed relative weight loss over time (mean difference 14.7 mum; P<0.001). These latter showed similar CIMT values as individuals with constant low BMI. CONCLUSION: Adolescent BMI predicts cardiovascular risk, as estimated by common CIMT in young adulthood. Individuals who experience the largest increase in BMI and those who remain overweight over time have the thickest common CIMT.

Adolescent↗

Individual-based and group-based occupational exposure assessment: some equations to evaluate different strategies.

Basically, two strategies can be considered for the analysis of hazardous pollutants in the work environment: group-based and individual-based strategies. This paper provides existing and recently derived equations for both strategies describing the influence of several factors on attenuation and on the standard error of an estimated linear regression coefficient relating a continuous exposure variable and a continuous health outcome via a simple linear regression model. We applied these equations using exposure variability information from industry-wide surveys over the past decade in order to gain more insight into the effects of various sources of exposure variability on choices among different analysis strategies. In general, for the modeling scenario considered here, there is not a straightforward criterion for choosing an optimal analysis strategy. Researchers have to decide between individual-based strategies generating precise, though biased, estimates or group-based strategies generating less precise but essentially unbiased estimates. For most exposure variability scenarios evaluated, an individual-based strategy yielded substantial attenuation. It is the authors' contention that the choice between individual-based and group-based strategies should be based on validity, rather than on precision, of the estimated exposure-response coefficient.

Air Pollutants, Occupational↗

Association of free-prostate specific antigen subfractions and human glandular kallikrein 2 with volume of benign and malignant prostatic tissue.

BACKGROUND: We investigated the association of different subfractions of prostate specific antigen (PSA) and human glandular kallikrein 2 (hK2), such as total PSA (tPSA), complexed PSA (cPSA), free PSA (fPSA), "single-chain Intact fPSA" (fPSA-I), "multi-chain nicked fPSA" (fPSA-N), and total hK2 with volumes of total prostate gland, transition zone (tz), and prostate cancer (PCa) tissue in patients with benign and malignant prostatic disease. METHODS: Serum samples were collected from men with negative biopsy (n=164) and PCa (n=252). Total and fPSA were measured using a commercially immunoassay. We measured hK2 and fPSA-I by previously reported in-house research assays specific for hK2 and single-chain, non-cleaved fPSA, respectively. Levels of fPSA-N (=fPSA-fPSA-I) and cPSA (=tPSA-fPSA) were calculated. Total prostate and tz volume were measured using transrectal ultrasound (TRUS); PCa volume was calculated using a computer assisted volumetric program. Association with tz and cancer volumes (CaVols) was performed by linear regression analysis. RESULTS: All PSA subfractions and hK2 were associated with tz volume in multivariable linear regression analysis. Only hK2, fPSA, and fPSA-N were significantly associated with CaVol in multivariable analysis, fPSA-I seemed to be cancer related. CONCLUSIONS: The multi-chain fPSA-N subfractions of fPSA may be a valuable predictor of both benign prostate hyperplasia (BPH) and CaVol that is likely to be more useful in predicting tz volumes than CaVols. fPSA-I may provide information on cancer without being influenced by the presence of BPH.

Aged↗

Bone size and bone mass in 10-year-old Danish children: effect of current diet.

Lifestyle factors, such as diet, are believed to be involved in modifying bone health, although the results remain controversial, particularly in children and adolescents. The objective of the study was to identify associations between dietary factors and whole body bone measurements in 10-year-old children. The study was a cross-sectional analysis of a random sample of 105 healthy Danish children, aged 10 years (9.97+/-0.09). Whole body bone mineral content (BMC) and bone area (BA) were determined by dual-energy X-ray absorptiometry. The influence of diet (7 day food records) on BMC and BA were examined in bi- and multivariate analyses. The mean intakes of calcium, protein, phosphorus and sodium were 1226 mg, 78 g, 1523 mg and 3.3 g, respectively. In bivariate analyses, BMC and BA were strongly positively correlated with height (p<0.001) and weight (p<0.001), and with intakes of energy (p<0.005) and several nutrients. BMC was adjusted for size by including BA, height and weight in the multiple linear regression, and BA was adjusted for size by including height and weight in the multiple linear regression. In multivariate analyses, size-adjusted BMC was positively associated with calcium intake (p=0.02). Size-adjusted BA was positively associated with dietary protein (p=0.003), and negatively associated with intakes of sodium (p = 0.048) and phosphorus (p=0.01). In conclusion, calcium intake was positively associated with bone mineralization. There was a positive association between protein and BA, while for phosphorus and sodium the association was negative.

Body Height↗

Mass transfer, kinetics and equilibrium studies for the biosorption of methylene blue using Paspalum notatum.

Batch experiments were carried out for the sorption of methylene blue onto Paspalum notatum. The operating variables studied were initial dye concentration, initial solution pH, adsorbent dosage and contact time. Experimental equilibrium data were fitted to Freundlich, Langmuir and Redlich-Peterson isotherms by non-linear regression method. Six error functions was used to determine the optimum isotherm by non-linear regression method. The present study shows r2 as the best error function to determine the parameters involved in both two- and three-parameter isotherms. Langmuir isotherm was found to be the optimum isotherm for methylene blue onto P. notatum. The monolayer methylene blue sorption capacity of P. notatum was found to be 31 mg/g. The kinetics of methylene blue onto P. notatum was found to follow a pseudo second order kinetics. A Boyd plot confirms the external mass transfer as the rate-limiting step in the dye sorption process. The influence of initial dye concentration on the dye sorption process was represented in the form of dimensionless mass transfer numbers (Sh/Sc0.33) and was found to vary as C(0)-5x10(-6).

Adsorption↗

Molybdenum balance in healthy young Japanese women.

The absorption and balance of molybdenum (Mo) were examined in 43 healthy young Japanese women in four metabolic studies performed once a year from 2001 to 2004. In each year, an 18-d metabolic study, including two successive balance study sessions of 4 d, was designed and four kinds of dietary menus were supplied to the subjects periodically. Since the protein sources of the menus were specified in 2001-2003, and soybean products were poor in 2001 and 2002 and rich in the 2003, Mo intake in 2001 and 2002 was about 150microg/d while that in 2003 reached 318microg/d. In 2004, the protein sources were not specified and Mo intake was 217microg/d. This range of Mo intake overlapped that in the Japanese population. When the results of the four studies were pooled, Mo balance was calculated as 0.09+/-0.37microg/d/kg (mean+/-SD), and no significant relationship (r=0.142) was observed between the intake and balance. Between the apparent absorption (Y) and the intake (X), a significant (r=0.988, p<0.001) positive linear regression (Y=0.927X-0.523) was observed. Similarly, a significant (r=0.960, p<0.001) positive linear regression was observed between Mo intake and urinary excretion. These results indicate that more than 90% of Mo contained in a routine dietary menu is absorbed, most of Mo absorbed is excreted in urine, and Mo balance is in equilibrium in the general Japanese population.

Adolescent↗

Increase in first admissions for schizophrenia and other major psychoses in Italy.

Despite reports of falling first-admission rates for schizophrenia in some Western countries, methodological problems and bias preclude a definite conclusion about a genuine fall in the incidence of schizophrenia. This study set out to test the hypothesis that first admissions for schizophrenia in Italy have fallen in recent years. All admissions rated as 'first contact' in Italy from 1984 to 1994 for severe mental illnesses to general hospital psychiatric services, as reported in the Italian National Institute for Statistics Health-Care Yearbooks, were considered. Data were analyzed as rates per 100000 in the general population, and changes over time in incidence of schizophrenia, paranoia, affective psychoses and drug-induced psychoses (diagnosed according to ICD 9) were recorded. Changes in rates over time, with rates as the dependent variable and years as the independent variable, were the main outcome measure. First-admission rates for schizophrenia and paranoia increased progressively from 1984 to 1994, as did those for affective psychoses, mania and, to a lesser extent, major depression. In the same period, all admissions (both total and rated as 'first-contact') for mental disorders increased. Although linear regression tests for admission rates in most, but not all, cases indicate a significant ascending linear trend, quadratic model results show a significantly better fit than does the simple linear regression model for the majority of data. The change described by the quadratic model suggests an increase in admission rates more marked in the second half than in the first half of the period of the study. First-admission rates for schizophrenia and, to a lesser extent, paranoia seemed to increase concurrent to a decrease in first-admission rates for 'other' non-organic psychoses. Contrary to reports from other Western countries, hospital incidence in Italy for schizophrenia is on the increase, as is that for other severe psychoses. This increase is likely to be a reflection of changes in mental health-care organisation, in treatment and diagnostic patterns, and in cultural attitudes towards mental illness. Radical changes in the true incidence of psychoses, in particular of mood disorders, as described elsewhere, cannot be ruled out as contributing factors. Data bias and limitations preclude a generalisation of results, however.

Adolescent↗

Age effects on interleukin-6 and interleukin-1beta responses to endurance exercise in patients with neuromuscular diseases.

Plasma IL-6 before and 20 min after prolonged muscular exercise for 20 min at the individual aerobic/anaerobic threshold was analyzed in patients with neuromuscular diseases and in controls. Patients were assigned to the following diagnostic categories: Controls (n=18); amyotrophic lateral sclerosis (n=7); peripheral neuropathy (n=6); muscular dystrophy (n=13); mitochondriopathy (n=3); myopathy (others) (n=3); inflammatory myopathy (n=6); mononeuropathy (n=4). The concentrations of IL-6 before exercise were 5.55+/-0.94 pg/ml, and 6.52+/-0.97 pg/ml after exercise (P=0.0001). We introduced the independent variables age, sex and diagnostic category into a stepwise multiple linear regression model. Age emerged as a significant predictor of the IL-6 ratio (IL-6 post exercise/lL-6 before exercise). The regression equation was: IL-6 ratio=0.87+0.009xage (years), R=0.33, P<0.01, simple linear regression model. All IL-1beta concentrations were below the sensitivity of the assay (5 pg/ml). Concerning patients with neuromuscular diseases, the age associated increased IL-6 release after exercise could mean additional muscle damage.

Journal Article↗

[Food consumption scores and serum lipids levels in the population of São Paulo, Brazil].

OBJECTIVE: To study food patterns assessed using scores of consumption and their relationship with serum total cholesterol (TOTAL-C), low density lipoprotein-cholesterol (LDL-C) and high density lipoproteins (HDL-C) concentration in the population of the metropolitan area of São Paulo, Brazil. METHODS: Data on food frequency consumption (FFC), serum lipids, and other covariates were available for a representative sample of 1,045 adults. A 12-month retrospective food frequency questionnaire was used. FFC was assessed using scores of consumption, which was obtained by grouping food according to their composition into two large groups: score I (known as risk food for cardiovascular diseases) and score II (known as healthy food). The association between the scores and serum blood lipoprotein levels among the study population was analyzed through multiple linear regression analyses. Modeling step-wise techniques were used to enter the covariates into the linear models. RESULTS: Increasing mean levels of TOTAL-C and LDL-C were seen from the lowest through the highest quintile of score I when compared to the score II, where decreasing mean levels of TOTAL-C and LDL-C were observed from the lowest to the highest quintile. The results of the linear regression analyses between serum TOTAL-C and LDL-C levels for both FFC score I and score II, after multivariate adjusting, showed a significant positive relationship with score I and a significant and inverse relationship with score II. CONCLUSIONS: In population studies, FFC analyses through scores can be the choice method to evaluate the quality of diet and its potential effect on serum levels of TOTAL-C and LDL-C.

Adult↗

Corneal edema recovery dynamics in the rabbit. A useful model?

Open-eye and closed-eye recovery from contact lens-induced corneal edema was measured on the right eyes of 10 New Zealand White rabbits using ultrasound pachometry. Edema was produced by either 2 hours of eye closure (Patch Test) or 2 hours wearing of a thick hydrogel contact lens over the closed eye (Lens Test). The measured corneal edema recovery data were analyzed by both linear-regression analysis and nonlinear-regression analysis based on a previously published exponential open-eye edema recovery model. Linear-regression analysis revealed that the initial rabbit open-eye edema recovery rate of 36.3 +/- 11.9 (standard deviation) micron/hr was not significantly different (P greater than 0.25) from the initial young human open-eye edema recovery rate of 35.6 +/- 3.4 micron/hr. Similarly, the initial rabbit closed-eye edema recovery rate of 14.3 +/- 5.4 micron/hr was found to be not significantly different (P greater than 0.25) from the initial young human closed-eye edema recovery rate of 15.0 +/- 2.2 microns/hr. Corneal edema recovery indices derived using nonlinear-regression analysis also had a strong similarity between rabbit and human corneal edema recovery rates. For example, the calculated percent recovery per hour (PRPH) for rabbit open-eye corneal edema recovery of 41.4 +/- 11.3%/hr agreed well with the reported human open-eye PRPH of 34.2-58.9%/hr. The rabbit closed-eye PRPH of 25.6 +/- 10.7%/hr was also found to lie between the calculated human closed-eye PRPH values of 19.9-30.2%/hr.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

[Effect of total hormone concentration on the determination of amount of binding in the hormone/receptor interaction between erythrocytes and insulin].

The interaction of erythrocytes and [125I]insulin/insulin were studied up to a total insulin concentration of 409 mumol/l. Assuming a single class receptor model the evaluation of receptor affinity Ka and concentration R0 may be performed either by non-linear regression analyses with iteration procedures of R0, Ka and U (nonspecific binding), or by a linear regression analysis of the initial part of the Scatchard plot. Nonlinear fitting of data to a two class receptor model gives results that are reliable only for the high affinity receptor site. The non-definable step of R0 determination leads to uncertainties in results determined by the negative cooperativity model. From the results of this investigation and from considerations of signal modulation by receptor occupancy, some recommendations have been formulated for the evaluation of binding parameters; these should contribute to an improvement in the comparability of studies on the interactions of erythrocytes and insulin.

Erythrocytes↗

A comparison of multivariable regression models to analyse cost data.

RATIONALE, AIMS AND OBJECTIVES: Analysis of cost data is important in providing reliable information to aid budgeting decisions. Certain features of cost data, such as its typically highly skewed distribution and the need to estimate arithmetic mean costs in order to allow inferences to be made on total costs, make it difficult to analyse. Multivariable regression analysis is useful for estimating the influence of explanatory variables on cost in order to predict costs of future patients and allows for the control of variables which influence cost but whose distributions differ between comparison groups. This is especially important in the case of observational studies, where there may be no control over the balance of characteristics between the comparison groups. METHOD: This paper compares the appropriateness of various multivariable models of cost data by examining regression diagnostics, using as an example data collected on costs incurred in the treatment of inflammatory bowel disease. The models compared are normal and bootstrapped multiple linear regression, median regression, gamma model with the log link and normal linear regression (NLR) of log costs. RESULTS: Gamma modelling with the log link was found to be the most suitable model. CONCLUSIONS: Bootstrapping was found to make very little difference to conclusions from the NLR model.

Health Care Costs↗