Statistical Models: The Rest of the Story Scott L. Zeger Hurley-Dorrier Professor and Chair Department of Biostatistics The Johns Hopkins University Bloomberg.

Statistical Models: The Rest of the Story

Scott L. Zeger

Hurley-Dorrier Professor and Chair

Department of Biostatistics

The Johns Hopkins University Bloomberg School

What is a model?

What is a statistical model?

Tool for those empirical sciences where signals come embedded in noise

Lens through which to view data to better understand the signal

Tool for quantifying the evidence in data about a particular truth we seek

Empirical science: search for “truth”

Truth for Population

Observed Value for a Representative

Sample

Probability – statistical model

Statistical inference

How to Choose the Best Model

• Miminize the mean squared error• Minimize the Akaike Information Criterion (AIC)• Minimize the Bayesian Information Criterion (BIC)• Maximize the likelihood function• Cross-validate• Jackknife• Bootstrap• Boost, then bag• etc

You can not choose the best model because there isn’t one

You can choose a useful model based upon prior scientific knowledge

You can explore and report how your scientific findings vary over a set of other useful models

You can average your results across useful models

Causal Model

Smoking Disease

Dollars

Death

Causal Model

Iraq invasion

Violence Death

What Do We Know about Smoking and Medical Expenditures

• WHO, U.S. Surgeon General and IARC say smoking causes 13 major diseases:– Lung cancer; COPD; atherosclerosis; MI;

stroke; ….• In the U.S., most people receive treatment for

major chronic diseases (e.g. lung cancer)

• It cost money to treat your disease

What we know LITTLE about

• Whether smoking causes people to use more or less medical services to treat smoking caused diseases

• Whether smoking causes people without a major disease to seek more or less medical services– “I hate my doctor, she tries to take my cigs

away”– “I go as often as I can afford; got to watch out

for those diseases that can kill me”

Competing Causal Models

Smoking Disease Dollars

Smoking Dollars

Odds Ratios of Lung Cancer/COPD by Pack-years for Current and Former Smokers

Medical Expenditures for Persons with vs without Lung Cancer/COPD

Difference in Average Expenditures by Propensity to Have Disease

Smoking Attributable Burden for Cohort of 60 Million Who Started Under 21 Years Old,

1954-2000

Disease: LC/COPD

(millions case-years)

43.7

Disease: CHD Group

(millions case-years)

80.8

Dollars

(billions)

1,087

Deaths

(million years lost)

128.0

(13m persons)

Smoking Disease Dollars

“Know this”:

$1 Trillion +- 0.2 T for 10% of pop

???

Estimate well what you can; estimate poorly what you must.

Don’t dilute decent causal estimates with causal speculates (unless you intend to make everything uncertain)

Causal Model

Iraq invasion

Violence Death

What We Know Well

• 2,237 U.S. soldiers (DoD)

• 99 British soldiers (British Govt)

• 4,027 Iraqi police (News reports compiled by iCasualties.org)

• 28,198 - 31,800 Iraqi civilians (IBC web-site)

The count includes civilian deaths caused by coalition military action and by military or paramilitary responses to the coalition presence (e.g. insurgent and terrorist attacks). It also includes excess civilian deaths caused by criminal action resulting from the breakdown in law and order which followed the coalition invasion. Compiled from eye-witness reports and news articles

What We Know Less Well

Iraq invasion

Violence Death

~30,000 Iraqi deaths

Lack of sanitation

Lack of clean water

Poor nutrition

Limited access to medical care

Extreme stress and grief

98,000 (95% CI: 8,000 - 194,000) without Falluja

~ 20 - 50% violent

Summary

• A model defines the boundaries of an analysis and can determine what will be learned from data– Like a lens determines what you will see

• Same model for two problems – Separate what can be estimated precisely from

what can not– Prior knowledge about pathway

• Too much uncertainty invalidates, whether it should or not

Timing of Proceeds Relative to Smoking Attributable Expenditures for Major Diseases Only

Smoking Attributable Fraction of Disease (SAF) and Dollars (SAFE)