Bayesian Meta-Analysis for Binary Data and Prior Distribution on Models.

In meta-analysis, the structure of the between-sample heterogeneity plays a crucial role in estimating the meta-parameter. A Bayesian meta-analysis for binary data has recently been proposed that measures this heterogeneity by clustering the samples and then determining the posterior probability of the cluster models through model selection. The meta-parameter is then estimated using Bayesian model averaging techniques. Although an objective Bayesian meta-analysis is proposed for each type of heterogeneity, we concentrate the attention of this paper on priors over the models. We consider four alternative priors which are motivated by reasonable but different assumptions. A frequentist validation with simulated data has been carried out to analyze the properties of each prior distribution for a set of different number of studies and sample sizes. The results show the importance of choosing an adequate model prior as the posterior probabilities for the models are very sensitive to it. The hierarchical Poisson prior and the hierarchical uniform prior show a good performance when the real model is the homogeneity, or when the sample sizes are high enough. However, the uniform prior can detect the true model when it is an intermediate model (neither homogeneity nor heterogeneity) even for small sample sizes and few studies. An illustrative example with real data is also given, showing the sensitivity of the estimation of the meta-parameter to the model prior.

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Bayesian analysis of nosocomial infection risk and length of stay in a department of general and digestive surgery.

OBJECTIVE: Nosocomial infection is one of the main causes of morbidity and mortality in patients admitted to hospital. One aim of this study is to determine its intrinsic and extrinsic risk factors. Nosocomial infection also increases the duration of hospital stay. We quantify, in relative terms, the increased duration of the hospital stay when a patient has the infection. METHODS: We propose the use of logistic regression models with an asymmetric link to estimate the probability of a patient suffering a nosocomial infection. We use Poisson-Gamma regression models as a multivariate technique to detect the factors that really influence the average hospital stay of infected and noninfected patients. For both models, frequentist and Bayesian estimations were carried out and compared. RESULTS: The models are applied to data from 1039 patients operated on in a Spanish hospital. Length of stay, the existance of a preoperative stay and obesity were found the main risk factors for a nosomial infection. The existence of a nosocomial infection multiplies the length of stay in the hospital by a factor of 2.87. CONCLUSION: The results show that the asymmetric logit improves the predictive capacity of conventional logistic regressions.