NURS 8200 Week 7 Discussion 2: Logistic Regression in Nursing Practice

NURS 8200 Week 7: Quantitative Methods: Linear Regression

NURS 8200 Discussion 2: Logistic Regression in Nursing Practice

Logistic Regression in Nursing Practice – Logistic regression is used to analyze a wide variety of variables that may surround a singular outcome. For example, logistic regression could be used to identify the likelihood of a patient having a heart attack or stroke based on a variety of factors including age, sex, genetic characteristics, weight, and any preexisting health conditions. The biological systems and issues with which the health care field is concerned represent the kinds of applications for which logistic regression is especially useful.

Logistic regression is used in the health care field for many purposes, including diagnoses, predictions, and forecasting. The three articles in this week’s Learning Resources illustrate the many uses of logistic regression in the health care field. This Discussion allows you to explore the different uses of logistic regression and cultivate a deeper understanding of the application of logistic regression in evidence-based practice.

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Logistic Regression in Nursing Practice Note: This Discussion takes place in small groups, which should have been assigned by your Instructor.

To prepare FOR Logistic Regression in Nursing Practice:

  • Review the three articles in this week’s Learning Resources and evaluate their use of logistic regression. Select one article that interests you to examine more closely in this Discussion
  • Critically analyze the article you selected considering the following questions:
    • What are the goals and purposes of the research study the article describes?
    • How is logistic regression used in the study? What are the results of its use?
    • What other quantitative and statistical methods could be used to address the research issue discussed in the article?
    • What are the strengths and weaknesses of the study?
    • How could the weaknesses of the study be remedied?
    • How could findings from this study contribute to evidence-based practice, the nursing profession, or society?

By Day 3 OF Logistic Regression in Nursing Practice

Post a cohesive response in your small group that addresses the following:

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  • In the first line of your posting, identify the article you examined, providing its correct APA citation.
  • Post your critical analysis of the article as outlined above.
  • Propose potential remedies to address the weaknesses of each study.
  • Analyze the importance of this study to evidence-based practice, the nursing profession, or society.

Read a selection of your colleagues’ postings in your small group.

By Day 6 OF Logistic Regression in Nursing Practice

Respond to two of your colleagues in your small group in one or more of the following ways:

  • Ask a probing question, substantiated with additional background information, evidence, or research.
  • Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.
  • Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.
  • Validate an idea with your own experience and additional research.
  • Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.
  • Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

Logistic Regression in Nursing Practice Note: Please see the Course Syllabus and Discussion Posting and Response Rubric for formal Discussion question posting and response evaluation criteria.

Return to this Logistic Regression in Nursing Practice Discussion in a few days to read the responses to your initial posting. Note what you learned and/or any insights you gained as a result of the comments made by your colleagues.

Be sure to support your work with specific citations from this week’s Learning Resources and any additional sources.

Post your responses to the Small Group Discussion based on the course requirements.

Your Logistic Regression in Nursing Practice Discussion postings should be written in standard edited English and follow APA guidelines as closely as possible given the constraints of the online platform. Be sure to support your work with specific citations from this week’s Learning Resources and additional scholarly sources as appropriate. Refer to the Essential Guide to APA Style for Walden Students to ensure your in-text citations and reference list are correct. Initial postings must be 250–350 words (not including references).

Note: Your Instructor will assign you to a group by Day 1 of this week. Click on the Select a Topic drop-down menu to reveal Groups A–E. After choosing the correct group, click on the Go button.

Using this Discussion, post questions you have about using SPSS and collaborate with your colleagues to complete Assignment 5, assigned and due this week. The questions you post will not only give you the opportunity to address any problems you encounter and assist your colleagues, but will also give your Instructor an idea of the challenges and successes you and your classmates are experiencing. This will allow your Instructor to identify overall areas in which there is a lack of comprehension and areas of mastery and complete understanding, which will be useful in better explaining SPSS in future online courses.

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Note: You do not earn any points for participating in this Discussion. It is not required that you participate; however, it is an opportunity for you to connect with your colleagues to discuss the statistical exercises.

Post your responses to the Discussion based on the course requirements.

Your Discussion postings should be written in standard edited English and follow APA guidelines as closely as possible given the constraints of the online platform. Be sure to support your work with specific citations from this week’s Learning Resources and additional scholarly sources as appropriate. Refer to the Essential Guide to APA Style for Walden Students to ensure your in-text citations and reference list are correct. Initial postings must be 250–350 words (not including references).

Assignment 1: Article Critique [Major Assessment 4]

Continue to work on your article critique, assigned in Week 2 and due in Week 9. Continue evaluating your selected research article and developing the required sections of your paper. Your evaluation should be nearing its final stages.

By Day 7 of Week 9

You are not required to submit this assignment this week. Your article critique is due by Day 7 of Week 9.

NURS 8200 Week 7: Quantitative Methods: Linear Regression

Suppose you were involved in a research study examining the effect of drinking soda on a child’s weight. You performed a study over the course of several months on a sample of fifth graders, allowing one group to drink two cans of soda per day, another group one can per day, and the control group no soda at all. After you gathered your data, you would need to analyze the results for each of the three groups to determine whether to accept either the null or alternative hypothesis in your study. A useful method of analysis for this particular study is known as linear regression.

As you examine linear regression, you may notice some limitations or shortcomings of this method of statistical analysis. Linear regression assumes that the relationships between variables are linear and that the variables themselves are continuous in nature. Linear regression is therefore not useful to examine variables that are binary or dichotomous (i.e., variables that only have two possible outcomes, such as gender).

This week continues your exploration of correlation and relationships between variables in quantitative research studies, focusing on the concepts of linear regression. This week also provides an overview of the concepts and applications of logistic regression, especially as it pertains to the health care field and evidence-based practice. Last week you examined the uses and methods of simple linear regression as a basis for this type of analysis. This week, you expand on those basic concepts and explore multiple regression, which can be used to show relationships between more than two variables.

Learning Objectives

Students will:

  • Analyze, interpret, and report results of a linear regression analysis
  • Analyze, interpret, and report results of a logistic regression analysis
  • Assess the application of logistic regression in nursing research and practice

Photo Credit: [blackred]/[iStock / Getty Images Plus]/Getty Images


Learning Resources

Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

Required Media

“Multiple Regression”

Used by permission from SPSSVideoTutor.com A division of ConsumerRaters LLC., 1121 S Military Trail, 314, Deerfield Beach, FL 33442, USA

Note: The approximate length of this media piece is 5 minutes.

 

“Logistic Regression”

Used by permission from SPSSVideoTutor.com A division of ConsumerRaters LLC., 1121 S Military Trail, 314, Deerfield Beach, FL 33442, USA

Note: The approximate length of this media piece is 15 minutes.

 

Logistic Regression in Nursing Practice Required Readings

Gray, J.R., Grove, S.K., & Sutherland, S. (2017). Burns and Grove’s the practice of nursing research: Appraisal, synthesis, and generation of evidence (8th ed.). St. Louis, MO: Saunders Elsevier.

  • Chapter 24, “Using Statistics to Predict”This chapter asserts that predictive analyses are based on probability theory instead of decision theory. It also analyzes how variation plays a critical role in simple linear regression and multiple regression.

Statistics and Data Analysis for Nursing Research

    • Chapter 9, “Correlation and Simple Regression” (pp. 208–222)This section of Chapter 9 discusses the simple regression equation and outlines major components of regression, including errors of prediction, residuals, OLS regression, and ordinary least-square regression.
    • Chapter 10, “Multiple Regression”Chapter 10 focuses on multiple regression as a statistical procedure and explains multivariate statistics and their relationship to multiple regression concepts, equations, and tests.
  • Chapter 12, “Logistic Regression”This chapter provides an overview of logistic regression, which is a form of statistical analysis frequently used in nursing research.

Hoerster, K. D., Mayer, J. A., Gabbard, S., Kronick, R. G., Roesch, S. C., Malcarne, V. L., & Zuniga, M. L. (2011). Impact of individual-, environmental-, and policy-level factors on health care utilization among US farmworkers. American Journal of Public Health, 101(4), 685–692. doi:10.2105/AJPH.2009.190892

Note: You will access this article from the Walden Library databases.

This article discusses the results of a study of how many U.S. farmworkers accessed U.S. health care. The study considered this question on several levels—individual, environmental, and policy—and used logistic regression to analyze the multivariate data gathered.

Tritica-Majnaric, L., Zekic-Susac, M., Sarlija, N., & Vitale, B. (2010). Prediction of influenza vaccination outcome by neural networks and logistic regression. Journal of Biomedical Informatics, 43(5), 774–781. doi:10.1016/j.jbi.2010.04.011

Note: You will access this article from the Walden Library databases.

This article describes the methods and results of a neural network study on the effectiveness of the influenza vaccine using historical data in three neural network algorithms. The article also provides a discussion of logistic regression in comparison to the neural network algorithms used.

Xiao, Y., Griffin, M. P., Lake, D. E., & Moorman, J. R. (2010). Nearest-neighbor and logistic regression analyses of clinical and heart rate characteristics in the early diagnosis of neonatal sepsis. Medical Decision Making, 30(2), 258–266. doi:10.1177/0272989X09337791

Note: You will access this article from the Walden Library databases.

This article outlines the procedures and findings of a study on the use of two methods of neonatal sepsis diagnosis: nearest-neighbor analysis and logistic regression analysis. The results indicated that each method generates unique information useful to diagnosis, and therefore both methods should be used simultaneously for improved accuracy of diagnoses.

Optional Resources

Walden University. (n.d.). Linear regression. Retrieved August 1, 2011, from http://streaming.waldenu.edu/hdp/researchtutorials/educ8106_player/educ8106_linear_regression.html

Rubric Detail- Logistic Regression in Nursing Practice

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Exemplary Proficient Sufficient Developing
Discussion Postings and Responses
(100%) – 4 (100%)
• Discussion postings and responses are responsive to the requirements of the Discussion instructions and are posted by the due date. • Discussion postings and responses significantly contribute to the quality of interaction by providing rich and relevant examples, applicable research support, discerning ideas, and/or stimulating thoughts/probes and are respectful when offering suggestions, constructive feedback, or opposing viewpoints. • Discussion postings and responses demonstrate an in-depth understanding of concepts and issues presented in the course (e.g., insightful interpretations or analyses, accurate and perceptive parallels, and well-supported opinions) and are well supported, when appropriate, by pertinent research. • Discussion postings and responses provide evidence that the student has read and considered a sampling of colleagues’ postings and synthesized key comments and ideas, as applicable.
(75%) – 3 (75%)
• Discussion postings and responses are responsive to the requirements of the Discussion instructions and are posted by the due date. • Discussion postings and responses contribute to the quality of interaction by providing examples, research support when appropriate, ideas, and/or thoughts/probes, and are respectful when offering suggestions, constructive feedback, or opposing viewpoints. • Discussion postings and responses demonstrate some depth of understanding of the issues and show that the student has absorbed the general principles and ideas presented in the course, although viewpoints and interpretations are not always thoroughly supported. • Discussion postings and responses provide evidence that the student has considered at least some colleagues’ postings and synthesized some key comments and ideas, as applicable.
(50%) – 2 (50%)
• Discussion postings and responses are posted by the due date but are not always responsive to the requirements of the Discussion instructions. • Discussion postings and responses do little to contribute to the quality of interaction or to stimulate thinking and learning. • Discussion postings and responses demonstrate a minimal understanding of concepts presented, tend to address peripheral issues, and, although generally accurate, display some omissions and/or errors. • Discussion postings and responses do not provide evidence that the student has considered at least some colleagues’ postings or synthesized at least some key comments and ideas, as applicable.
(0%) – 1 (25%)
• Discussion postings and responses are posted past the late deadline, defined as 11:59 p.m. on the due date, and/or do not address the requirements of the Discussion instructions. • Discussion postings and responses do not contribute to the quality of interaction or stimulate thinking and learning. • Discussion postings and responses do not demonstrate an understanding of the concepts presented in the course, and/or do not address relevant issues, and/or are inaccurate and contain many omissions and/or errors. • Discussion postings and responses do not provide evidence that the student has read or considered colleagues’ postings, as applicable.
Total Points: 4

Tritica-Majnaric, L., Zekic-Susac, M., Sarlija, N., & Vitale, B. (2010). Prediction of influenza vaccination outcome by neural networks and logistic regression. Journal of Biomedical Informatics, 43(5), 774–781. doi:10.1016/j.jbi.2010.04.011

What are the goals and purposes of the research study the article describes?

The goals of the study is to design model to enable successful prediction of the outcome of influenza vaccination based on real historical medical data. To compare a non-linear neural network approach and a logistics regression one. 

How is logistic regression used in the study? What are the results of its use?

Logistic regression was used as a comparison model to a neural network model in estimating the risk of reaction to influenza vaccine and to extract variables which are found to be important in risk prediction. The use of logistics regression for this study was due to the multivariate data involving a dichotomous response. 

  “Artificial neural networks are a computer-based method which can incorporate non-linear effects and interactions between multiple variables in a valid probability mode” (Tritica-Majnaric, 2010, pg.776). Three neural network algorithms were tested to include: multilayer perceptron (MLP), radial-basis function network (RBFN) and probabilistic network (PNN).  

What other quantitative and statistical methods could be used to address the research issue discussed in the article?

Well, I think that this study needs to be repeated in multiple populations in multiple geographical areas. I think correlation statistics could aid in identifying what the best preventive model is best across the world and allow for variances in different areas. We don’t have to all use the same model, however we should all compare our probability evaluations to ensure best practices are being evaluated. 

What are the strengths and weaknesses of the study?

The strength of the study was the implementation of a 10-fold cross-validation which was due to the weakness of sample size and recognition of potential bias. The weakness of the study was the sample size, age variance, and subjective 26 input variables which could be bias by the voice of the preprocessing method. 

How could the weaknesses of the study be remedied?

The weakness of the study could be remedied with future research focused on other preprocessing methods in the modeling and the use of more datasets. Also, the sample size could be larger and more geographical data besides just one area. In this study it was Croatia

How could findings from this study contribute to evidence-based practice, the nursing profession, or society?

The findings of this study could initiate more solidified evidence of predictive models for the influenza vaccine. Correlation studies could be done with other populations and age groups to identify the best predictive model and algorithm for preventative influenza vaccines and measures. Preventing influenza is extremely important to vulnerable populations in this country due to the increase in mortality rate if in infected. It is important to the nursing profession not only of better patient outcomes but also for protection of our fellow nurses and medical professionals. Better preventative vaccines and measures would aide in workplace efficiency and complications with the medical professionals being infected with influenza. 

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