Lecture 14Introduction to Logistic Regression.ppt

Lecture 14:Introduction to Logistic Regression BMTRY 701Biostatistical Methods II Binary outcomes Linear regression is appropriate for continuous outcomes in biomedical research, our outcomes are more commonly of different forms Binary is probably the most prevalent disease versus not disease cured versus not cured progressed versus not progressed dead versus alive Example: Prostate Cancer What factors are related to capsular penetration? The prostate capsule is the membrane the surrounds the prostate gland As prostate cancer advances, the disease may extend into the capsule (extraprostatic extension) or beyond (extracapsular extension) and into the seminal vesicles. Capsular penetration is a poor prognostic indicator, which accounts for a reduced survival expectancy and a higher progression rate following radical prostatectomy. Let’s start with PSA and Gleason score Both are well-known factors related to disease severity What does a linear regression of capsular penetration on PSA and Gleason mean? PSA PSA is the abbreviation for prostate-specific antigen which is an enzyme produced in the epithelial cells of both benign and malignant tissue of the prostate gland. The enzyme keeps ejaculatory fluid from congealing after it has been expelled from the body. Prostate-specific antigen is used as a tumor marker to determine the presence of prostate cancer because a greater prostatic volume, associated with prostate cancer, produces larger amount of prostate-specific antigen. Gleason Score The prostate cancer Gleason Score is the sum of the two Gleason grades. After a prostate biopsy, a pathologist examines the samples of prostate cancer cells to see how the patterns, sizes, and shapes are different from healthy prostate cells. Cancerous cells that appear similar from healthy prostate are called well-differentiated while cancerous cells that appear very different from healthy prostate cells are called poorly-differentiated. The pathologist assigns one Gleas