ld-archer / E_FEM

This is the repository for the English version of the Future Elderly Model, originally developed at the Leonard D. Schaeffer Center for Health Policy and Microsimulation.
MIT License
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lnly sociso cumulative predictors #115

Closed ld-archer closed 1 year ago

ld-archer commented 1 year ago

Maybe it makes more sense to think about the length of time a simulant spends in each category as predictors here instead of just the 1 year lagged models. If someone is chronically lonely or social isolated they must have a different probability of certain outcomes compared with someone who has a particularly lonely year.

Reason for this train of thought is the life year and DFLY outcomes show an reduction in lifespan and healthy lifespan which is not what we hypothesised. This seems to go against the expectation when looking at the transition models and the cross tabulations, so maybe this is the other explanation.

#### Life Years
[1] "No Loneliness"
[1] "Cohort Average Lifeyears:         36.33"
[1] "Intervention Average Lifeyears:   35.14"
[1] "Increase:                         -1.19"
[1] "No Social Isolation"
[1] "Cohort Average Lifeyears:         36.33"
[1] "Intervention Average Lifeyears:   32.44"
[1] "Increase:                         -3.898"
[1] "No Loneliness OR Social Isolation"
[1] "Cohort Average Lifeyears:         36.33"
[1] "Intervention Average Lifeyears:   31.39"
[1] "Increase:                         -4.944"
#### Disability Free Life Years
[1] "No Loneliness"
[1] "Cohort Average Disability Free Lifeyears:         13.09"
[1] "Intervention Average Disability Free Lifeyears:   13.58"
[1] "Increase:                                         0.4839"
[1] "No Social Isolation"
[1] "Cohort Average Disability Free Lifeyears:         13.09"
[1] "Intervention Average Disability Free Lifeyears:   12.16"
[1] "Increase:                                         -0.9301"
[1] "No Loneliness OR Social Isolation"
[1] "Cohort Average Disability Free Lifeyears:         13.09"
[1] "Intervention Average Disability Free Lifeyears:   12.51"
[1] "Increase:                                         -0.583"
#### Disease Free Life Years
[1] "No Loneliness"
[1] "Cohort Average Disease Free Lifeyears:         4.692"
[1] "Intervention Average Disease Free Lifeyears:   4.821"
[1] "Increase:                                         0.1291"
[1] "No Social Isolation"
[1] "Cohort Average Disease Free Lifeyears:         4.692"
[1] "Intervention Average Disease Free Lifeyears:   4.52"
[1] "Increase:                                         -0.1715"
[1] "No Loneliness OR Social Isolation"
[1] "Cohort Average Disease Free Lifeyears:         4.692"
[1] "Intervention Average Disease Free Lifeyears:   4.649"
[1] "Increase:                                         -0.04238"

#### Mortality Model
*Loneliness increases with the levels, so lnly == 1 is low, and lnly == 3 is highest*
*Social isolation also increases with each level, so 1 is no isolation and 6 is very high.*
time_scaled_probit
died
2
male    .221925
white   .0582912
hsless  .1789429
college -.0892654
l2age65l    .0335443
l2age6574   .0412819
l2age75p    .0670353
l2lnly2 -.2687503
l2lnly3 -.0563827
l2sociso2   -.3363536
l2sociso3   -.3865913
l2sociso4   -.309466
l2sociso5   -.2221707
l2sociso6   .0343754
_cons   -4.134855

Looking at the transition model, loneliness is a bit odd. It suggests that probability of mortality is highest in the low loneliness group, and smallest in the medium group. Social isolation is also very odd in this model, as compared with the reference factor of 1 (no isolation), all groups apart from 6 (highest) show a reduced probability of mortality. Then the highest isolation group have a higher probability of mortality. This is in contrast to probit models I have fit in R:

Coefficients:
             Estimate Std. Error z value Pr(>|z|)    
(Intercept) -3.797544   0.287848 -13.193  < 2e-16 ***
male         0.243942   0.020420  11.946  < 2e-16 ***
white        0.232698   0.064961   3.582 0.000341 ***
hsless       0.167679   0.021575   7.772 7.72e-15 ***
college     -0.057417   0.036136  -1.589 0.112078    
l2age65l     0.028893   0.004764   6.065 1.32e-09 ***
l2age6574    0.044328   0.003771  11.754  < 2e-16 ***
l2age75p     0.051058   0.002100  24.309  < 2e-16 ***
l2lnly1     -0.741774   0.026422 -28.074  < 2e-16 ***
l2lnly2     -0.627767   0.031701 -19.803  < 2e-16 ***
l2sociso1   -0.431891   0.033686 -12.821  < 2e-16 ***
l2sociso2   -0.354473   0.030490 -11.626  < 2e-16 ***
l2sociso3   -0.297204   0.035302  -8.419  < 2e-16 ***
l2sociso4   -0.228024   0.039510  -5.771 7.86e-09 ***
l2sociso5   -0.184818   0.057018  -3.241 0.001189 ** 
---
Signif. codes:  0 ‘***’ 0.001 ‘**’ 0.01 ‘*’ 0.05 ‘.’ 0.1 ‘ ’ 1

The relationships here are what we would expect from looking at the raw data: Highest loneliness group has the highest probability of mortality, as does the highest social isolation. We can also see that the magnitude of each level is roughly where we would expect, where the probability of mortality increases in order as loneliness and social isolation increase.

Perhaps this shows that the problem in the life years and dflys is not due to the outcomes chosen, but some quirk of the transition model estimation? I need to make sure here that the sample we are estimating the stata probits (top) on is correct, and try a version in R with this exact sample (R probits are fitted to entire transition sample NOT using the survey weights).

ld-archer commented 1 year ago

NO NEED FOR CUMULATIVE PREDICTORS!!!!!!! IT WORKS!

Made lots of little changes to some of the transition models in the last week and it seems to be paying off.

Going to close this issue as no longer necessary and open new ones to make the variables dynamic, as well as improve the social isolation model. I also need to add the chronic diseases back to the mortality model and add loneliness and social isolation as predictors of chronic disease.

Reference information:

time_scaled_probit
died
2
male    .2518757
white   .218156
hsless  .0885608
college -.0248863
l2age65l    .0382895
l2age6574   .0430296
l2age75p    .054453
l2lnly1 -.7919944
l2lnly2 -.6713157
l2sociso1   -.2675508
l2sociso2   -.2196578
l2sociso3   -.1661182
l2sociso4   -.1401404
l2sociso5   -.1066686
_cons   -4.23072

Outcomes:

#### Life Years
[1] "No Loneliness"
[1] "Cohort Average Lifeyears:         41.59"
[1] "Intervention Average Lifeyears:   43.68"
[1] "Increase:                         2.085"
[1] "No Social Isolation"
[1] "Cohort Average Lifeyears:         41.59"
[1] "Intervention Average Lifeyears:   42.87"
[1] "Increase:                         1.279"
[1] "No Loneliness OR Social Isolation"
[1] "Cohort Average Lifeyears:         41.59"
[1] "Intervention Average Lifeyears:   44.83"
[1] "Increase:                         3.238"

#### Disability Free Life Years
[1] "No Loneliness"
[1] "Cohort Average Disability Free Lifeyears:         14.79"
[1] "Intervention Average Disability Free Lifeyears:   15.99"
[1] "Increase:                                         1.206"
[1] "No Social Isolation"
[1] "Cohort Average Disability Free Lifeyears:         14.79"
[1] "Intervention Average Disability Free Lifeyears:   15.86"
[1] "Increase:                                         1.071"
[1] "No Loneliness OR Social Isolation"
[1] "Cohort Average Disability Free Lifeyears:         14.79"
[1] "Intervention Average Disability Free Lifeyears:   17.06"
[1] "Increase:                                         2.275"

#### Disease Free Life Years
[1] "No Loneliness"
[1] "Cohort Average Disease Free Lifeyears:         5.151"
[1] "Intervention Average Disease Free Lifeyears:   5.392"
[1] "Increase:                                         0.2411"
[1] "No Social Isolation"
[1] "Cohort Average Disease Free Lifeyears:         5.151"
[1] "Intervention Average Disease Free Lifeyears:   5.312"
[1] "Increase:                                         0.1613"
[1] "No Loneliness OR Social Isolation"
[1] "Cohort Average Disease Free Lifeyears:         5.151"
[1] "Intervention Average Disease Free Lifeyears:   5.552"
[1] "Increase:                                         0.4019"

IMPORTANT NOTE: Loneliness and Social isolation are not yet included in the chronic disease or functional limitation models. I think the effect we are seeing here is purely the reduction in the probability of mortality directly from loneliness and social isolation, which is brilliant! Adding them to lots of other models could improve or worsen these results, so need to come back here and compare when I start updating things further.