A Review of the Logistic Regression Model with Emphasis on Medical Research

Abstract

This study explored and reviewed the logistic regression (LR) model, a multivariable method for modeling the relationship between multiple independent variables and a categorical dependent variable, with emphasis on medical research. Thirty seven research articles published between 2000 and 2018 which employed logistic regression as the main statistical tool as well as six text books on logistic regression were reviewed. Logistic regression concepts such as odds, odds ratio, logit transformation, logistic curve, assumption, selecting dependent and independent variables, model fitting, reporting and interpreting were presented. Upon perusing the literature, considerable deficiencies were found in both the use and reporting of LR. For many studies, the ratio of the number of outcome events to predictor variables (events per variable) was sufficiently small to call into question the accuracy of the regression model. Also, most studies did not report on validation analysis, regression diagnostics or goodness-of-fit measures; measures which authenticate the robustness of the LR model. Here, we demonstrate a good example of the application of the LR model using data obtained on a cohort of pregnant women and the factors that influence their decision to opt for caesarean delivery or vaginal birth. It is recommended that researchers should be more rigorous and pay greater attention to guidelines concerning the use and reporting of LR models.