DEVELOPMENT OF HEART RISK APPRAISAL FUNCTIONS IN THE PRESENCE OF MULTIPLE INDICATORS - THE FRAMINGHAM-STUDY NURSING-HOME INSTITUTIONALIZATION MODEL

A health risk appraisal function is a mathematical model designed to e stimate the risk or probability of a person's mortality or morbidity f or various diseases based upon risk factors such as age, medical histo ry and smoking behaviour, The Framingham Study has contributed substan tially to the development and use of these for endpoints such as morta lity and incidence of coronary heart disease and other cardiovascular diseases. This paper discusses a methodology for the development of he alth risk appraisal functions when the number of potential risk factor s is large and illustrates it with sex specific functions for nursing home institutionalization. The methodology involves grouping variables substantively into sets, applying principal component factor analysis and variable clustering to obtain substantively meaningful composite scores, ranking these in order of substantive importance, and then ent ering these with a hierarchical ordering into a Cox proportional hazar d regression.