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How to know if random intercepts and slopes are, necessary for glmer.nb model

On 20/10/2015 11:32, David Jones wrote:
David...a better LL (or significant Chi-square test) is not an excuse 
for applying an NB GLM or NB GLMM. Overdispersion can be caused by at 
least 10 different causes (and each requiring a different 
solution)...and you need to pinpoint what is driving the overdispersion. 
If you pick the wrong cause, then you may up with a wrong model.

However....you state that the overdispersion is due to a few patients 
who stay for a long time in the hospital. That would be an argument in 
favour of using the NB GLMM. But also for using a Poisson GLMM with an 
observation level random intercept. The later one is much faster to 
estimate. It is not my favourite model....but being pragmatic......it is 
perhaps the way forward.

Setting the theta to a fixed value in glmer.nb will certainly help.


Kind regards,

Alain

PS...is length of stay in a hospital not strictly positive? Not that I 
want to suggest to use a zero truncated distribution for a data set with 
500,000 observations....:-)