The analysis of rates using Poisson regression models.

Models are considered in which the underlying rate at which events occur can be represented by a regression function that describes the relation between the predictor variables and the unknown parameters. Estimates of the parameters can be obtained by means of iteratively reweighted least squares (IRLS). When the events of interest follow the Poisson distribution, the IRLS algorithm is equivalent to using the method of scoring to obtain maximum likelihood (ML) estimates. The general Poisson regression models include log-linear, quasilinear and intrinsically nonlinear models. The approach considered enables one to concentrate on describing the relation between the dependent variable and the predictor variables through the regression model. Standard statistical packages that support IRLS can then be used to obtain ML estimates, their asymptotic covariance matrix, and diagnostic measures that can be used to aid the analyst in detecting outlying responses and extreme points in the model space. Applications of these methods to epidemiologic follow-up studies with the data organized into a life-table type of format are discussed. The method is illustrated by using a nonlinear model, derived from the multistage theory of carcinogenesis, to analyze lung cancer death rates among British physicians who were regular cigarette smokers.