# \#ordinal

**URL:** https://discourse.datamethods.org/tag/ordinal/45.md

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## [RMS Semiparametric Ordinal Longitudinal Model](https://discourse.datamethods.org/t/rms-semiparametric-ordinal-longitudinal-model/4819)

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**Author:** [@f2harrell](https://discourse.datamethods.org/u/f2harrell)\
**Replies:** 130\
**Last updated:** [October 16, 2026, 7:08pm UTC](https://discourse.datamethods.org/t/rms-semiparametric-ordinal-longitudinal-model/4819 "2026-10-16T19:08:36Z")

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Regression Modeling Strategies: Semiparametric Ordinal Longitudinal Model This is the 22nd of several connected topics organized around chapters in Regression Modeling Strategies. This topic is for a chapter that is not…

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## [Relaxing Assumptions and Targeted Estimands with MOST](https://discourse.datamethods.org/t/relaxing-assumptions-and-targeted-estimands-with-most/28755)

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**Author:** [@mdebacker](https://discourse.datamethods.org/u/mdebacker)\
**Replies:** 14\
**Last updated:** [October 13, 2026, 11:55am UTC](https://discourse.datamethods.org/t/relaxing-assumptions-and-targeted-estimands-with-most/28755 "2026-10-13T11:55:54Z")

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Hi all, I would very much appreciate your thoughts on an idea before diving into the technical details and potentially getting stuck in tunnel vision. The idea is based on several points, so I’ll set the context first: …

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## [CPMs for competing risks and multi-state models](https://discourse.datamethods.org/t/cpms-for-competing-risks-and-multi-state-models/28827)

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**Author:** [@hanowell](https://discourse.datamethods.org/u/hanowell)\
**Replies:** 7\
**Last updated:** [August 26, 2026, 11:29am UTC](https://discourse.datamethods.org/t/cpms-for-competing-risks-and-multi-state-models/28827 "2026-08-26T11:29:48Z")

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I was reading Frank’s post about CPMs and became curious about how to employ CPMs in competing risks contexts, and multi-state modeling more generally. What would the data setup be, and what would the model setup options…

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## [Ordinal state transition model for multiple time-to-event outcomes using Age as underlying time scale?](https://discourse.datamethods.org/t/ordinal-state-transition-model-for-multiple-time-to-event-outcomes-using-age-as-underlying-time-scale/28796)

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**Author:** [@Jaron](https://discourse.datamethods.org/u/Jaron)\
**Replies:** 0\
**Last updated:** [June 16, 2026, 7:05pm UTC](https://discourse.datamethods.org/t/ordinal-state-transition-model-for-multiple-time-to-event-outcomes-using-age-as-underlying-time-scale/28796 "2026-06-16T19:05:00Z")

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I have an observational study where I want to compare 2 groups (A versus B) on whether they tend to get diagnosed with lower or higher stage cancers. For each patient, they have one outcome: the time until they are diag…

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## [RMS Ordinal Regression for Continuous Y](https://discourse.datamethods.org/t/rms-ordinal-regression-for-continuous-y/4816)

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**Author:** [@f2harrell](https://discourse.datamethods.org/u/f2harrell)\
**Replies:** 81\
**Last updated:** [June 9, 2026, 9:34am UTC](https://discourse.datamethods.org/t/rms-ordinal-regression-for-continuous-y/4816 "2026-06-09T09:34:27Z")

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Regression Modeling Strategies: Ordinal Regression for Continuous Y This is the 15th of several connected topics organized around chapters in Regression Modeling Strategies. The purposes of these topics are to introduce…

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## [RMS Ordinal Logistic Regression](https://discourse.datamethods.org/t/rms-ordinal-logistic-regression/4815)

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**Author:** [@f2harrell](https://discourse.datamethods.org/u/f2harrell)\
**Replies:** 66\
**Last updated:** [May 24, 2025, 10:49pm UTC](https://discourse.datamethods.org/t/rms-ordinal-logistic-regression/4815 "2025-05-24T22:49:39Z")

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Regression Modeling Strategies: Ordinal Logistic Regression This is the 13th of several connected topics organized around chapters in Regression Modeling Strategies. The purposes of these topics are to introduce key con…

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## [Experimenting with a Bayesian Partial Proportional Odds Model](https://discourse.datamethods.org/t/experimenting-with-a-bayesian-partial-proportional-odds-model/28677)

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**Author:** [@arthur\_albuquerque](https://discourse.datamethods.org/u/arthur_albuquerque)\
**Replies:** 4\
**Last updated:** [April 27, 2026, 12:16pm UTC](https://discourse.datamethods.org/t/experimenting-with-a-bayesian-partial-proportional-odds-model/28677 "2026-04-27T12:16:44Z")

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Imagine we have data from a RCT comparing two strategies (experimental = PCT and control = UC). These strategies aid physicians to decide whether a patient needs treatment with antibiotics or not. We then measure the num…

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## [Sample size calculation for Paired Data using ordinal models](https://discourse.datamethods.org/t/sample-size-calculation-for-paired-data-using-ordinal-models/28685)

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**Author:** [@Mahmoud-Hamza](https://discourse.datamethods.org/u/Mahmoud-Hamza)\
**Replies:** 1\
**Last updated:** [March 31, 2026, 4:03pm UTC](https://discourse.datamethods.org/t/sample-size-calculation-for-paired-data-using-ordinal-models/28685 "2026-03-31T16:03:21Z")

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I came across this blog post by Prof. Harrell Ordinal Models for Paired Data – Statistical Thinking. I was trying to replicate the simulation in order to estimate the sample size for my paired study. Eveyrthing works pe…

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## [When and why (not) to worry about the PO assumption](https://discourse.datamethods.org/t/when-and-why-not-to-worry-about-the-po-assumption/28473)

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**Author:** [@ylong](https://discourse.datamethods.org/u/ylong)\
**Replies:** 4\
**Last updated:** [October 9, 2025, 12:16pm UTC](https://discourse.datamethods.org/t/when-and-why-not-to-worry-about-the-po-assumption/28473 "2025-10-09T12:16:11Z")

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Aim We wrote an article (Long, Wiegers, Jacobs, Steyerberg, & Van Zwet, 2025) about the proportional odds (PO) assumption in the analysis of ordinal outcomes. we use various examples from neurological trials. We distingu…

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## [Predictive performance of first order Markov proportional odds model](https://discourse.datamethods.org/t/predictive-performance-of-first-order-markov-proportional-odds-model/28263)

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**Author:** [@eliast](https://discourse.datamethods.org/u/eliast)\
**Replies:** 14\
**Last updated:** [July 25, 2025, 2:18pm UTC](https://discourse.datamethods.org/t/predictive-performance-of-first-order-markov-proportional-odds-model/28263 "2025-07-25T14:18:23Z")

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Hi, I used ‘rms’ to fit a first order Markov proportional odds model ( outcome is the severity of medication side effects observed at 10 time points) with 3 baseline predictors then used soprobMarkovOrd to calculate SO…

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## [Ordinal longitudinal transition model - Accounting for irreversible disease progression](https://discourse.datamethods.org/t/ordinal-longitudinal-transition-model-accounting-for-irreversible-disease-progression/28136)

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**Author:** [@MPetrosino](https://discourse.datamethods.org/u/MPetrosino)\
**Replies:** 9\
**Last updated:** [July 25, 2025, 11:26am UTC](https://discourse.datamethods.org/t/ordinal-longitudinal-transition-model-accounting-for-irreversible-disease-progression/28136 "2025-07-25T11:26:17Z")

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we are interested in applying the ordinal longitudinal model to model diabetes complications using electronic health data from the Health Protection Agency of Milan but we have some doubts that we would love to discuss w…

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## [BBR Session 11: Nonparametric Tests Using the Proportional Odds Model](https://discourse.datamethods.org/t/bbr-session-11-nonparametric-tests-using-the-proportional-odds-model/2915)

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**Author:** [@f2harrell](https://discourse.datamethods.org/u/f2harrell)\
**Replies:** 21\
**Last updated:** [June 6, 2025, 1:43pm UTC](https://discourse.datamethods.org/t/bbr-session-11-nonparametric-tests-using-the-proportional-odds-model/2915 "2025-06-06T13:43:30Z")

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This is a place for questions, answers, and discussion about session 11 of the Biostatistics for Biomedical Research airing 2020-01-24 introducing the proportional odds model as a generalization of the Wilcoxon and Krusk…

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## [Obtaining a continuous estimate from ordinal data](https://discourse.datamethods.org/t/obtaining-a-continuous-estimate-from-ordinal-data/28007)

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**Author:** [@robinblythe](https://discourse.datamethods.org/u/robinblythe)\
**Replies:** 14\
**Last updated:** [May 20, 2025, 1:38am UTC](https://discourse.datamethods.org/t/obtaining-a-continuous-estimate-from-ordinal-data/28007 "2025-05-20T01:38:46Z")

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I am attempting to synthesise willingness-to-pay (WTP) estimates from the literature for a given intervention as part of a systematic review. The goals of this analysis are to understand roughly the parameters and moment…

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## [Should I Exclude Patients Based on Treatment Criteria?](https://discourse.datamethods.org/t/should-i-exclude-patients-based-on-treatment-criteria/27987)

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**Author:** [@Louis\_Martin](https://discourse.datamethods.org/u/Louis_Martin)\
**Replies:** 4\
**Last updated:** [April 29, 2025, 9:52pm UTC](https://discourse.datamethods.org/t/should-i-exclude-patients-based-on-treatment-criteria/27987 "2025-04-29T21:52:41Z")

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Hi all, I’m working on a retrospective analysis to determine whether a drug reduces the prevalence of brain bleeds among very premature babies in the NICU. Babies were supposed to receive treatment if they weighed less …

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## [Ordinal regression with very few subjects in some levels](https://discourse.datamethods.org/t/ordinal-regression-with-very-few-subjects-in-some-levels/26295)

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**Author:** [@lorenzoFabbri](https://discourse.datamethods.org/u/lorenzoFabbri)\
**Replies:** 1\
**Last updated:** [February 18, 2025, 8:08pm UTC](https://discourse.datamethods.org/t/ordinal-regression-with-very-few-subjects-in-some-levels/26295 "2025-02-18T20:08:46Z")

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I am trying to find the most appropriate modeling strategy for my case. The dependent variable is a ordinal one, which is the result of summing up the responses of some individuals to a series of questions. Each question…

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## [Interpreting Ordinal Regression with Linear Spline](https://discourse.datamethods.org/t/interpreting-ordinal-regression-with-linear-spline/25385)

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**Author:** [@Louis\_Martin](https://discourse.datamethods.org/u/Louis_Martin)\
**Replies:** 1\
**Last updated:** [January 21, 2025, 5:06pm UTC](https://discourse.datamethods.org/t/interpreting-ordinal-regression-with-linear-spline/25385 "2025-01-21T17:06:02Z")

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I’m planning to perform a retrospective analysis to determine whether steroid doses improve outcomes for a subset of NICU patients. The outcome variable will be respiratory interventions at NICU discharge, where outcomes…

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## [Handling nonsense ordinal outcome predictions](https://discourse.datamethods.org/t/handling-nonsense-ordinal-outcome-predictions/16139)

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**Author:** [@martinspn](https://discourse.datamethods.org/u/martinspn)\
**Replies:** 13\
**Last updated:** [June 26, 2024, 11:46am UTC](https://discourse.datamethods.org/t/handling-nonsense-ordinal-outcome-predictions/16139 "2024-06-26T11:46:37Z")

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Hi everyone, I am developing a predictive model for the 90-day modified Rankin Score (mRS) among hospitalized patients who had strokes. One of the selection criteria was pre-stroke mRS ≤ 2 (patient lives independently).…

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## [Utility-weighted ordinal analysis](https://discourse.datamethods.org/t/utility-weighted-ordinal-analysis/15472)

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**Author:** [@arthur\_albuquerque](https://discourse.datamethods.org/u/arthur_albuquerque)\
**Replies:** 4\
**Last updated:** [June 6, 2024, 7:45pm UTC](https://discourse.datamethods.org/t/utility-weighted-ordinal-analysis/15472 "2024-06-06T19:45:32Z")

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The most common primary endpoint in the stroke field is the ordinal modified Rankin scale (mRS), from 0 to 6 (death). It has been argued that the Utility-Weighted mRS is more patient-centered, thus preferable. In the UW …

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## [Case-Cohort Design - longitudinal ordinal outcome with interval-censoring](https://discourse.datamethods.org/t/case-cohort-design-longitudinal-ordinal-outcome-with-interval-censoring/9554)

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**Author:** [@Erin1](https://discourse.datamethods.org/u/Erin1)\
**Replies:** 2\
**Last updated:** [April 11, 2024, 5:17pm UTC](https://discourse.datamethods.org/t/case-cohort-design-longitudinal-ordinal-outcome-with-interval-censoring/9554 "2024-04-11T17:17:34Z")

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A Case-Cohort design was used to study several biomarkers and an uncommon outcome. The biomarkers were measured for all cases, as well as a random sample of the cohort, referred to as the subcohort (sampling without repl…

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## [Practicalities of using Markov Longitudinal Ordinal Models in Cardiovascular Outcome Trials](https://discourse.datamethods.org/t/practicalities-of-using-markov-longitudinal-ordinal-models-in-cardiovascular-outcome-trials/7237)

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**Author:** [@mshunshin](https://discourse.datamethods.org/u/mshunshin)\
**Replies:** 5\
**Last updated:** [January 25, 2024, 6:49pm UTC](https://discourse.datamethods.org/t/practicalities-of-using-markov-longitudinal-ordinal-models-in-cardiovascular-outcome-trials/7237 "2024-01-25T18:49:41Z")

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Cardiovascular outcome trials often have a composite outcome - e.g. Death, Stroke, MI, and Hospitalisation - lumped all together than analysed as time to event. More recently, the “win ratio” has started to be advocated…

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## [Ordinal regression when odds are not proportional](https://discourse.datamethods.org/t/ordinal-regression-when-odds-are-not-proportional/4550)

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**Author:** [@agazzi\_giorgio](https://discourse.datamethods.org/u/agazzi_giorgio)\
**Replies:** 6\
**Last updated:** [January 19, 2024, 1:45pm UTC](https://discourse.datamethods.org/t/ordinal-regression-when-odds-are-not-proportional/4550 "2024-01-19T13:45:16Z")

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I’m working on a survey study and my data do not satisfy the proportional odds assumption (checked as Ordinal Logistic Regression | R Data Analysis Examples). I know that there are more complex models which can allow fo…

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## [Summary Statistics vs Raw Data](https://discourse.datamethods.org/t/summary-statistics-vs-raw-data/4165)

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**Author:** [@f2harrell](https://discourse.datamethods.org/u/f2harrell)\
**Replies:** 9\
**Last updated:** [October 23, 2023, 2:32pm UTC](https://discourse.datamethods.org/t/summary-statistics-vs-raw-data/4165 "2023-10-23T14:32:24Z")

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The purpose of this topic is for clinical trialists and statisticians to discuss power, sample size, missing data-handling, and treatment \\times time interaction advantages of using longitudinal raw data in analyzing pa…

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## [Prior/posterior predictive distributions for an unconstrained/constrained PPO model](https://discourse.datamethods.org/t/prior-posterior-predictive-distributions-for-an-unconstrained-constrained-ppo-model/6847)

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**Author:** [@cselman](https://discourse.datamethods.org/u/cselman)\
**Replies:** 0\
**Last updated:** [June 3, 2023, 6:16am UTC](https://discourse.datamethods.org/t/prior-posterior-predictive-distributions-for-an-unconstrained-constrained-ppo-model/6847 "2023-06-03T06:16:18Z")

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Hi all, I was wondering how one can use Stan to generate prior and posterior predictive distributions for partial proportional odds (PPO) models? I’ve provided code (written by Frank Harrell and Ben Goodrich, rmsb/inst/…

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## [Different results in unconstrained partial proportional odds model](https://discourse.datamethods.org/t/different-results-in-unconstrained-partial-proportional-odds-model/6798)

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**Author:** [@cselman](https://discourse.datamethods.org/u/cselman)\
**Replies:** 0\
**Last updated:** [May 22, 2023, 7:14am UTC](https://discourse.datamethods.org/t/different-results-in-unconstrained-partial-proportional-odds-model/6798 "2023-05-22T07:14:20Z")

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Hi there I have been trying to use the original Stan code (provided by Harrell and Goodrich) for an unconstrained partial proportional odds model to analyse some simulated data mimicking a two-arm trial (with clusters r…

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## [Advice regarding analysis plan for a study](https://discourse.datamethods.org/t/advice-regarding-analysis-plan-for-a-study/6273)

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**Author:** [@S\_Chakraborty](https://discourse.datamethods.org/u/S_Chakraborty)\
**Replies:** 2\
**Last updated:** [December 9, 2022, 2:10am UTC](https://discourse.datamethods.org/t/advice-regarding-analysis-plan-for-a-study/6273 "2022-12-09T02:10:17Z")

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Background: Diabetes is a common comorbidity in cancer patients and we have observed that patients with diabetes tend to have a higher risk of side effects during chemoradiation for carcinoma cervix. Infact quite a few o…

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## [Article: JAMA meta-analysis of Placebo response and cannabis based therapies for pain](https://discourse.datamethods.org/t/article-jama-meta-analysis-of-placebo-response-and-cannabis-based-therapies-for-pain/6255)

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**Author:** [@R\_cubed](https://discourse.datamethods.org/u/R_cubed)\
**Replies:** 2\
**Last updated:** [December 3, 2022, 12:16pm UTC](https://discourse.datamethods.org/t/article-jama-meta-analysis-of-placebo-response-and-cannabis-based-therapies-for-pain/6255 "2022-12-03T12:16:28Z")

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I came across a recently published meta-analysis that got some attention in the mainstream media: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2799017?utm\_source=For\_The\_Media&utm\_medium=referral&utm\_cam…

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## [Estimands from Bayesian Constrained Partial Proportional Odds Model in rmsb](https://discourse.datamethods.org/t/estimands-from-bayesian-constrained-partial-proportional-odds-model-in-rmsb/6056)

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**Author:** [@arthur\_albuquerque](https://discourse.datamethods.org/u/arthur_albuquerque)\
**Replies:** 1\
**Last updated:** [October 4, 2022, 8:29pm UTC](https://discourse.datamethods.org/t/estimands-from-bayesian-constrained-partial-proportional-odds-model-in-rmsb/6056 "2022-10-04T20:29:36Z")

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I want to fit a Bayesian Constrained Partial Proportional Odds Model with rmsb. In the example below, my dependent variable is a 7-level ordinal score (y) from 0 to 6. Y represents the observed outcome, and X the exposur…

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## [A randomized trial of epinephrine in out-of-hospital cardiac arrest](https://discourse.datamethods.org/t/a-randomized-trial-of-epinephrine-in-out-of-hospital-cardiac-arrest/89)

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**Author:** [@f2harrell](https://discourse.datamethods.org/u/f2harrell)\
**Replies:** 13\
**Last updated:** [September 27, 2022, 11:10am UTC](https://discourse.datamethods.org/t/a-randomized-trial-of-epinephrine-in-out-of-hospital-cardiac-arrest/89 "2022-09-27T11:10:58Z")

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GD Perkins et al presented an extremely well designed and conducted double blind randomized trial of epinephrine vs. placebo, randomizing over 8,000 patients. The primary outcome was the probability of survival at 30 da…

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## [Methods for analyzing (primary) percentage data](https://discourse.datamethods.org/t/methods-for-analyzing-primary-percentage-data/3946)

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**Author:** [@albertoca](https://discourse.datamethods.org/u/albertoca)\
**Replies:** 12\
**Last updated:** [August 7, 2022, 7:47pm UTC](https://discourse.datamethods.org/t/methods-for-analyzing-primary-percentage-data/3946 "2022-08-07T19:47:28Z")

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I wanted to ask about the best method to analyze percentages that do not represent an underlying count or a binary variable, as a response variable. In this case, it is a variable (% wound healing) that is expressed natu…

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## [Ordinal vs. Multinomial Logistic Regression?](https://discourse.datamethods.org/t/ordinal-vs-multinomial-logistic-regression/5682)

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**Author:** [@mksp](https://discourse.datamethods.org/u/mksp)\
**Replies:** 6\
**Last updated:** [June 11, 2022, 10:56pm UTC](https://discourse.datamethods.org/t/ordinal-vs-multinomial-logistic-regression/5682 "2022-06-11T22:56:09Z")

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Dear Esteemed Experts For a study with the outcome is the disease severity classified in 3 levels as follows: “Stationary”, “Active”, “Aggressive” Should I use multinomial or ordinal logistic regression ?

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