Interesting. That is what I have thought most people were implying by the word āimportanceā when I have seen it here on this forum.
However, I am still a bit confused as to what is practically and usefully important about importance. What are your thoughts on the following example? What am I missing? I am particularly curious about this idea of āimportanceā because I have not only seen the question here on the forum, but I have encountered questions/discussions aiming at similar ideas from researchers that I have worked with. I would be curious to hear how your physician colleagues use āimportanceā in practice. How exactly do they use the knowledge of āthe big players in predicting Yā?
Letās assume an overly simple example (Iām not a physician, so ignore the potentially awful physiology here), where we have a regression model for systolic blood pressure, systolic_bp
, with continuous standardized predictors drug
, drinks
, and age
. Letās say that drug
is a dose of blood pressure medication that affects systolic_bp
, and drinks
is number of alcoholic drinks and it affects both systolic_bp
and the drug
, i.e. classic confounder. We fit the basic Gaussian linear regression model, systolic_bp ~ 1 + age + drug + drinks
.
Now, we find some measure of āimportanceā for the predictors. I can only think of 3 reasons why importance is practically and usefully important (but I may easily be overlooking something!!!): 1) purely academic, statistical modeling question; 2) for the purpose of intervening: while age
cannot be intervened on, drug
and possibly drinks
could, so it would be nice to know which to choose to intervene on to affect systolic_bp
if one doesnāt have the resources to intervene on both (i.e. biggest bang for buck); 3) for the purpose of prediction if the physician only has limited information: given you know age
only, can you make a good guesstimate at systolic_bp
(obviously not, but this is all hypothetical).
A physician would not be interested in (1), only (2) and (3). For (2), it seems that one would need to be very careful about the causal structure of the problem at hand. The most āimportantā predictor, may not necessarily be the best predictor to intervene on. It seems like one would need a good grasp of the causal structure, and then they could use the coefficients from standardized predictors to determine biggest bang for the buckā¦ would relative explained variation as āimportanceā in this scenario be better? For (3), it seems that one would want to run multiple models, since using any measure of importance would not seem to imply that the predictor would necessarily be a good one on its own. For this case, it seems multiple models and model comparison, or something like projection predictive feature selection, would be better than measuring āimportanceāā¦?
I can think of a tempting 4th reason, but I think it would be incorrect - to imply some sort of discovery of causal nature. It would be extremely tempting, when seeing a regression with many predictors and rank of their āimportanceā, and having a general lack of or fuzzy understanding of the causal structure, for one to attribute some causal connection with the most important predictor and the outcome. I think that this could be misleading, though, as good prediction doesnāt imply causality. This might be extremely tempting for general users, though, and I would wonder, from a general user/practitioner/researcher perspective, if this isnāt what people may have in mind when they are looking for the ābiggest players in predicting Y.ā