Generalized Bayes inference on a linear personalized minimum clinically important difference

Abstract: Inference on the minimum clinically important difference, or MCID, is an important practical problem in medicine. The basic idea is that a treatment being statistically significant may not lead to an improvement in the patients' well-being. The MCID is defined as a threshold such that, if a diagnostic measure exceeds this threshold, then the patients are more likely to notice an improvement. Typical formulations use an underspecified model, which makes a genuine Bayesian solution out of reach. Here, for a challenging personalized MCID problem, where the practically-significant threshold depends on patients' profiles, we develop a novel generalized posterior distribution, based on a working binary quantile regression model, that can be used for estimation and inference. The advantage of this formulation is two-fold: we can theoretically control the bias of the misspecified model and it has a latent variable representation which we can leverage for efficient Gibbs sampling. To ensure that the generalized Bayes inferences achieve a level of frequentist reliability, we propose a variation on the so-called generalized posterior calibration algorithm to suitably tune the spread of our proposed posterior.