Marginal analysis of multiple outcomes with informative cluster size.

Autor: Mitani AA; Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, Massachusetts., Kaye EK; Department of Health Policy & Health Services Research, Boston University Henry M. Goldman School of Dental Medicine, Boston, Massachusetts., Nelson KP; Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts.
Jazyk: angličtina
Zdroj: Biometrics [Biometrics] 2021 Mar; Vol. 77 (1), pp. 271-282. Date of Electronic Publication: 2020 Mar 05.
DOI: 10.1111/biom.13241
Abstrakt: In surveillance studies of periodontal disease, the relationship between disease and other health and socioeconomic conditions is of key interest. To determine whether a patient has periodontal disease, multiple clinical measurements (eg, clinical attachment loss, alveolar bone loss, and tooth mobility) are taken at the tooth-level. Researchers often create a composite outcome from these measurements or analyze each outcome separately. Moreover, patients have varying number of teeth, with those who are more prone to the disease having fewer teeth compared to those with good oral health. Such dependence between the outcome of interest and cluster size (number of teeth) is called informative cluster size and results obtained from fitting conventional marginal models can be biased. We propose a novel method to jointly analyze multiple correlated binary outcomes for clustered data with informative cluster size using the class of generalized estimating equations (GEE) with cluster-specific weights. We compare our proposed multivariate outcome cluster-weighted GEE results to those from the convectional GEE using the baseline data from Veterans Affairs Dental Longitudinal Study. In an extensive simulation study, we show that our proposed method yields estimates with minimal relative biases and excellent coverage probabilities.
(© 2020 The International Biometric Society.)
Databáze: MEDLINE
Externí odkaz: