Improving multilevel analyses: the integrated epidemiologic design.
Epidemiology
; 20(4): 525-32, 2009 Jul.
Article
em En
| MEDLINE
| ID: mdl-19436212
ABSTRACT
Multilevel analysis has been widely used to allow the simultaneous examination of the effects of individual- and group-level variables on individual health outcomes. In spite of its utility, multilevel design can have some drawbacks in the estimation of risk factor effects when the within-group variation of variables of interest is small relative to between-group variation. An extreme case of this is a group-level risk factor, which by definition has no within-group variation. To improve the estimation of group-level and individual-level risk factor effects, we consider an integrated epidemiologic design using a population-based estimating equation approach that can be considered a further extension of the multilevel design. Although the integrated design uses the same individual-level and group-level data as the multilevel design, it includes aggregated health outcome data in each group as additional information. This paper explains differences between the 2 designs, describing advantages and disadvantages of the integrated design over the multilevel design. The 2 designs are applied to a real example of mortality following chronic kidney disease, illustrating differences that might be encountered in practice.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Projetos de Pesquisa Epidemiológica
/
Análise Multinível
Tipo de estudo:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Risk_factors_studies
Limite:
Adult
/
Aged
/
Humans
/
Male
/
Middle aged
País/Região como assunto:
Europa
Idioma:
En
Revista:
Epidemiology
Ano de publicação:
2009
Tipo de documento:
Article