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A comparison of models for clustered binary outcomes: analysis of a designed immunology experiment
Author(s) -
Betensky Rebecca A.,
Williams Paige L.,
Lederman Howard M.
Publication year - 2001
Publication title -
journal of the royal statistical society: series c (applied statistics)
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.205
H-Index - 72
eISSN - 1467-9876
pISSN - 0035-9254
DOI - 10.1111/1467-9876.00219
Subject(s) - cluster (spacecraft) , human immunodeficiency virus (hiv) , immunology , covariate , immune system , population , binary number , lymphocyte , lymphocyte subsets , biology , statistics , medicine , computer science , mathematics , t cell , environmental health , arithmetic , programming language
The lymphocyte proliferative assay (LPA) of immune competence was conducted on 52 subjects, with up to 36 processing conditions per subject, to evaluate whether samples could be shipped or stored overnight, rather than being processed on fresh blood as currently required. The LPA study resulted in clustered binary data, with both cluster level and cluster‐varying covariates. Two modelling strategies for the analysis of such clustered binary data are through the cluster‐specific and population‐averaged approaches. Whereas most research in this area has focused on the analysis of matched pairs data, in many situations, such as the LPA study, cluster sizes are naturally larger. Through considerations of interpretation and efficiency of these models when applied to large clusters, the mixed effect cluster‐specific model was selected as most appropriate for the analysis of the LPA data. The model confirmed that the LPA response is significantly impaired in individuals infected with the human immunodeficiency virus (HIV). The LPA response was found to be significantly lower for shipped and overnight samples than for fresh samples, and this effect was significantly stronger among HIV‐infected individuals. Surprisingly, an anticoagulant effect was not detected.