A comparison of confidence interval methods for the intraclass correlation coefficient in cluster randomized trials

Statistics in Medicine - Tập 21 Số 24 - Trang 3757-3774 - 2002
Obioha C. Ukoumunne1
1Department of Public Health Sciences, King's College London, 5th Floor, Capital House, 42 Weston Street, London SE1 3QD, U.K.

Tóm tắt

AbstractA Correction has been published for this article in Statistics in Medicine 23(18) 2004, 2935. This study compared different methods for assigning confidence intervals to the analysis of variance estimator of the intraclass correlation coefficient (ρ). The context of the comparison was the use of ρ to estimate the variance inflation factor when planning cluster randomized trials. The methods were compared using Monte Carlo simulations of unbalanced clustered data and data from a cluster randomized trial of an intervention to improve the management of asthma in a general practice setting. The coverage and precision of the intervals were compared for data with different numbers of clusters, mean numbers of subjects per cluster and underlying values of ρ. The performance of the methods was also compared for data with Normal and non‐Normally distributed cluster specific effects. Results of the simulations showed that methods based upon the variance ratio statistic provided greater coverage levels than those based upon large sample approximations to the standard error of ρ. Searle's method provided close to nominal coverage for data with Normally distributed random effects. Adjusted versions of Searle's method to allow for lack of balance in the data generally did not improve upon it either in terms of coverage or precision. Analyses of the trial data, however, showed that limits provided by Thomas and Hultquist's method may differ from those of the other variance ratio statistic methods when the arithmetic mean differs markedly from the harmonic mean cluster size. The simulation results demonstrated that marked non‐Normality in the cluster level random effects compromised the performance of all methods. Confidence intervals for the methods were generally wide relative to the underlying size of ρsuggesting that there may be great uncertainty associated with sample size calculations for cluster trials where large clusters are randomized. Data from cluster based studies with sample sizes much larger than those typical of cluster randomized trials are required to estimate ρ with a reasonable degree of precision. Copyright © 2002 John Wiley & Sons, Ltd.

Từ khóa


Tài liệu tham khảo

10.1136/bmj.39343.649097.55

Murray DM, 1998, Design and Analysis of Group‐Randomized Trials

10.1136/bmj.318.7193.1251

10.1136/bmj.317.7165.1041

10.1016/0197-2456(92)90026-V

10.1016/0197-2456(94)00026-Y

Kish L, 1965, Survey Sampling

10.1097/00001648-199401000-00013

10.1093/her/8.4.555

Ukoumunne OC, 1999, Methods for evaluating area‐wide and organization‐based interventions in health and health care: a systematic review, Health Technology Assessments, 3

10.1136/bmj.317.7167.1171

10.1002/sim.4780111208

10.1177/096228020000900202

10.1002/1097-0258(20010215)20:3<401::AID-SIM801>3.0.CO;2-1

10.1002/1097-0258(20010215)20:3<453::AID-SIM803>3.0.CO;2-L

10.2307/2531060

10.1080/00949659708811823

10.2307/1403259

10.1214/aoms/1177731946

StataCorp., 2000, Stata Statistical Software: Release7.0

Searle SR, 1971, Linear Models

10.1201/9781482277142

10.1214/aos/1176344202

10.1111/j.1469-1809.1972.tb00291.x

10.2307/2528131

Fisher RA, 1970, Statistical Methods for Research Workers

10.1080/00401706.1979.10489750

Colhoun H, 1996, Health Survey for England 1994

10.1191/096228000672549488

10.1080/03610928608829315

10.1002/sim.935

10.1016/0895-4356(92)90095-5

10.1177/135581960000500105

10.1093/oxfordjournals.aje.a009904

10.1002/1097-0258(20010215)20:3<377::AID-SIM799>3.0.CO;2-N

10.1017/CBO9780511802843

Goldstein H, 1995, Multilevel Statistical Models

10.1002/sim.991