An evaluation of quadratic inference functions for estimating intervention effects in cluster randomized trials

Cluster randomized trials (CRTs) usually randomize groups of individuals to interventions, and outcomes are typically measured at the individual level. Marginal intervention effects are frequently of interest in CRTs due to their population-averaged interpretations. Such effects are estimated using...

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Main Authors: Hengshi Yu, Fan Li, Elizabeth L. Turner
Format: Article
Language:English
Published: Elsevier 2020-09-01
Series:Contemporary Clinical Trials Communications
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2451865420300892
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author Hengshi Yu
Fan Li
Elizabeth L. Turner
author_facet Hengshi Yu
Fan Li
Elizabeth L. Turner
author_sort Hengshi Yu
collection DOAJ
description Cluster randomized trials (CRTs) usually randomize groups of individuals to interventions, and outcomes are typically measured at the individual level. Marginal intervention effects are frequently of interest in CRTs due to their population-averaged interpretations. Such effects are estimated using generalized estimating equations (GEE), or a recent alternative called the quadratic inference function (QIF). However, the performance of QIF relative to GEE have not been extensively evaluated in the CRT context, especially when the marginal mean model includes additional covariates. Motivated by the HALI trial, we conduct simulation studies to compare the finite-sample operating characteristics of QIF and GEE. We demonstrate that QIF and GEE are equivalent under some conditions. When the marginal mean model includes individual-level covariates, QIF shows an efficiency improvement over GEE with overall larger power, but its test size may be more liberal than GEE and GEE achieves better coverage than QIF. The test size inflation may not by fully addressed from using finite-sample bias corrections. The estimates of QIF tend to be closer to GEE in the HALI data, although the former presents a small standard error. Overall, we confirm that the QIF approach generally has potentially better efficiency than GEE in our simulation studies but might be more cautiously used as a viable approach for the analysis of CRTs. More research is needed, however, to address the finite-sample bias in the variance estimation of the QIF to better control its test size.
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spelling doaj.art-705a0322a4944e6498855d7235c96d392022-12-21T18:18:29ZengElsevierContemporary Clinical Trials Communications2451-86542020-09-0119100605An evaluation of quadratic inference functions for estimating intervention effects in cluster randomized trialsHengshi Yu0Fan Li1Elizabeth L. Turner2Department of Biostatistics, University of Michigan, Ann Arbor, MI, 48109, USA; Corresponding author.Department of Biostatistics, Yale University, New Haven, CT, 06510, USA; Center for Methods in Implementation and Prevention Science, Yale University, New Haven, CT, 06510, USADepartment of Biostatistics and Bioinformatics, Duke University, Durham, NC, 27710, USA; Duke Global Health Institute, Durham, NC, 27710, USACluster randomized trials (CRTs) usually randomize groups of individuals to interventions, and outcomes are typically measured at the individual level. Marginal intervention effects are frequently of interest in CRTs due to their population-averaged interpretations. Such effects are estimated using generalized estimating equations (GEE), or a recent alternative called the quadratic inference function (QIF). However, the performance of QIF relative to GEE have not been extensively evaluated in the CRT context, especially when the marginal mean model includes additional covariates. Motivated by the HALI trial, we conduct simulation studies to compare the finite-sample operating characteristics of QIF and GEE. We demonstrate that QIF and GEE are equivalent under some conditions. When the marginal mean model includes individual-level covariates, QIF shows an efficiency improvement over GEE with overall larger power, but its test size may be more liberal than GEE and GEE achieves better coverage than QIF. The test size inflation may not by fully addressed from using finite-sample bias corrections. The estimates of QIF tend to be closer to GEE in the HALI data, although the former presents a small standard error. Overall, we confirm that the QIF approach generally has potentially better efficiency than GEE in our simulation studies but might be more cautiously used as a viable approach for the analysis of CRTs. More research is needed, however, to address the finite-sample bias in the variance estimation of the QIF to better control its test size.http://www.sciencedirect.com/science/article/pii/S2451865420300892Generalized estimating equationsGeneralized method of momentsMarginal intervention effect estimationPopulation-average intervention effectQuadratic inference function
spellingShingle Hengshi Yu
Fan Li
Elizabeth L. Turner
An evaluation of quadratic inference functions for estimating intervention effects in cluster randomized trials
Contemporary Clinical Trials Communications
Generalized estimating equations
Generalized method of moments
Marginal intervention effect estimation
Population-average intervention effect
Quadratic inference function
title An evaluation of quadratic inference functions for estimating intervention effects in cluster randomized trials
title_full An evaluation of quadratic inference functions for estimating intervention effects in cluster randomized trials
title_fullStr An evaluation of quadratic inference functions for estimating intervention effects in cluster randomized trials
title_full_unstemmed An evaluation of quadratic inference functions for estimating intervention effects in cluster randomized trials
title_short An evaluation of quadratic inference functions for estimating intervention effects in cluster randomized trials
title_sort evaluation of quadratic inference functions for estimating intervention effects in cluster randomized trials
topic Generalized estimating equations
Generalized method of moments
Marginal intervention effect estimation
Population-average intervention effect
Quadratic inference function
url http://www.sciencedirect.com/science/article/pii/S2451865420300892
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