Gui-Shuang Ying1, Maureen G Maguire1, Robert J Glynn2, Bernard Rosner2. 1. Center for Preventive Ophthalmology and Biostatistics, Department of Ophthalmology, Perelman School of Medicine, University of Pennsylvania , Philadelphia, Pennsylvania, USA. 2. Division of Preventive Medicine and the Channing Lab, Department of Medicine, Brigham and Women's Hospital , Boston, Massachusetts, USA.
Abstract
PURPOSE: To describe and demonstrate methods for analyzing longitudinal correlated eye data with a continuous outcome measure. METHODS: We described fixed effects, mixed effects and generalized estimating equations (GEE) models, applied them to data from the Complications of Age-Related Macular Degeneration Prevention Trial (CAPT) and the Age-Related Eye Disease Study (AREDS). In CAPT (N = 1052), we assessed the effect of eye-specific laser treatment on change in visual acuity (VA). In the AREDS study, we evaluated effects of systemic supplement treatment among 1463 participants with AMD category 3. RESULTS: In CAPT, the inter-eye correlations (0.33 to 0.53) and longitudinal correlations (0.31 to 0.88) varied. There was a small treatment effect on VA change (approximately one letter) at 24 months for all three models (p = .009 to 0.02). Model fit was better with the mixed effects model than the fixed effects model (p < .001). In AREDS, there was no significant treatment effect in all models (p > .55). Current smokers had a significantly greater VA decline than non-current smokers in the fixed effects model (p = .04) and the mixed effects model with random intercept (p = .0003), but marginally significant in the mixed effects model with random intercept and slope (p = .08), and GEE models (p = .054 to 0.07). The model fit was better with the fixed effects model than the mixed effects model (p < .0001). CONCLUSION: Longitudinal models using the eye as the unit of analysis can be implemented using available statistical software to account for both inter-eye and longitudinal correlations. Goodness-of-fit statistics may guide the selection of the most appropriate model.
PURPOSE: To describe and demonstrate methods for analyzing longitudinal correlated eye data with a continuous outcome measure. METHODS: We described fixed effects, mixed effects and generalized estimating equations (GEE) models, applied them to data from the Complications of Age-Related Macular Degeneration Prevention Trial (CAPT) and the Age-Related Eye Disease Study (AREDS). In CAPT (N = 1052), we assessed the effect of eye-specific laser treatment on change in visual acuity (VA). In the AREDS study, we evaluated effects of systemic supplement treatment among 1463 participants with AMD category 3. RESULTS: In CAPT, the inter-eye correlations (0.33 to 0.53) and longitudinal correlations (0.31 to 0.88) varied. There was a small treatment effect on VA change (approximately one letter) at 24 months for all three models (p = .009 to 0.02). Model fit was better with the mixed effects model than the fixed effects model (p < .001). In AREDS, there was no significant treatment effect in all models (p > .55). Current smokers had a significantly greater VA decline than non-current smokers in the fixed effects model (p = .04) and the mixed effects model with random intercept (p = .0003), but marginally significant in the mixed effects model with random intercept and slope (p = .08), and GEE models (p = .054 to 0.07). The model fit was better with the fixed effects model than the mixed effects model (p < .0001). CONCLUSION: Longitudinal models using the eye as the unit of analysis can be implemented using available statistical software to account for both inter-eye and longitudinal correlations. Goodness-of-fit statistics may guide the selection of the most appropriate model.
Entities:
Keywords:
Linear regression models; correlated data; fixed effects model; generalized estimating equations; inter-eye correlation; longitudinal correlation; mixed effects model
Authors: Samantha Sze-Yee Lee; David Alonso-Caneiro; Gareth Lingham; Fred K Chen; Paul G Sanfilippo; Seyhan Yazar; David A Mackey Journal: Invest Ophthalmol Vis Sci Date: 2022-05-02 Impact factor: 4.925