title: Using second-order generalized estimating equations to model heterogeneous intraclass correlation in cluster-randomized trials.
abstract: In cluster-randomized trials, it is commonly assumed that the magnitude of the correlation among subjects within a cluster is constant across clusters. However, the correlation may in fact be heterogeneous and depend on cluster characteristics. Accurate modeling of the correlation has the potential to improve inference. We use second-order generalized estimating equations to model heterogeneous correlation in cluster-randomized trials. Using simulation studies we show that accurate modeling of heterogeneous correlation can improve inference when the correlation is high or varies by cluster size. We apply the methods to a cluster-randomized trial of an intervention to promote breast cancer screening.
authors.affiliation: Department of Biostatistics, University of California, Los Angeles, CA 90095-1772, U.S.A. ccrespi@ucla.edu
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Crespi
authors.forename: Weng Kee
authors.initials: WK
authors.lastname: Wong
authors.forename: Shiraz I
authors.initials: SI
authors.lastname: Mishra
mesh_terms: D000465:Algorithms; D015982:Bias; D001943:Breast Neoplasms / Q000175:diagnosis; D016000:Cluster Analysis; D003198:Computer Simulation; D005260:Female; D006126:Group Processes; D006127:Group Structure; D006266:Health Education; D006801:Humans; D016014:Linear Models; D008327:Mammography / Q000706:statistics & numerical data; D008403:Mass Screening; D015233:Models, Statistical; D016032:Randomized Controlled Trials as Topic