Evaluation of the type I error rate when using parametric bootstrap analysis of a cluster randomized controlled trial with binary outcomes and a small number of clusters

•The type I error rate is inflated under scenarios of a small number of clusters per treatment in a cluster randomized trials when using parametric bootstrap.•When analyzing cluster randomized trials, the pbkrtest package is limited in performance as it resamples the observations ignoring clusters.•...

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Published inComputer methods and programs in biomedicine Vol. 215; p. 106654
Main Authors Golzarri-Arroyo, Lilian, Dickinson, Stephanie L., Jamshidi-Naeini, Yasaman, Zoh, Roger S., Brown, Andrew W., Owora, Arthur H., Li, Peng, Oakes, J. Michael, Allison, David B.
Format Journal Article
LanguageEnglish
Published Ireland Elsevier B.V 01.03.2022
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Abstract •The type I error rate is inflated under scenarios of a small number of clusters per treatment in a cluster randomized trials when using parametric bootstrap.•When analyzing cluster randomized trials, the pbkrtest package is limited in performance as it resamples the observations ignoring clusters.•We want to highlight that while the well-known nesting/degrees of freedom issue undermines p-values when k <= 20, we show here that small number of clusters and small ICC inflate type I error rates, setting the nesting/df issue aside. Cluster randomized controlled trials (cRCTs) are increasingly used but must be analyzed carefully. We conducted a simulation study to evaluate the validity of a parametric bootstrap (PB) approach with respect to the empirical type I error rate for a cRCT with binary outcomes and a small number of clusters. We simulated a case study with a binary (0/1) outcome, four clusters, and 100 subjects per cluster. To compare the validity of the test with respect to error rate, we simulated the same experiment with K=10, 20, and 30 clusters, each with 2,000 simulated datasets. To test the null hypothesis, we used a generalized linear mixed model including a random intercept for clusters and obtained p-values based on likelihood ratio tests (LRTs) using the parametric bootstrap method as implemented in the R package “pbkrtest”. The PB test produced error rates of 9.1%, 5.5%, 4.9%, and 5.0% on average across all ICC values for K=4, K=10, K=20, and K=30, respectively. The error rates were higher, ranging from 9.1% to 36.5% for K=4, in the models with singular fits (i.e., ignoring clustering) because the ICC was estimated to be zero. Using the parametric bootstrap for cRCTs with a small number of clusters results in inflated error rates and is not valid
AbstractList •The type I error rate is inflated under scenarios of a small number of clusters per treatment in a cluster randomized trials when using parametric bootstrap.•When analyzing cluster randomized trials, the pbkrtest package is limited in performance as it resamples the observations ignoring clusters.•We want to highlight that while the well-known nesting/degrees of freedom issue undermines p-values when k <= 20, we show here that small number of clusters and small ICC inflate type I error rates, setting the nesting/df issue aside. Cluster randomized controlled trials (cRCTs) are increasingly used but must be analyzed carefully. We conducted a simulation study to evaluate the validity of a parametric bootstrap (PB) approach with respect to the empirical type I error rate for a cRCT with binary outcomes and a small number of clusters. We simulated a case study with a binary (0/1) outcome, four clusters, and 100 subjects per cluster. To compare the validity of the test with respect to error rate, we simulated the same experiment with K=10, 20, and 30 clusters, each with 2,000 simulated datasets. To test the null hypothesis, we used a generalized linear mixed model including a random intercept for clusters and obtained p-values based on likelihood ratio tests (LRTs) using the parametric bootstrap method as implemented in the R package “pbkrtest”. The PB test produced error rates of 9.1%, 5.5%, 4.9%, and 5.0% on average across all ICC values for K=4, K=10, K=20, and K=30, respectively. The error rates were higher, ranging from 9.1% to 36.5% for K=4, in the models with singular fits (i.e., ignoring clustering) because the ICC was estimated to be zero. Using the parametric bootstrap for cRCTs with a small number of clusters results in inflated error rates and is not valid
Cluster randomized controlled trials (cRCTs) are increasingly used but must be analyzed carefully. We conducted a simulation study to evaluate the validity of a parametric bootstrap (PB) approach with respect to the empirical type I error rate for a cRCT with binary outcomes and a small number of clusters.BACKGROUNDCluster randomized controlled trials (cRCTs) are increasingly used but must be analyzed carefully. We conducted a simulation study to evaluate the validity of a parametric bootstrap (PB) approach with respect to the empirical type I error rate for a cRCT with binary outcomes and a small number of clusters.We simulated a case study with a binary (0/1) outcome, four clusters, and 100 subjects per cluster. To compare the validity of the test with respect to error rate, we simulated the same experiment with K=10, 20, and 30 clusters, each with 2,000 simulated datasets. To test the null hypothesis, we used a generalized linear mixed model including a random intercept for clusters and obtained p-values based on likelihood ratio tests (LRTs) using the parametric bootstrap method as implemented in the R package "pbkrtest".METHODSWe simulated a case study with a binary (0/1) outcome, four clusters, and 100 subjects per cluster. To compare the validity of the test with respect to error rate, we simulated the same experiment with K=10, 20, and 30 clusters, each with 2,000 simulated datasets. To test the null hypothesis, we used a generalized linear mixed model including a random intercept for clusters and obtained p-values based on likelihood ratio tests (LRTs) using the parametric bootstrap method as implemented in the R package "pbkrtest".The PB test produced error rates of 9.1%, 5.5%, 4.9%, and 5.0% on average across all ICC values for K=4, K=10, K=20, and K=30, respectively. The error rates were higher, ranging from 9.1% to 36.5% for K=4, in the models with singular fits (i.e., ignoring clustering) because the ICC was estimated to be zero.RESULTSThe PB test produced error rates of 9.1%, 5.5%, 4.9%, and 5.0% on average across all ICC values for K=4, K=10, K=20, and K=30, respectively. The error rates were higher, ranging from 9.1% to 36.5% for K=4, in the models with singular fits (i.e., ignoring clustering) because the ICC was estimated to be zero.Using the parametric bootstrap for cRCTs with a small number of clusters results in inflated error rates and is not valid.CONCLUSIONUsing the parametric bootstrap for cRCTs with a small number of clusters results in inflated error rates and is not valid.
Cluster randomized controlled trials (cRCTs) are increasingly used but must be analyzed carefully. We conducted a simulation study to evaluate the validity of a parametric bootstrap (PB) approach with respect to the empirical type I error rate for a cRCT with binary outcomes and a small number of clusters. We simulated a case study with a binary (0/1) outcome, four clusters, and 100 subjects per cluster. To compare the validity of the test with respect to error rate, we simulated the same experiment with K=10, 20, and 30 clusters, each with 2,000 simulated datasets. To test the null hypothesis, we used a generalized linear mixed model including a random intercept for clusters and obtained p-values based on likelihood ratio tests (LRTs) using the parametric bootstrap method as implemented in the R package "pbkrtest". The PB test produced error rates of 9.1%, 5.5%, 4.9%, and 5.0% on average across all ICC values for K=4, K=10, K=20, and K=30, respectively. The error rates were higher, ranging from 9.1% to 36.5% for K=4, in the models with singular fits (i.e., ignoring clustering) because the ICC was estimated to be zero. Using the parametric bootstrap for cRCTs with a small number of clusters results in inflated error rates and is not valid.
ArticleNumber 106654
Author Jamshidi-Naeini, Yasaman
Allison, David B.
Golzarri-Arroyo, Lilian
Brown, Andrew W.
Li, Peng
Oakes, J. Michael
Dickinson, Stephanie L.
Zoh, Roger S.
Owora, Arthur H.
AuthorAffiliation 2. Department of Applied Health Science, Indiana University School of Public Health-Bloomington
1. Department of Epidemiology and Biostatistics, Indiana University School of Public Health-Bloomington
4. School of Public Health, University of Minnesota
3. School of Nursing, University of Alabama at Birmingham
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Snippet •The type I error rate is inflated under scenarios of a small number of clusters per treatment in a cluster randomized trials when using parametric...
Cluster randomized controlled trials (cRCTs) are increasingly used but must be analyzed carefully. We conducted a simulation study to evaluate the validity of...
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SubjectTerms Cluster Analysis
Computer Simulation
Humans
Linear Models
Research Design
Sample Size
Title Evaluation of the type I error rate when using parametric bootstrap analysis of a cluster randomized controlled trial with binary outcomes and a small number of clusters
URI https://www.clinicalkey.com/#!/content/1-s2.0-S0169260722000396
https://dx.doi.org/10.1016/j.cmpb.2022.106654
https://www.ncbi.nlm.nih.gov/pubmed/35093646
https://www.proquest.com/docview/2624201471
https://pubmed.ncbi.nlm.nih.gov/PMC8847311
Volume 215
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