In multilevel settings such as individual participant data meta-analysis, a variable is 'systematically missing' if it is wholly missing in some clusters and 'sporadically missing' if it is partly missing in some clusters. Previously proposed methods to impute incomplete multilevel data handle either systematically or sporadically missing data, but frequently both patterns are observed. We describe a new multiple imputation by chained equations (MICE) algorithm for multilevel data with arbitrary patterns of systematically and sporadically missing variables. The algorithm is described for multilevel normal data but can easily be extended for other variable types. We first propose two methods for imputing a single incomplete variable: an extension of an existing method and a new two-stage method which conveniently allows for heteroscedastic data. We then discuss the difficulties of imputing missing values in several variables in multilevel data using MICE, and show that even the simplest joint multilevel model implies conditional models which involve cluster means and heteroscedasticity. However, a simulation study finds that the proposed methods can be successfully combined in a multilevel MICE procedure, even when cluster means are not included in the imputation models.
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http://dx.doi.org/10.1177/0962280216666564 | DOI Listing |
Cancer Pathog Ther
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Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510120, China.
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View Article and Find Full Text PDFJ Public Health Dent
January 2025
Oral Health Workforce Research Center, Center for Health Workforce Studies, College of Integrated Health Sciences, University at Albany, State University of New York (SUNY), Rensselaer, New York, USA.
Objective: This study aimed to investigate changes in oral health services from 2012 to 2021 and identify factors influencing the number of different types of services directly provided by all Federally Qualified Health Centers (FQHCs).
Methods: Data from the 2012-2021 Uniform Data System were analyzed using multilevel mixed-effect negative binomial regression models. These models explored associations between oral health staffing, federal grant revenue, and state Medicaid dental policies for adults, and the number of different types of oral health services provided at FQHCs.
Int J Behav Nutr Phys Act
January 2025
MRC Epidemiology Unit, University of Cambridge Level 3 Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Cambridge, CB2 0SL, UK.
Background: The workplace is an important determinant of health that people are exposed to for the first-time during adolescence or early adulthood. This study investigates how diet, physical activity, and sleep change as people aged 16-30 years transition into work and whether this varies for different individuals and job types.
Methods: Multilevel linear regression models assessed changes in fruit and vegetable intake, sleep duration, and physical activity among 3,302 UK Household Longitudinal Study (UKHLS) participants aged 16-30 years, who started work for the first time between 2015 and 2023.
J Gen Intern Med
January 2025
Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA.
Background: Active surveillance (AS) is the guideline-recommended treatment for low-risk prostate cancer and involves routine provider visits, lab tests, imaging, and prostate biopsies. Despite good uptake, adherence to AS, in terms of receiving recommended follow-up testing and remaining on AS in the absence of evidence of cancer progression, remains challenging.
Objective: We sought to better understand urologist, primary care providers (PCPs), and patient experiences with AS care delivery to identify opportunities to improve adherence.
Sci Rep
January 2025
Department of Health Administration, Yonsei University Graduate School, Wonju, Republic of Korea.
This study is the first to examine the determinants of future anxiety in South Korea using the Social Ecological Model (SEM). It aimed to show that, beyond individual factors, mezzo- and macro-level aspects, particularly those related to housing, may influence anxiety. Utilizing 2018 data from the Korean Health Panel Survey, we employed a three-level multilevel analysis to investigate how these factors contribute to the perception of future anxiety among Koreans.
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