Tuesday, 11 April 2023

Clustered data

Introduction

Clustered data is a type of data that has a natural grouping or structure, such that the observations within each group are more similar to each other than to those in other groups. Clustered data can arise in various contexts, such as longitudinal studies, multilevel models, spatial analysis, social networks, and genetics. Clustered data poses some challenges for statistical analysis, as the standard methods that assume independence and homogeneity of the observations may not be appropriate or efficient. Therefore, specialized techniques have been developed to account for the clustering effect and to model the variability and correlation within and between the groups. Some examples of these techniques are mixed-effects models, generalized estimating equations, cluster analysis, and random effects meta-analysis.

A nested structure 

Clustering refers to the grouping of subjects into different groups (or clusters), with at least some of the groups containing multiple subjects. This gives the data a multilevel structure in which subjects are nested within these clusters or groups. The presence of clustering brings additional complexity, which must be accounted for in data analysis. Outcomes for two observations in the same cluster are often more alike than outcomes for two observations from different clusters, even after accounting for unit characteristics. This within-cluster homogeneity in outcomes violates the assumption of most regression models that the observations are independent. Multilevel analyses allow for the appropriate analysis of data with a multilevel structure where there is no longer independence among observations.
Using a traditional regression method, when the assumption of independence is violated, the estimation of regression coefficients and their associated standard errors can be biased. Treating group-level variables as though they are measured at the individual level can lead to standard errors being underestimated, which in turn can lead to erroneously significant results and artificially narrow confidence intervals. This is partly due to sample size inflation problems resulting from the failure to account for the multilevel data structure. Falsely treating individuals as independent erroneously increases the precision of estimates made because of erroneously increasing the degrees of freedom in the analysis. Ignoring the nested data structure may result in relationships being found to be significant when they truly are not—this is known as misestimated precision. Issues related to ignoring multilevel structures can occur even if group-level factors are not part of your research question. 

If your data arose from a multilevel structure, it is important to take this into 

account in your analysis regardless of the research question at hand.

Cluster randomized control trials

We can find design-related clusters in the data. 

Specifically, cluster randomized controlled trials (RCTs) are a type of experimental design that can be used to evaluate the effectiveness of interventions that are delivered or implemented at a group level, such as health policies, educational programs, or community-based strategies. In cluster randomized controlled trials, the units of randomization are not individual participants, but clusters of participants that share some common characteristics or settings, such as schools, villages, hospitals, or regions. By randomizing clusters instead of individuals, cluster randomized controlled trials can avoid some ethical or practical issues that might arise from individual randomization, such as contamination, spillover effects, or lack of consent. However, cluster randomized controlled trials also pose some methodological challenges that need to be carefully addressed in the design, analysis, and reporting stages. Some of these challenges include: selecting an appropriate cluster size and number of clusters; estimating and accounting for the intracluster correlation coefficient; adjusting for potential confounding factors at both cluster and individual levels; choosing an appropriate statistical model and method to account for the hierarchical structure of the data; and reporting the results in a transparent and comprehensive way. Cluster randomized controlled trials are increasingly used in global health research to evaluate complex interventions that aim to improve health outcomes and reduce health inequalities in low- and middle-income countries.

Statistical considerations

Cluster randomized controlled trials require special statistical considerations when designing the trial, and later when analyzing the data because individuals within clustered data are not fully independent of each other. Such trials are not as statistically efficient as standard RCTs because groups tend to form because of certain selection factors, so individuals within the group tend to be more similar to each other with respect to important potential confounders than those selected truly at random. For example, patients seen by the same physician are more likely to receive similar treatment for a given condition than those being treated for the same condition by different doctors. Patients attending a single physician practice are likely to share similarities including geography, socioeconomic status, ethnic background, or age by virtue of the area they have all chosen to live. In the same way, physicians who have chosen to work together are likely to share similarities. Similarities, or homogeneity, between subjects in clusters, reduce the variability of their responses, compared with that expected from a random sample. This results in a loss of statistical power to detect a difference between the intervention and control groups. A compensatory increase in sample size is required to maintain power in a cluster RCT, and the degree of similarity within clusters should also be assessed.

Pros and cons of clustering

One of the main benefits of clustered data is that it can reveal hidden patterns and insights that are not apparent in the raw data. For example, by clustering customers based on their purchase history, we can identify different segments of customers with different needs and preferences, and tailor our marketing strategies accordingly. By clustering genes based on their expression levels, we can discover new biological functions and pathways that are involved in certain diseases or conditions. By clustering images based on their pixels or features, we can detect anomalies or outliers that may indicate fraud or defects.

 

Another benefit of clustered data is that it can reduce the complexity and dimensionality of the data, making it easier to process and analyze. For example, by clustering words based on their semantic similarity, we can create a lower-dimensional representation of text documents that preserves the main topics and themes. By clustering products based on their attributes, we can create a hierarchical structure of product categories that simplifies the navigation and search process. By clustering locations based on their geographic proximity, we can create a spatial index that speeds up the query and retrieval of spatial data.

 

However, clustered data also poses some challenges and limitations that need to be addressed. One of the main challenges is how to choose the appropriate clustering technique and parameters for a given problem. There are many different types of clustering algorithms, such as k-means, hierarchical clustering, density-based clustering, or spectral clustering, each with its own advantages and disadvantages. Moreover, some clustering algorithms require specifying the number of clusters or other parameters in advance, which may not be easy to determine or may vary depending on the application. Therefore, it is important to evaluate the quality and validity of the clusters using various criteria and metrics, such as internal measures (e.g., cohesion and separation), external measures (e.g., purity and Rand index), or stability measures (e.g., silhouette coefficient and gap statistic).

 

Another challenge of clustered data is how to interpret and communicate the results of the clustering analysis. Depending on the problem domain and the objective of the analysis, different types of cluster labels or descriptions may be needed to convey the meaning and significance of the clusters. For example, for customer segmentation, we may want to use descriptive labels that summarize the characteristics and behaviors of each customer segment. For gene expression analysis, we may want to use functional labels that indicate the biological roles and pathways of each gene cluster. For image analysis, we may want to use visual labels that show representative images or features of each image cluster. Therefore, it is important to use appropriate methods and tools to generate meaningful and informative cluster labels or descriptions that can facilitate the understanding and decision-making process.

Conclusions

Clustered data is a valuable source of information and knowledge that can help us solve various problems and tasks in different domains and applications. However, working with clustered data also requires careful consideration and evaluation of the clustering techniques and parameters, as well as the interpretation and communication of the clustering results. In this blog post, we have provided a brief overview of some of the benefits and challenges of clustered data analysis, and some examples of how to apply clustering techniques to real-world problems. We hope this blog post has sparked your interest in clustered data analysis and encouraged you to explore more about this topic.

References

1. Jessalyn K Holodinsky, Peter C Austin, Tyler S Williamson, An introduction to clustered data and multilevel analyses, Family Practice, Volume 37, Issue 5, October 2020, Pages 719–722, https://doi.org/10.1093/fampra/cmaa017.
2.    Snijders   T , Bosker R.  Multilevel Analysis: An Introduction to Basic and Advanced Multilevel Modeling. 2nd ed.London, UK: Sage Publications.
3.    Rice   N , Leyland A. Multilevel models: applications to health data. J Health Serv Res Policy 1996; 1: 154–64.
4.    Hox   JJ , Kreft IG. Multilevel analysis methods. Sociol Methods Res 1994;22(3):283–99.
5.    Hox   JJ.  Multilevel Analysis. New York, NY: Routledge, 2010.
6.    Leyland   AH , Groenewegen PP. Multilevel modelling and public health policy. Scand J Public Health 2003; 31: 267–74.
7.    Offorha, B.C., Walters, S.J. & Jacques, R.M. Statistical analysis of publicly funded cluster randomised controlled trials: a review of the National Institute for Health Research Journals Library. Trials 23, 115 (2022). https://doi.org/10.1186/s13063-022-06025-1.
8.    Marion K Campbell, Jill Mollison, Nick Steen, Jeremy M Grimshaw, Martin Eccles, Analysis of cluster randomized trials in primary care: a practical approach, Family Practice, Volume 17, Issue 2, April 2000, Pages 192–196, https://doi.org/10.1093/fampra/17.2.192.

Links

1.    https://www.healthknowledge.org.uk/public-health-textbook/research-methods/1a-epidemiology/clustered-data
2.    Study design: Cluster RCT – RWE Navigator (rwe-navigator.eu)
3.    https://www.npcnow.org/resources/research-methods-101-other-types-randomized-controlled-trials







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