Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Experiment Videos

Multilevel modeling and practice-based research.

L Miriam Dickinson1, Anirban Basu

  • 1Department of Family Medicine, University of Colorado Health Sciences Center, Aurora, Colorado 80045-0508, USA. Miriam.Dickinson@UCHSC.edu

Annals of Family Medicine
|June 2, 2005
PubMed
Summary
This summary is machine-generated.

Related Concept Videos

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by
Same author

Biomonitoring of nutritional and toxic elements in raw and cooked rice in the Health Effects of Arsenic Longitudinal Study, Bangladesh.

Ecotoxicology and environmental safety·2026
Same author

Influenza Antiviral Prescriptions in the US Inpatient and Outpatient Settings During the 2015-2022 Influenza Seasons.

Influenza and other respiratory viruses·2026
Same author

PERsonalised Medicine for Intensification of Treatment (PERMIT) in type 2 diabetes mellitus: a target trial emulation from routine data.

Health technology assessment (Winchester, England)·2026
Same author

Interplay Between the Gut-Microbiota-Brain Axis and the Immune System in Viral Neuroinvasion and CNS Pathogenesis.

Comprehensive Physiology·2026
Same author

From sensing to shaping: microglial responses in the pathogenesis of viral encephalitis.

Current opinion in immunology·2026
Same author

Cardiac Resynchronization Therapy: A Review.

JAMA·2026
Same journal

Advancing Family Medicine Through Dyadic Electronic Medical Record Linkage in Dementia Care.

Annals of family medicine·2026
Same journal

Association of General Practice Continuity With Hospital Admissions and Costs: A Retrospective Study.

Annals of family medicine·2026
Same journal

Association of Advanced Access With Primary Care Performance: A Systematic Review.

Annals of family medicine·2026
Same journal

Death by Rousui in Japan: Rethinking Death, Diagnosis, and Care in an Aging Society.

Annals of family medicine·2026
Same journal

Navigating Changing Waters, Staying Anchored in Our Values at the 2026 ADFM Annual Conference.

Annals of family medicine·2026
Same journal

Multicomponent School of Caring Program to Support Caregivers of Patients With Dementia: A Quasi-Experimental Effectiveness Study in Primary Care.

Annals of family medicine·2026
See all related articles

Hierarchical health care data require multilevel statistical models for accurate interpretation. Ignoring data clustering in practice-based research networks can lead to flawed conclusions and impact sample size calculations.

Area of Science:

  • Health Services Research
  • Biostatistics
  • Epidemiology

Background:

  • The US healthcare system exhibits a hierarchical structure, with patients nested within physicians and practices.
  • Research data from practice-based research networks (PBRNs) often display similar nested or clustered patterns.
  • Traditional statistical methods may fail to account for this multilevel data structure, risking interpretation errors.

Purpose of the Study:

  • To illustrate the concept of multilevel data structure in PBRN research.
  • To demonstrate the implications of multilevel data for statistical analysis and interpretation.
  • To highlight the importance of accounting for data nesting in research design.

Main Methods:

  • Presentation of various multilevel (hierarchical) statistical models.

Related Experiment Videos

  • Contrast of multilevel models with traditional linear regression.
  • Use of a simulated observational study to demonstrate statistical approaches and the impact of ignoring data clustering.
  • Discussion of different outcome data types, study designs, and the effects of clustering on sample size and statistical power.

    • Main Results:

    • Multilevel models reveal variations in physician-level effects across clinics and settings (rural vs. urban) that traditional methods miss.
    • Study conclusions differed significantly when analyzed with multilevel methods versus traditional linear regression.
    • Data clustering impacts sample size requirements, with increased intraclass correlation and patients per cluster dramatically increasing the needed number of patients.

    Conclusions:

    • Accounting for multilevel data structure in PBRN studies yields more accurate conclusions.
    • Multilevel analysis allows for exploration of contextual effects and site-specific differences.
    • Properly accommodating multilevel structures in research planning leads to more accurate sample size estimations.