Ongoing monitoring of data clustering in multicenter studies
Guthrie, L.B Oken, E Sterne, J.A.C Gillman, M.W Patel, R Vilchuck, K Bogdanovich, N Kramer, M.S Martin, R.M
Guthrie, L.B
Oken, E
Sterne, J.A.C
Gillman, M.W
Patel, R
Vilchuck, K
Bogdanovich, N
Martin, R.M
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Alternative Title
Abstract
Background: Multicenter study designs have several advantages, but the possibility of non-random measurement error resulting from procedural differences between the centers is a special concern. While it is possible to address and correct for some measurement error through statistical analysis, proactive data monitoring is essential to ensure high-quality data collection. Methods. In this article, we describe quality assurance efforts aimed at reducing the effect of measurement error in a recent follow-up of a large cluster-randomized controlled trial through periodic evaluation of intraclass correlation coefficients (ICCs) for continuous measurements. An ICC of 0 indicates the variance in the data is not due to variation between the centers, and thus the data are not clustered by center. Results: Through our review of early data downloads, we identified several outcomes (including sitting height, waist circumference, and systolic blood pressure) with higher than expected ICC values. Further investigation revealed variations in the procedures used by pediatricians to measure these outcomes. We addressed these procedural inconsistencies through written clarification of the protocol and refresher training workshops with the pediatricians. Further data monitoring at subsequent downloads showed that these efforts had a beneficial effect on data quality (sitting height ICC decreased from 0.92 to 0.03, waist circumference from 0.10 to 0.07, and systolic blood pressure from 0.16 to 0.12). Conclusions: We describe a simple but formal mechanism for identifying ongoing problems during data collection. The calculation of the ICC can easily be programmed and the mechanism has wide applicability, not just to cluster randomized controlled trials but to any study with multiple centers or with multiple observers. © 2012 Guthrie et al; licensee BioMed Central Ltd.
Keywords
adult, analysis of variance, anthropometry, article, blood pressure, clinical competence, clinical practice, cluster analysis, education, female, health care quality, human, in service training, male, methodology, multicenter study (topic), patient care, pediatrics, physician, psychological aspect, randomized controlled trial (topic), reproducibility, standard, statistical analysis, statistics, treatment outcome, Adult, Analysis of Variance, Anthropometry, Blood Pressure, Clinical Competence, Cluster Analysis, Continuity of Patient Care, Data Interpretation, Statistical, Education, Female, Humans, Inservice Training, Male, Multicenter Studies as Topic, Outcome and Process Assessment (Health Care), Pediatrics, Physician's Practice Patterns, Physicians, Quality Assurance, Health Care, Randomized Controlled Trials as Topic, Reproducibility of Results, Statistics as Topic, Treatment Outcome
Source Title
BMC Medical Research Methodology
Publisher
Series/Report No.
Collections
Rights
Attribution 4.0 International
Date
2012
DOI
10.1186/1471-2288-12-29
Type
Review