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Statistical primer: an introduction to the application of linear mixed-effects models in cardiothoracic surgery outcomes research—a case study using homograft pulmonary valve replacement data

OBJECTIVES: The emergence of big cardio-thoracic surgery datasets that include not only short-term and long-term discrete outcomes but also repeated measurements over time offers the opportunity to apply more advanced modelling of outcomes. This article presents a detailed introduction to developing...

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Autores principales: Wang, Xu, Andrinopoulou, Eleni-Rosalina, Veen, Kevin M, Bogers, Ad J J C, Takkenberg, Johanna J M
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9496250/
https://www.ncbi.nlm.nih.gov/pubmed/36005884
http://dx.doi.org/10.1093/ejcts/ezac429
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author Wang, Xu
Andrinopoulou, Eleni-Rosalina
Veen, Kevin M
Bogers, Ad J J C
Takkenberg, Johanna J M
author_facet Wang, Xu
Andrinopoulou, Eleni-Rosalina
Veen, Kevin M
Bogers, Ad J J C
Takkenberg, Johanna J M
author_sort Wang, Xu
collection PubMed
description OBJECTIVES: The emergence of big cardio-thoracic surgery datasets that include not only short-term and long-term discrete outcomes but also repeated measurements over time offers the opportunity to apply more advanced modelling of outcomes. This article presents a detailed introduction to developing and interpreting linear mixed-effects models for repeated measurements in the setting of cardiothoracic surgery outcomes research. METHODS: A retrospective dataset containing serial echocardiographic measurements in patients undergoing surgical pulmonary valve replacement from 1986 to 2017 in Erasmus MC was used to illustrate the steps of developing a linear mixed-effects model for clinician researchers. RESULTS: Essential aspects of constructing the model are illustrated with the dataset including theories of linear mixed-effects models, missing values, collinearity, interaction, nonlinearity, model specification, results interpretation and assumptions evaluation. A comparison between linear regression models and linear mixed-effects models is done to elaborate on the strengths of linear mixed-effects models. An R script is provided for the implementation of the linear mixed-effects model. CONCLUSIONS: Linear mixed-effects models can provide evolutional details of repeated measurements and give more valid estimates compared to linear regression models in the setting of cardio-thoracic surgery outcomes research.
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spelling pubmed-94962502022-09-23 Statistical primer: an introduction to the application of linear mixed-effects models in cardiothoracic surgery outcomes research—a case study using homograft pulmonary valve replacement data Wang, Xu Andrinopoulou, Eleni-Rosalina Veen, Kevin M Bogers, Ad J J C Takkenberg, Johanna J M Eur J Cardiothorac Surg Review OBJECTIVES: The emergence of big cardio-thoracic surgery datasets that include not only short-term and long-term discrete outcomes but also repeated measurements over time offers the opportunity to apply more advanced modelling of outcomes. This article presents a detailed introduction to developing and interpreting linear mixed-effects models for repeated measurements in the setting of cardiothoracic surgery outcomes research. METHODS: A retrospective dataset containing serial echocardiographic measurements in patients undergoing surgical pulmonary valve replacement from 1986 to 2017 in Erasmus MC was used to illustrate the steps of developing a linear mixed-effects model for clinician researchers. RESULTS: Essential aspects of constructing the model are illustrated with the dataset including theories of linear mixed-effects models, missing values, collinearity, interaction, nonlinearity, model specification, results interpretation and assumptions evaluation. A comparison between linear regression models and linear mixed-effects models is done to elaborate on the strengths of linear mixed-effects models. An R script is provided for the implementation of the linear mixed-effects model. CONCLUSIONS: Linear mixed-effects models can provide evolutional details of repeated measurements and give more valid estimates compared to linear regression models in the setting of cardio-thoracic surgery outcomes research. Oxford University Press 2022-08-25 /pmc/articles/PMC9496250/ /pubmed/36005884 http://dx.doi.org/10.1093/ejcts/ezac429 Text en © The Author(s) 2022. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Review
Wang, Xu
Andrinopoulou, Eleni-Rosalina
Veen, Kevin M
Bogers, Ad J J C
Takkenberg, Johanna J M
Statistical primer: an introduction to the application of linear mixed-effects models in cardiothoracic surgery outcomes research—a case study using homograft pulmonary valve replacement data
title Statistical primer: an introduction to the application of linear mixed-effects models in cardiothoracic surgery outcomes research—a case study using homograft pulmonary valve replacement data
title_full Statistical primer: an introduction to the application of linear mixed-effects models in cardiothoracic surgery outcomes research—a case study using homograft pulmonary valve replacement data
title_fullStr Statistical primer: an introduction to the application of linear mixed-effects models in cardiothoracic surgery outcomes research—a case study using homograft pulmonary valve replacement data
title_full_unstemmed Statistical primer: an introduction to the application of linear mixed-effects models in cardiothoracic surgery outcomes research—a case study using homograft pulmonary valve replacement data
title_short Statistical primer: an introduction to the application of linear mixed-effects models in cardiothoracic surgery outcomes research—a case study using homograft pulmonary valve replacement data
title_sort statistical primer: an introduction to the application of linear mixed-effects models in cardiothoracic surgery outcomes research—a case study using homograft pulmonary valve replacement data
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9496250/
https://www.ncbi.nlm.nih.gov/pubmed/36005884
http://dx.doi.org/10.1093/ejcts/ezac429
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