Mera-Mamián AY, Moreno-Montoya J, Rodríguez-Villamizar LA, Muñoz DI, Segura ÁM, García HI. Construction of multilevel statistical models in health research: Foundations and generalities.
BIOMEDICA : REVISTA DEL INSTITUTO NACIONAL DE SALUD 2023;
43:520-533. [PMID:
38109143 PMCID:
PMC10826466 DOI:
10.7705/biomedica.6946]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 09/27/2023] [Indexed: 12/19/2023]
Abstract
This topic review aims to present a global vision of multilevel analysis models’ applicability to health research, explaining its theoretical, methodological, and statistical foundations. We describe the basic steps to build these models and examples of their application according to the data hierarchical structure. It ir worth noticing that before using these models, researchers must have a rationale for needing them, and a statistical evaluation accounting for the variance percentage explained by the observations grouping effect. The requirements to conduct this type of analysis depends on special conditions such as the type of variables, the number of units per level, or the type of hierarchical structure. We conclude that multilevel analysis models are a useful tool to integrate information, considering the complexity of the relationships and interactions involved in most health conditions, including the loss of independence between observation units.
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