GEE in SPSS

[William Dudley-2]

I need advice on how to set up a multilevel model.  I have a mulitnomial outcome (TX_decision) with three levels of treatment decision (unchanged, reduced dose, Increased dose).  These data are at the patient level but patients are nested within providers (and providers are nested within clinics but I only have 4 clinics so I am ignoring clinic as a Level III variable).

My predictors are at all levels: continuous (patient age), binary (gender) and multinational (such as disease type ).

Bivariate analyses (such as cross tabs) show some interesting relationship between the the predictors and the outcome.  However, I feel that I need to take into account the fact that patients are nested within providers.  I have about 175 patients and about 10 providers.

I'd like to run the analyses in SPSS but not sure how to set this  up within the GEE procedure.

Thanks for any help you might be able to provide.

Bill

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[Bruce Weaver]

Bill, I'm curious about why you want to use GEE.  My first thought was to use
GENLINMIXED.  You could take a look at chapter 6 in "Multilevel Modeling of
Categorical Outcomes Using IBM SPSS", by Heck, Thomas & Tabata.  The chapter
title is:  "Two-Level Models with Multinomial and Ordinal Outcomes".

   http://www2.hawaii.edu/~ltabata/mlm/HTT2012.html

That reminds me, I think your outcome variable is actually ordinal, not
multinomial:  reduced < unchanged < increased.    

HTH.



William Dudley-2 wrote

> I need advice on how to set up a multilevel model.  I have a mulitnomial
> outcome (TX_decision) with three levels of treatment decision (unchanged,
> reduced dose, Increased dose).  These data are at the patient level but
> patients are nested within providers (and providers are nested within
> clinics but I only have 4 clinics so I am ignoring clinic as a Level III
> variable).
>
> My predictors are at all levels: continuous (patient age), binary (gender)
> and multinational (such as disease type ).
>
> Bivariate analyses (such as cross tabs) show some interesting relationship
> between the the predictors and the outcome.  However, I feel that I need
> to
> take into account the fact that patients are nested within providers.  I
> have about 175 patients and about 10 providers.
>
> I'd like to run the analyses in SPSS but not sure how to set this  up
> within the GEE procedure.
>
> Thanks for any help you might be able to provide.
>
> Bill
>
>
> --
> William N. Dudley, PhD
> Professor - Public Health Education
> The School of Health and Human Sciences
> The University of North Carolina at Greensboro
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Bruce Weaver
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[Art Kendall]

There are very strong parallels between complex samples and multilevel
models.  They grew up in different statistical cultures. They definitely ate
used on the same kind of data.

When I retired in 2001 one of my hopes was to explore when and IF the two
approaches lead to different estimates and/or conclusions.  I'll never have
time to to do this.

It would be interesting if people for either stat culture were to run their
data through the two approaches.

There has been a long tradition of showing that what were thought to be
different stat methods were special instances of a more general model.
Maybe somebody would want to compare/contrast complex samples approaches to
multilevel model approaches.





-----
Art Kendall
Social Research Consultants
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