Evidence map›Paper›PMID 32072073›Full record

ArticleContemporary clinical trials communications2020

An empirical comparison of methods for analyzing over-dispersed zero-inflated count data from stratified cluster randomized trials.

Sayem Borhan, Courtney Kennedy, George Ioannidis, Alexandra Papaioannou, Jonathan Adachi, Lehana Thabane

Registry-linked trialOpen access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Contemporary clinical trials communications, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01398527 (An Interdisciplinary Knowledge Translation Intervention in Long-term Care), which is not on this map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
1.5field-weighted citation impact, top 16% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01398527 nacompletednot on this map

An Interdisciplinary Knowledge Translation Intervention in Long-term Care: The Vitamin D and Osteoporosis Study (ViDOS) Pilot Cluster Randomized Controlled Trial

TypeinterventionalSponsorMcMaster UniversityRan2009 to 2013Enrolled40ConditionsOsteoporosisArmsEduc sessions & LTC Osteoporosis toolkit
3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.

  1. Interventions for preventing falls in older people in care facilities.The Cochrane database of systematic reviews · 2025
    Pooled it
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 1 country.

Sayem BorhanDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.
Courtney KennedyGERAS Centre, Hamilton Health Sciences, Hamilton, ON, Canada.
George IoannidisGERAS Centre, Hamilton Health Sciences, Hamilton, ON, Canada.
Alexandra PapaioannouGERAS Centre, Hamilton Health Sciences, Hamilton, ON, Canada.
Jonathan AdachiDepartment of Medicine, McMaster University, Hamilton, ON, Canada.
Lehana ThabaneDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.
Hamilton Health Sciences · CAMcMaster University · CASt. Joseph’s Healthcare Hamilton · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe assessment of methods for analyzing over-dispersed zero inflated count outcome has received very little or no attention in stratified cluster randomized trials. In this study, we performed sensitivity analyses to empirically compare eight methods for analyzing zero inflated over-dispersed count outcome from the Vitamin D and Osteoporosis Study (ViD

methodForty long-term care (LTC) homes were stratified and then randomized into knowledge translation (KT) intervention (19 homes) and control (21 homes) groups. The homes/clusters were stratified by home size (<250/> = 250) and profit status (profit/non-profit). The outcome of this study was number of falls measured at 6-month post-intervention. The following methods were used to assess the effect of KT intervention on number of falls: i) standard Poisson and negative binomial regression; ii) mixed-effects method with Poisson and negative binomial distribution; iii) generalized estimating equation (GEE) with Poisson and negative binomial; iv) zero inflated Poisson and negative binomial - with the latter used as a primary approach. All these methods were compared with or without adjusting for stratification.

resultsA total of 5,478 older people from 40 LTC homes were included in this study. The mean (=1) of the number of falls was smaller than the variance (=6). Also 72% and 46% of the number of falls were zero in the control and intervention groups, respectively. The direction of the estimated incidence rate ratios (IRRs) was similar for all methods. The zero inflated negative binomial yielded the lowest IRRs and narrowest 95% confidence intervals when adjusted for stratification compared to GEE and mixed-effect methods. Further, the widths of the 95% confidence intervals were narrower when the methods adjusted for stratification compared to the same method not adjusted for stratification.

conclusionThe overall conclusion from the GEE, mixed-effect and zero inflated methods were similar. However, these methods differ in terms of effect estimate and widths of the confidence interval.

trial registrationClinicalTrials.gov: NCT01398527. Registered: 19 July 2011.

Indexed as

Cluster randomized trialCountOverdispersedSensitivityStratificationZero inflated

Identifiers

PMID32072073
PMCPMC7015989
OpenAlexW3003977935

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.