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Thread: Cox regression to adjust for site effect in multicenter trial

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    Cox regression to adjust for site effect in multicenter trial




    Hello All,

    Can stratified Cox regression be used to adjust for site effect in multicenter trials?

    Thank you in advance to all those who reply.
    Last edited by ineedhelpplease; 02-27-2017 at 11:30 PM.

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    Re: Cox regression to adjust for site effect in multicenter trial

    I would think a multilevel approach would be more appropriate. Are there confounders that may vary per site location? Did any randomization happen related to the variable of interest?
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    Re: Cox regression to adjust for site effect in multicenter trial

    Hi hlsmith,

    Thank you for the response and follow-up questions.

    There are potential confounders between sites, and randomization did occur.

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    Re: Cox regression to adjust for site effect in multicenter trial


    Multilevel models, which I haven't done with survival, would be an approach. You would want to control for level based confounders at the facility level not in the regular person level survival model.


    But I haven't done this yet. Keep us posted! Have you done multilevel modeling for clustered data before, say repeated measurements?
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