Skip to main content
padlock icon - secure page this page is secure

The Analysis of Methadone Clinic Data Using Marginal and Conditional Logistic Models with Mixture or Random Effects

Buy Article:

$52.00 + tax (Refund Policy)

The paper develops methods for the statistical analysis of outcomes of methadone maintenance treatment (MMT). Subjects for this study were a cohort of patients entering MMT in Sydney in 1986. Urine drug tests on these subjects were performed weekly during MMT, and were reported as either positive or negative for morphine, the marker of recent heroin use. To allow correlation between the repeated binary measurements, a marginal logistic model was fitted using the generalized estimating equation (GEE) approach and the alternating logistic regression approach. Conditional logistic models are also considered. Results of separate fitting to each patient and score tests suggest that there is substantial between-patient variation in response to MMT. To account for the population heterogeneity and to facilitate subject-specific inference, the conditional logistic model is extended by introducing random intercepts. The two, three and four group mixture models are also investigated. The model of best fit is a three group mixture model, in which about a quarter of the subjects have a poor response to MMT, with continued heroin use independent of daily dose of methadone; about a quarter of the subjects have a very good response, with little or no heroin use, again independent of dose; and about half the subjects responded in a dose-dependent fashion, with reduced heroin use while receiving higher doses of methadone. These findings are consistent with clinical experience. There is also an association between reduced drug use and increased duration in treatment. The mixture model is recommended since it is quite tractable in terms of estimation and model selection as well as being supported by clinical experience.
No References
No Citations
No Supplementary Data
No Article Media
No Metrics

Keywords: Correlated binary data; EM algorithm; GEE approach; mixture model with latent groups; random effects model; serial dependence

Document Type: Research Article

Affiliations: 1: University of Hong Kong, 2: University of New South Wales, 3: Prince of Wales Hospital, Sydney, Australia, 4: Australian National University

Publication date: March 1, 1998

  • Access Key
  • Free content
  • Partial Free content
  • New content
  • Open access content
  • Partial Open access content
  • Subscribed content
  • Partial Subscribed content
  • Free trial content
Cookie Policy
X
Cookie Policy
Ingenta Connect website makes use of cookies so as to keep track of data that you have filled in. I am Happy with this Find out more