Homogeneity Test of Proportions for Combined Unilateral and Bilateral Data via GEE and MLE Approaches

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Hauptverfasser: Zhou, Jia, Ma, Chang-Xing
Format: Preprint
Veröffentlicht: 2025
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author Zhou, Jia
Ma, Chang-Xing
author_facet Zhou, Jia
Ma, Chang-Xing
contents In clinical trials involving paired organs such as eyes, ears, and kidneys, binary outcomes may be collected bilaterally or unilaterally. In such combined datasets, bilateral outcomes exhibit intra-subject correlation, while unilateral outcomes are assumed independent. We investigate the generalized Estimating Equations (GEE) approach for testing homogeneity of proportions across multiple groups for the combined unilateral and bilateral data, and compare it with three likelihood-based statistics (likelihood ratio, Wald-type, and score) under Rosner's constant $R$ model and Donner's equal correlation $ρ$ model. Monte Carlo simulations evaluate empirical type I error and power under varied sample sizes and parameter settings. The GEE and score tests show superior type I error control, outperforming likelihood ratio and Wald-type tests. Applications to two real datasets in otolaryngologic and ophthalmologic studies illustrate the methods. We recommend the GEE and score tests for homogeneity testing, and suggest GEE for more complex models with covariates, while favoring the score statistic for small sample exact tests due to its computational efficiency.
format Preprint
id arxiv_https___arxiv_org_abs_2508_12008
institution arXiv
publishDate 2025
record_format arxiv
spellingShingle Homogeneity Test of Proportions for Combined Unilateral and Bilateral Data via GEE and MLE Approaches
Zhou, Jia
Ma, Chang-Xing
Methodology
62F03
In clinical trials involving paired organs such as eyes, ears, and kidneys, binary outcomes may be collected bilaterally or unilaterally. In such combined datasets, bilateral outcomes exhibit intra-subject correlation, while unilateral outcomes are assumed independent. We investigate the generalized Estimating Equations (GEE) approach for testing homogeneity of proportions across multiple groups for the combined unilateral and bilateral data, and compare it with three likelihood-based statistics (likelihood ratio, Wald-type, and score) under Rosner's constant $R$ model and Donner's equal correlation $ρ$ model. Monte Carlo simulations evaluate empirical type I error and power under varied sample sizes and parameter settings. The GEE and score tests show superior type I error control, outperforming likelihood ratio and Wald-type tests. Applications to two real datasets in otolaryngologic and ophthalmologic studies illustrate the methods. We recommend the GEE and score tests for homogeneity testing, and suggest GEE for more complex models with covariates, while favoring the score statistic for small sample exact tests due to its computational efficiency.
title Homogeneity Test of Proportions for Combined Unilateral and Bilateral Data via GEE and MLE Approaches
topic Methodology
62F03
url https://arxiv.org/abs/2508.12008