Simulation study shows mixed effects models and GEEs outperform others in ocular data analysis, indicating the need for proper treatment of correlations.
Mixed effects models and GEEs out-perform other approaches when the predictor of interest is bivariate and correlated, assuming correlations are similar for the predictor and outcome. For univariate predictors, averaging the outcome across eyes within each subject performs similarly to mixed effects modeling. Treating correlated measurements as independent (such as when using data from both eyes without averaging or factored into a model) inflates Type-I error rates and yields inappropriately high power, especially as correlation increases; this modeling approach leads to inference errors and should be avoided.
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Ollinger et al. (2026) studied this question.
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