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Open Access Article

Application of Multilevel Growth-Curve Analysis in Cancer Treatment Toxicities: The Exemplar of Oral Mucositis and Pain

William N. Dudley
Deborah B. McGuire
Douglas E. Peterson
Bob Wong
ONF 2009, 36(1), E11-E19 DOI: 10.1188/09.ONF.E11-E19

Purpose/Objectives: To introduce the use of a statistical technique known as multilevel growth-curve analysis and illustrate how the method can be advantageous in comparison with traditional repeated measures for the study of trajectories of signs and symptoms in individual patients over time.

Data Sources: Data were derived from use of the technique in a randomized clinical trial of a psychoeducational intervention to reduce severity of oral mucositis and oral pain.

Data Synthesis: The development of new biologic models that seek to explain clustering of signs and symptoms or the appearance and resolution of signs and symptoms motivates the need to use more sophisticated statistical techniques to test such models.

Conclusions: The application of multilevel growth model to an existing data set demonstrates that the model can be effective in the study of individual differences in trajectories of change in signs and symptoms.

Implications for Nursing: This method for the study of changes in patients' signs and symptoms over time can be of particular interest to nursing, both from a clinical point of view and as a way to test theoretical models that have been proposed to capture patient experiences with signs and symptoms.

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