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COMMENTS AND OPINIONS
Racial Disparities in Diabetes and Physicians: Lack of Association Does Not Indicate Cause or Cure—Reply
Thomas Dean Sequist, MD, MPH;
Garrett M. Fitzmaurice, ScD;
Richard Marshall, MD;
Shimon Shaykevich, MS;
Dana Gelb Safran, ScD;
John Z. Ayanian, MD, MPP
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In reply
We appreciate the comments of Field and colleagues regarding the use of random-effects models to account for physician effects in our study of racial disparities in diabetes care. As an alternative, the authors suggest treating physician effects as fixed rather than random. The primary advantage of treating physician effects as fixed rather than random is to avoid the assumption that the physician effects are uncorrelated with the measured predictors in the model. We acknowledge that models with fixed rather than random effects have the potential to avoid certain types of confounding by physician-level variables and are an appealing analytic approach when the scientific focus is exclusively on patient-level factors. However, a notable feature of models that treat physician effects as fixed rather than random . . . [Full Text of this Article]
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RELATED ARTICLE
Physician Performance and Racial Disparities in Diabetes Mellitus Care
Thomas D. Sequist, Garrett M. Fitzmaurice, Richard Marshall, Shimon Shaykevich, Dana Gelb Safran, and John Z. Ayanian
Arch Intern Med. 2008;168(11):1145-1151.
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RELATED LETTER
Racial Disparities in Diabetes and Physicians: Lack of Association Does Not Indicate Cause or Cure
Barry Saver
Arch Intern Med. 2009;169(2):203-204.
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