# Two Modeling Strategies in Analyzing Clustered Time-to-Event Data: the Strong Heart Family Study

## TL;DR

This paper compares two statistical methods for analyzing family data on telomere length and stroke risk in the Strong Heart Family Study.

## Contribution

The paper applies and compares shared frailty and marginal Cox models for clustered time-to-event data in a family study context.

## Key findings

- Both modeling strategies produced similar results in analyzing telomere length and stroke association.
- The study highlights the need for further simulation to evaluate the performance of each method.

## Abstract

Researchers need applicable tools to analyze and account for familial relatedness when working with family study data. In this brief article, we describe the application of 2 modeling strategies for studying the association between leukocyte telomere length and incident stroke based on data collected in the Strong Heart Family Study: the shared frailty model and the marginal Cox proportional hazards model. Although these modeling strategies are based on different theoretical frameworks, their results were similar. Future simulation study may help us to better understand the limitations and performance of each strategy in a controlled environment.