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An Introduction to Tree-Structured Modeling With Application to Quality of Life Data

Su, Xiaogang; Azuero, Andres; Cho, June; Kvale, Elizabeth; Meneses, Karen M.; McNees, M. Patrick

Nursing Research:
doi: 10.1097/NNR.0b013e318221f9bc
Methods
Abstract

Background: Investigators addressing nursing research are faced increasingly with the need to analyze data that involve variables of mixed types and are characterized by complex nonlinearity and interactions. Tree-based methods, also called recursive partitioning, are gaining popularity in various fields. In addition to efficiency and flexibility in handling multifaceted data, tree-based methods offer ease of interpretation.

Objectives: The aims of this study were to introduce tree-based methods, discuss their advantages and pitfalls in application, and describe their potential use in nursing research.

Method: In this article, (a) an introduction to tree-structured methods is presented, (b) the technique is illustrated via quality of life (QOL) data collected in the Breast Cancer Education Intervention study, and (c) implications for their potential use in nursing research are discussed.

Discussion: As illustrated by the QOL analysis example, tree methods generate interesting and easily understood findings that cannot be uncovered via traditional linear regression analysis. The expanding breadth and complexity of nursing research may entail the use of new tools to improve efficiency and gain new insights. In certain situations, tree-based methods offer an attractive approach that help address such needs.

Author Information

Xiaogang Su, PhD, is Associate Professor, School of Nursing; Andres Azuero, PhD, MBA, is Assistant Professor, School of Nursing; June Cho, PhD, RN, is Assistant Professor, School of Nursing, University of Alabama at Birmingham.

Elizabeth Kvale, MD, is Assistant Professor, School of Medicine, University of Alabama at Birmingham, and GRECC Investigator, Department of Veterans Affairs Medical Center, Birmingham, Alabama.

Karen M. Meneses, PhD, RN, FAAN, is Professor and Associate Dean for Research, School of Nursing; and M. Patrick McNees, PhD, FAAN, is Professor, School of Nursing, and Professor and Associate Dean for Research, School of Health Professions, University of Alabama at Birmingham.

Accepted for publication April 27, 2011.

This study was supported by the National Institute of Nursing Research and the Office of Cancer Survivorship at the National Cancer Institute (5R01-NR005332-04; principal investigator: K.M.M.).

Corresponding author: Xiaogang Su, PhD, School of Nursing, University of Alabama at Birmingham, 1530 3rd Avenue South, Birmingham, AL 35294-1210 (e-mail: xgsu@uab.edu).

© 2011 Lippincott Williams & Wilkins, Inc.