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Suppose I conduct an experiment to test the hypothesis that treatment A suppresses protein X. I am fortunate in that I work on kidneys, which come in pairs, however I am unfortunate in that I don't have much idea about how quickly or slowly any suppressive effect might appear. I therefore apply treatment A to six kidneys selected at random from six pairs (i.e. one kidney per pair gets the treatment); I apply a control treatment to the contralateral kidney in each pair. I measure protein X at 2 hours, 4 hours, and 6 hours following initiation of treatment. My hypothesis is not specific with respect to time of effect (I accept the design limitation here).

In my data I observe a group (treatment) effect, a time effect, and a 'pair' effect (concordance between kidneys within a pair). There appears to be a small within-pair (i.e. between group) difference in expression at the first time point, a bigger difference at the second, and an obvious difference by the third.

It strikes me that this data is both paired, and repeated-measures. I am not aware of a canonical statistical test for this situation. I could use a repeated-measures ANOVA and lose the increase in power due to pairing, or multiple paired T-tests and lose the time effect (and have to deal with multiple comparisons).

Alternatively I could fit a mixed model, with 'pair' as a random effect, and time and group as fixed effects. I'm not an expert, but this seems reasonable - it reflects the structure of the data/ experiment, I have 36 observations, that's three parameters to fit (is it? Or is it four? Does the intercept count if I've used effectively a random intercept like this?). I could then extract a p-value using lme4 and lmerTest, e.g. lmer(concentration~timepoint + group + (1|pair)), and see if there is a group effect.

Is this a correct treatment? I've read around this a bit and loosely understand various arguments re the meaning of significance with respect to mixed models, and about e.g. why lme4 doesn't report p-values by default. Nevertheless this is a fairly classic experimental design and my gut feeling is that testing significance in this manner is reasonable. I would be grateful for any expert advice. I would be particularly grateful for any relevance references.

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  • $\begingroup$ With paired data like this, you can take your dependent variable to be the difference in concentration of protein X within each pair. So you could use the mixed model you suggested with the "group" variable removed to predict difference in concentration. $\endgroup$
    – JLinsta
    Commented Sep 15, 2023 at 19:43
  • $\begingroup$ In this model, each unit is a pair of kidneys and you can apply any repeated-measures analysis. $\endgroup$
    – JLinsta
    Commented Sep 15, 2023 at 19:51
  • $\begingroup$ Thank you. So you mean take the difference within each pair, and do a sort of repeated measures one-way ANOVA in R comparing that difference to zero? How do I do that in R? Is there any advantage or disadvantage to doing that vs using a mixed model predicting difference in concentration? And is either of these solutions better than my original suggestion - is lmer(concentration~timepoint + group + (1|pair)) wrong for any reason? Thank you! $\endgroup$
    – Richard D
    Commented Sep 15, 2023 at 22:01
  • $\begingroup$ ANOVA is used when comparing >2 groups. Your sample consists of differences in pairs of kidneys. Since each pair of kidneys received the same treatments, the sample isn't grouped in any way. Thus, your proposed mixed effects model is more appropriate in this case. The only difference is that you should treat each PAIR as a sample point in your model and have the dependent variable be change in concentration within the pairs. $\endgroup$
    – JLinsta
    Commented Sep 18, 2023 at 13:25

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