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Table 2 Multilevel models for receiving medical order for lung cancer screening among eligible patients, 2014–2016 (N = 12,801)

From: New recommendation and coverage of low-dose computed tomography for lung cancer screening: uptake has increased but is still low

Fixed Effects

Model 1

Model 2

Model 3a

Estimate (SE)

Estimate (SE)

Estimate (SE)

Intercept

−3.56** (0.11)

−4.41*** (0.22)

−5.44*** (0.88)

Patient-level Factors

 

OR (95% CI)

OR (95% CI)

Age

 78–80

 

0.4**(0.3–0.7)

0.4**(0.3–0.7)

 65–77

 

1.2 (1.0–1.4)

1.2 (0.9–1.4)

 55–64

 

1.0

1.0

Sex

 Female

 

1.1 (0.9–1.3)

1.0 (0.8–1.2)

 Male

 

1.0

1.0

Race

 Hispanic

 

1.2 (0.8–1.8)

1.1 (0.8–1.7)

 Black

 

1.2 (0.8–2.0)

1.1 (0.6–1.9)

 Asian

 

1.6* (1.1–2.4)

1.6* (1.1–2.4)

 Other

 

1.0 (0.6–1.6)

0.9 (0.5–1.6)

 Non-Hispanic White

 

1.0

1.0

Smoking status

 Current Smoker

 

1.6***(1.4–2.0)

1.7***(1.4–2.0)

 Former Smoker

 

1.0

1.0

Pack-year (packs per day*years of smoking)

 60+

 

1.0 (0.8–1.3)

1.0 (0.8–1.4)

 50–59

 

1.2 (0.9–1.6)

1.2 (0.9–1.6)

 40–49

 

1.0 (0.9–1.3)

1.1 (0.9–1.3)

 30–39

 

1.0

1.0

Visiting one’s own primary care provider

 Yes

 

2.4***(1.8–3.2)

2.4***(1.7–3.4)

 No

 

1.0

1.0

Severity of major comorbidities

 Severe (CCI ≥5)

 

0.2***(0.1–0.3)

0.2***(0.1–0.3)

 Moderate (CCI =3–4)

 

0.6***(0.4–0.8)

0.5***(0.4–0.7)

 Mild (CCI =1–2)

 

1.0 (0.8–1.2)

1.0 (0.8–1.3)

 No major comorbidity (CCI =0)

 

1.0

1.0

Provider-level Factors

  

OR (95% CI)

Gender

 Female

  

1.6* (1.1–2.3)

 Male

  

1.0

Professional

 Physician

  

3.1 (0.6–16.1)

 Other

  

1.0

Graduated from medical universities outside of US.

 Yes

  

0.4** (0.3–0.7)

 No

  

1.0

Error Variance

Estimate (SE)

Estimate (SE)

Estimate (SE)

 Level-2 Intercept

3.17 (0.37)***

3.28 (0.41)***

2.63 (0.36)***

Model Fit

 -2 Log Likelihood

5873.46

4934.42***

3882.77***

  1. ICC = .49; Control variables of Model 2 and 3 not presented in the table include frequency of office visits, and calendar year
  2. OR Odds Ratio, SE Standard Error, 95% CI 95% Confidence interval
  3. *p < .05; ** p < .01; ***p < .0001
  4. aBest fitting model