# Cox proportional hazard model for survival analysis on multilevel data

#### abcdefghij

##### New Member
I am trying to run a survival analysis on a multilevel data (two levels) with five units nested within each person (each case has data from five different years). I have a number of covariates to enter into the model as I am interested in their interaction.
I am considering using a Cox proportional hazard model but I found this is not a good fit for multilevel data unless random effect is incorporated.
My questions are: first, is Cox regression model with mixed effects the best model for analyzing my data given its nature. Secondly, does anyone know how to incorporate random effect into a conventional Cox proportional hazards model on SPSS? I have found a description on how to do this from an article by Austin, P. C. (2017) (A tutorial on multilevel survival analysis: methods, models, and applications. International Statistical Review) but he has demonstrated this using STATA and R.

#### hlsmith

##### Not a robit
Can you provide an example of what your data look like? So you have repeated measures clustered in subjects. Are these repeat values for covariates, outcome or both? Why is this survival data in your mind, I didn't follow that part in your description.

Lastly, the purpose of running multilevel analyses is to control for random effects, random intercepts, or both. So do you want to do this.

P.S., Austin usually has quality publications. Are you able to try a new program (e.g., STATA or R)?

#### abcdefghij

##### New Member
Can you provide an example of what your data look like? So you have repeated measures clustered in subjects. Are these repeat values for covariates, outcome or both? Why is this survival data in your mind, I didn't follow that part in your description.

Lastly, the purpose of running multilevel analyses is to control for random effects, random intercepts, or both. So do you want to do this.

P.S., Austin usually has quality publications. Are you able to try a new program (e.g., STATA or R)?