Using bootstrap method to evaluate the estimates of nicotine equivalents from linear mixed model and generalized estimating equation

Twenty-four-hour urinary excretion of nicotine equivalents, a biomarker for exposure to cigarette smoke, has been widely used in biomedical studies in recent years. Its accurate estimate is important for examining human exposure to tobacco smoke. The objective of this article is to compare the bootstrap confidence intervals of nicotine equivalents with the standard confidence intervals derived from linear mixed model (LMM) and generalized estimation equation. We use percentile bootstrap method because it has practical value for real-life application and it works well with nicotine data. To preserve the within-subject correlation of nicotine equivalents between repeated measures, we bootstrap the repeated measures of each subject as a vector. The results indicate that the bootstrapped estimates in most cases give better estimates than the LMM and generalized estimation equation without bootstrap.