library(survival) # the way a +cluster() term is handled in coxph has implications for update. fit1 <- coxph(Surv(time, status) ~ age, cluster= inst, lung) fit2 <- coxph(Surv(time, status) ~ age + cluster(inst), lung) all.equal(fit1, fit2) fit3 <- coxph(Surv(time, status) ~ age + sex + cluster(inst), lung) test1 <- update(fit1, .~ .+ sex) all.equal(test1, fit3) # Gives a spurious warning message test2 <- update(fit1, . ~ age + sex + cluster(inst), lung) all.equal(test2, fit3)