A review of RCTs in four medical journals to assess the use of imputation to overcome missing data in quality of life outcomesReportar como inadecuado




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Trials

, 9:51

First Online: 11 August 2008Received: 31 January 2008Accepted: 11 August 2008DOI: 10.1186-1745-6215-9-51

Cite this article as: Fielding, S., Maclennan, G., Cook, J.A. et al. Trials 2008 9: 51. doi:10.1186-1745-6215-9-51

Abstract

BackgroundRandomised controlled trials RCTs are perceived as the gold-standard method for evaluating healthcare interventions, and increasingly include quality of life QoL measures. The observed results are susceptible to bias if a substantial proportion of outcome data are missing. The review aimed to determine whether imputation was used to deal with missing QoL outcomes.

MethodsA random selection of 285 RCTs published during 2005-6 in the British Medical Journal, Lancet, New England Journal of Medicine and Journal of American Medical Association were identified.

ResultsQoL outcomes were reported in 61 21% trials. Six 10% reported having no missing data, 20 33% reported ≤ 10% missing, eleven 18% 11%–20% missing, and eleven 18% reported >20% missing. Missingness was unclear in 13 21%. Missing data were imputed in 19 31% of the 61 trials. Imputation was part of the primary analysis in 13 trials, but a sensitivity analysis in six. Last value carried forward was used in 12 trials and multiple imputation in two. Following imputation, the most common analysis method was analysis of covariance 10 trials.

ConclusionThe majority of studies did not impute missing data and carried out a complete-case analysis. For those studies that did impute missing data, researchers tended to prefer simpler methods of imputation, despite more sophisticated methods being available.

AbbreviationsANCOVAAnalysis of covariance

ANOVAAnalysis of variance

AUCArea under the curve

BMJBritish Medical Journal

CONSORTConsolidated Standards of Reporting Trials

ESRCEconomic and Social Research Council

GHQGeneral health questionnaire

JAMAJournal of American Medical Association

LVCFLast value carried forward

MARMissing at random

MCARMissing completely at random

MNARMissing not at random

NEJMNew England Journal of Medicine

QoLQuality of life

RCTRandomised controlled trial

WHOQOLWorld Health Organisation quality of life questionnaire.

Electronic supplementary materialThe online version of this article doi:10.1186-1745-6215-9-51 contains supplementary material, which is available to authorized users.

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Autor: Shona Fielding - Graeme Maclennan - Jonathan A Cook - Craig R Ramsay

Fuente: https://link.springer.com/







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