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Published in: Trials 1/2002

Open Access 01-12-2002 | Review

Problems in dealing with missing data and informative censoring in clinical trials

Author: Weichung Joseph Shih

Published in: Trials | Issue 1/2002

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Abstract

A common problem in clinical trials is the missing data that occurs when patients do not complete the study and drop out without further measurements. Missing data cause the usual statistical analysis of complete or all available data to be subject to bias. There are no universally applicable methods for handling missing data. We recommend the following: (1) Report reasons for dropouts and proportions for each treatment group; (2) Conduct sensitivity analyses to encompass different scenarios of assumptions and discuss consistency or discrepancy among them; (3) Pay attention to minimize the chance of dropouts at the design stage and during trial monitoring; (4) Collect post-dropout data on the primary endpoints, if at all possible; and (5) Consider the dropout event itself an important endpoint in studies with many.
Literature
1.
go back to reference Zanchetti A, Omboni A, on behalf of the Italian Candesartan Study Group: Comparison of candesartan versus enalapril in essential hypertension. Am J Hypertens. 2001, 14: 129-134. 10.1016/S0895-7061(00)01240-1.CrossRefPubMed Zanchetti A, Omboni A, on behalf of the Italian Candesartan Study Group: Comparison of candesartan versus enalapril in essential hypertension. Am J Hypertens. 2001, 14: 129-134. 10.1016/S0895-7061(00)01240-1.CrossRefPubMed
2.
go back to reference McKenney JM, McCormick LS, Schaefer EJ, Black DM, Watkins ML: Effect of niacin and atorvastatin on lipoprotein subclasses in patients with atherogenic dyslipidemia. Am J Cardiol. 2001, 88: 270-274. 10.1016/S0002-9149(01)01639-3.CrossRefPubMed McKenney JM, McCormick LS, Schaefer EJ, Black DM, Watkins ML: Effect of niacin and atorvastatin on lipoprotein subclasses in patients with atherogenic dyslipidemia. Am J Cardiol. 2001, 88: 270-274. 10.1016/S0002-9149(01)01639-3.CrossRefPubMed
3.
go back to reference The Pimobendan in Congestive Heart Failure (PICO) Investigators: Effect of pimobendan on exercise capacity in patients with heart failure: main results from the Pimobendan in Congestive Heart Failure (PICO) trial. Heart. 1996, 76: 223-231.CrossRef The Pimobendan in Congestive Heart Failure (PICO) Investigators: Effect of pimobendan on exercise capacity in patients with heart failure: main results from the Pimobendan in Congestive Heart Failure (PICO) trial. Heart. 1996, 76: 223-231.CrossRef
4.
go back to reference Diamond JA, Krakoff LR, Goldman A, Coplan N, Gharavi A, Martin K, Goldsmith R, Henzlova MJ, Machac J, Phillip RA: Comparison of two calcium blockers on hemodynamics, left ventricular mass, and coronary vasodilatory in advanced hypertension. Am J Hypertens. 2001, 14: 231-240. 10.1016/S0895-7061(00)01267-X.CrossRefPubMed Diamond JA, Krakoff LR, Goldman A, Coplan N, Gharavi A, Martin K, Goldsmith R, Henzlova MJ, Machac J, Phillip RA: Comparison of two calcium blockers on hemodynamics, left ventricular mass, and coronary vasodilatory in advanced hypertension. Am J Hypertens. 2001, 14: 231-240. 10.1016/S0895-7061(00)01267-X.CrossRefPubMed
5.
go back to reference Ferdinand K, Saini R, Lewin A, Yellen L, Barbosa JA, Kusgnir E: Efficacy and safety of omapatrilat with hydrochlorothiazide for the treatment of hypertension in subjects nonresponsive to hydrochlorothiazide alone. Am J Hypertens. 2001, 14: 788-793. 10.1016/S0895-7061(01)01294-8.CrossRefPubMed Ferdinand K, Saini R, Lewin A, Yellen L, Barbosa JA, Kusgnir E: Efficacy and safety of omapatrilat with hydrochlorothiazide for the treatment of hypertension in subjects nonresponsive to hydrochlorothiazide alone. Am J Hypertens. 2001, 14: 788-793. 10.1016/S0895-7061(01)01294-8.CrossRefPubMed
6.
go back to reference Armitage P: The analysis of data from clinical trials. The Statistician. 1979, 28: 171-183.CrossRef Armitage P: The analysis of data from clinical trials. The Statistician. 1979, 28: 171-183.CrossRef
7.
go back to reference Schwarz D, Flamant R, Lellouch J: Clinical Trials. London: Academic Press,. 1980 Schwarz D, Flamant R, Lellouch J: Clinical Trials. London: Academic Press,. 1980
8.
go back to reference Downs JR, Clearfield M, Tyroler HA, Whitney EJ, Kruyer W, Langendorfer AL, Zagrebelsky V, Weis S, Shapiro DR, Beere PA, Gotto AM: Air force/Texas coronary atherosclerosis prevention study (afcaps/texcaps): Additional perspectives on tolerability of long-term treatment with lovastatin. Am J Cardiol. 2001, 87: 1074-1079. 10.1016/S0002-9149(01)01464-3.CrossRefPubMed Downs JR, Clearfield M, Tyroler HA, Whitney EJ, Kruyer W, Langendorfer AL, Zagrebelsky V, Weis S, Shapiro DR, Beere PA, Gotto AM: Air force/Texas coronary atherosclerosis prevention study (afcaps/texcaps): Additional perspectives on tolerability of long-term treatment with lovastatin. Am J Cardiol. 2001, 87: 1074-1079. 10.1016/S0002-9149(01)01464-3.CrossRefPubMed
10.
go back to reference Rubin DM: Multiple Imputation for Nonresponse in Surveys. New York: Wiley,. 1987CrossRef Rubin DM: Multiple Imputation for Nonresponse in Surveys. New York: Wiley,. 1987CrossRef
11.
go back to reference Schafer JL: Analysis of Incomplete Multivariate Data. New York: Chapman and Hall,. 1997CrossRef Schafer JL: Analysis of Incomplete Multivariate Data. New York: Chapman and Hall,. 1997CrossRef
14.
go back to reference Murray GD, Findlay JG: Correcting for the bias caused by drop-outs in hypertension trials. Statistics in Medicine. 1988, 7: 941-946.CrossRefPubMed Murray GD, Findlay JG: Correcting for the bias caused by drop-outs in hypertension trials. Statistics in Medicine. 1988, 7: 941-946.CrossRefPubMed
15.
go back to reference Wei L, Shih WJ: Partial imputation approach to analysis of repeated measurements with dependent dropouts. Statistics in Medicine. 2001, 20: 1197-1214. 10.1002/sim.778.CrossRefPubMed Wei L, Shih WJ: Partial imputation approach to analysis of repeated measurements with dependent dropouts. Statistics in Medicine. 2001, 20: 1197-1214. 10.1002/sim.778.CrossRefPubMed
16.
go back to reference Diggle P, Kenward MG: Informative drop-out in longitudinal data analysis (with discussions). Applied Statistics. 1994, 43: 49-93.CrossRef Diggle P, Kenward MG: Informative drop-out in longitudinal data analysis (with discussions). Applied Statistics. 1994, 43: 49-93.CrossRef
17.
go back to reference Wu MC, Carroll RJ: Estimation and comparison of changes in the presence of informative right censoring by modeling the censoring process. Biometrics. 1988, 44: 175-188.CrossRef Wu MC, Carroll RJ: Estimation and comparison of changes in the presence of informative right censoring by modeling the censoring process. Biometrics. 1988, 44: 175-188.CrossRef
18.
go back to reference Schluchter MD: Methods for the analysis of informatively censored longitudinal data. Statistics in Medicine. 1992, 11: 1861-1870.CrossRefPubMed Schluchter MD: Methods for the analysis of informatively censored longitudinal data. Statistics in Medicine. 1992, 11: 1861-1870.CrossRefPubMed
19.
go back to reference Mu MC, Albert PS, Wu Bu: Adjusting for drop-out in clinical trials with repeated measures: design and analysis issues. Statistics in Medicine. 2001, 20: 93-108. 10.1002/1097-0258(20010115)20:1<93::AID-SIM655>3.3.CO;2-U.CrossRef Mu MC, Albert PS, Wu Bu: Adjusting for drop-out in clinical trials with repeated measures: design and analysis issues. Statistics in Medicine. 2001, 20: 93-108. 10.1002/1097-0258(20010115)20:1<93::AID-SIM655>3.3.CO;2-U.CrossRef
20.
go back to reference Little RJA: Modeling the drop-out mechanism in repeated-measures studies. Journal of American Statistical Association. 1995, 90: 1112-1121.CrossRef Little RJA: Modeling the drop-out mechanism in repeated-measures studies. Journal of American Statistical Association. 1995, 90: 1112-1121.CrossRef
21.
go back to reference Gould AL: A new approach to the analysis of clinical drug trial with withdrawals. Biometrics. 1980, 36: 721-727.CrossRefPubMed Gould AL: A new approach to the analysis of clinical drug trial with withdrawals. Biometrics. 1980, 36: 721-727.CrossRefPubMed
22.
go back to reference Lachin JM: Worst-rank score analysis with informatively missing observations in clinical trials. Controlled Clinical Trials. 1999, 20: 408-422. 10.1016/S0197-2456(99)00022-7.CrossRefPubMed Lachin JM: Worst-rank score analysis with informatively missing observations in clinical trials. Controlled Clinical Trials. 1999, 20: 408-422. 10.1016/S0197-2456(99)00022-7.CrossRefPubMed
23.
go back to reference Misbin RI: Guidance for evaluation of new treatments for diabetes mellitus. Division of Metabolism and Endocrine Drug Products, CDER FDA. 1998 Misbin RI: Guidance for evaluation of new treatments for diabetes mellitus. Division of Metabolism and Endocrine Drug Products, CDER FDA. 1998
24.
go back to reference Shih WJ, Quan H: Testing for treatment difference with dropouts present in clinical trials – A composite approach. Statistics in Medicine. 1997, 16: 1225-1239. 10.1002/(SICI)1097-0258(19970615)16:11<1225::AID-SIM548>3.0.CO;2-Y.CrossRefPubMed Shih WJ, Quan H: Testing for treatment difference with dropouts present in clinical trials – A composite approach. Statistics in Medicine. 1997, 16: 1225-1239. 10.1002/(SICI)1097-0258(19970615)16:11<1225::AID-SIM548>3.0.CO;2-Y.CrossRefPubMed
25.
go back to reference Cowley AJ, Weins BL, Segal R, Rich MW, Santanello , Dashbach EJ, Pitt B: Randomized comparison of losartin vs. captopril on quality of life in elderly patients with symptomatic heart failure: The losartin heart failure ELITE quality of life substudy. Quality of Life Research. 2000, 9: 377-384. 10.1023/A:1008948930206.CrossRefPubMed Cowley AJ, Weins BL, Segal R, Rich MW, Santanello , Dashbach EJ, Pitt B: Randomized comparison of losartin vs. captopril on quality of life in elderly patients with symptomatic heart failure: The losartin heart failure ELITE quality of life substudy. Quality of Life Research. 2000, 9: 377-384. 10.1023/A:1008948930206.CrossRefPubMed
26.
go back to reference Hogan J, Laird N: Model-based approaches to analyzing incomplete longitudinal and failure time data. Statistics in Medicine. 1997, 16: 259-272. 10.1002/(SICI)1097-0258(19970215)16:3<259::AID-SIM484>3.0.CO;2-S.CrossRefPubMed Hogan J, Laird N: Model-based approaches to analyzing incomplete longitudinal and failure time data. Statistics in Medicine. 1997, 16: 259-272. 10.1002/(SICI)1097-0258(19970215)16:3<259::AID-SIM484>3.0.CO;2-S.CrossRefPubMed
27.
go back to reference Finkelstein D, Schoenfeld D: Combining mortality and longitudinal measures in clinical trials. Statistics in Medicine. 1999, 18: 1341-1354. 10.1002/(SICI)1097-0258(19990615)18:11<1341::AID-SIM129>3.0.CO;2-7.CrossRefPubMed Finkelstein D, Schoenfeld D: Combining mortality and longitudinal measures in clinical trials. Statistics in Medicine. 1999, 18: 1341-1354. 10.1002/(SICI)1097-0258(19990615)18:11<1341::AID-SIM129>3.0.CO;2-7.CrossRefPubMed
28.
go back to reference Cochran WG: Planning and Analysis of Observational Studies. New York: Wiley,. 1983CrossRef Cochran WG: Planning and Analysis of Observational Studies. New York: Wiley,. 1983CrossRef
Metadata
Title
Problems in dealing with missing data and informative censoring in clinical trials
Author
Weichung Joseph Shih
Publication date
01-12-2002
Publisher
BioMed Central
Published in
Trials / Issue 1/2002
Electronic ISSN: 1745-6215
DOI
https://doi.org/10.1186/1468-6708-3-4

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