Allowing for uncertainty due to missing and LOCF imputed outcomes in meta‐analysis

The use of the last observation carried forward (LOCF) method for imputing missing outcome data in randomized clinical trials has been much criticized and its shortcomings are well understood. However, only recently have published studies widely started using more appropriate imputation methods. Con...

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Main Authors: Mavridis, D, Salanti, G, Furukawa, T, Cipriani, A, Chaimani, A, White, I
Format: Journal article
Language:English
Published: Wiley 2018
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author Mavridis, D
Salanti, G
Furukawa, T
Cipriani, A
Chaimani, A
White, I
author_facet Mavridis, D
Salanti, G
Furukawa, T
Cipriani, A
Chaimani, A
White, I
author_sort Mavridis, D
collection OXFORD
description The use of the last observation carried forward (LOCF) method for imputing missing outcome data in randomized clinical trials has been much criticized and its shortcomings are well understood. However, only recently have published studies widely started using more appropriate imputation methods. Consequently, meta‐analyses often include several studies reporting their results according to LOCF. The results from such meta‐analyses are potentially biased and overprecise. We develop methods for estimating summary treatment effects for continuous outcomes in the presence of both missing and LOCF‐imputed outcome data. Our target is the treatment effect if complete follow‐up was obtained even if some participants drop out from the protocol treatment. We extend a previously developed meta‐analysis model, which accounts for the uncertainty due to missing outcome data via an informative missingness parameter. The extended model includes an extra parameter that reflects the level of prior confidence in the appropriateness of the LOCF imputation scheme. Neither parameter can be informed by the data and we resort to expert opinion and sensitivity analysis. We illustrate the methodology using two meta‐analyses of pharmacological interventions for depression.
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spelling oxford-uuid:8454faa4-348c-4e6b-9e3f-625124a7df8e2022-03-26T21:50:26ZAllowing for uncertainty due to missing and LOCF imputed outcomes in meta‐analysisJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:8454faa4-348c-4e6b-9e3f-625124a7df8eEnglishSymplectic Elements at OxfordWiley2018Mavridis, DSalanti, GFurukawa, TCipriani, AChaimani, AWhite, IThe use of the last observation carried forward (LOCF) method for imputing missing outcome data in randomized clinical trials has been much criticized and its shortcomings are well understood. However, only recently have published studies widely started using more appropriate imputation methods. Consequently, meta‐analyses often include several studies reporting their results according to LOCF. The results from such meta‐analyses are potentially biased and overprecise. We develop methods for estimating summary treatment effects for continuous outcomes in the presence of both missing and LOCF‐imputed outcome data. Our target is the treatment effect if complete follow‐up was obtained even if some participants drop out from the protocol treatment. We extend a previously developed meta‐analysis model, which accounts for the uncertainty due to missing outcome data via an informative missingness parameter. The extended model includes an extra parameter that reflects the level of prior confidence in the appropriateness of the LOCF imputation scheme. Neither parameter can be informed by the data and we resort to expert opinion and sensitivity analysis. We illustrate the methodology using two meta‐analyses of pharmacological interventions for depression.
spellingShingle Mavridis, D
Salanti, G
Furukawa, T
Cipriani, A
Chaimani, A
White, I
Allowing for uncertainty due to missing and LOCF imputed outcomes in meta‐analysis
title Allowing for uncertainty due to missing and LOCF imputed outcomes in meta‐analysis
title_full Allowing for uncertainty due to missing and LOCF imputed outcomes in meta‐analysis
title_fullStr Allowing for uncertainty due to missing and LOCF imputed outcomes in meta‐analysis
title_full_unstemmed Allowing for uncertainty due to missing and LOCF imputed outcomes in meta‐analysis
title_short Allowing for uncertainty due to missing and LOCF imputed outcomes in meta‐analysis
title_sort allowing for uncertainty due to missing and locf imputed outcomes in meta analysis
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AT chaimania allowingforuncertaintyduetomissingandlocfimputedoutcomesinmetaanalysis
AT whitei allowingforuncertaintyduetomissingandlocfimputedoutcomesinmetaanalysis