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Handling missing data in a composite outcome with partially observed components: Simulation study based on clustered paediatric routine data

Gachau, S; Njeru Njagi, E; Owuor, N; Mwaniki, P; Quartagno, M; Sarguta, R; English, M; (2021) Handling missing data in a composite outcome with partially observed components: Simulation study based on clustered paediatric routine data. Journal of Applied Statistics 10.1080/02664763.2021.1895087. (In press). Green open access

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Abstract

Composite scores are useful in providing insights and trends about complex and multidimensional quality of care processes. However, missing data in subcomponents may hinder the overall reliability of a composite measure. In this study, strategies for handling missing data in Paediatric Admission Quality of Care (PAQC) score, an ordinal composite outcome, were explored through a simulation study. Specifically, the implications of the conventional method employed in addressing missing PAQC score subcomponents, consisting of scoring missing PAQC score components with a zero, and a multiple imputation (MI)-based strategy, were assessed. The latent normal joint modelling MI approach was used for the latter. Across simulation scenarios, MI of missing PAQC score elements at item level produced minimally biased estimates compared to the conventional method. Moreover, regression coefficients were more prone to bias compared to standards errors. Magnitude of bias was dependent on the proportion of missingness and the missing data generating mechanism. Therefore, incomplete composite outcome subcomponents should be handled carefully to alleviate potential for biased estimates and misleading inferences. Further research on other strategies of imputing at the component and composite outcome level and imputing compatibly with the substantive model in this setting, is needed.

Type: Article
Title: Handling missing data in a composite outcome with partially observed components: Simulation study based on clustered paediatric routine data
Open access status: An open access version is available from UCL Discovery
DOI: 10.1080/02664763.2021.1895087
Publisher version: https://doi.org/10.1080/02664763.2021.1895087
Language: English
Additional information: © 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/ licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Inst of Clinical Trials and Methodology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Inst of Clinical Trials and Methodology > MRC Clinical Trials Unit at UCL
URI: https://discovery.ucl.ac.uk/id/eprint/10122343
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