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What impact do assumptions about missing data have on conclusions? A practical sensitivity analysis for a cancer survival registry

Smuk, M; Carpenter, JR; Morris, TP; (2017) What impact do assumptions about missing data have on conclusions? A practical sensitivity analysis for a cancer survival registry. BMC Medical Research Methodology , 17 10.1186/s12874-017-0301-0. Green open access

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Abstract

Background: Within epidemiological and clinical research, missing data are a common issue and often over looked in publications. When the issue of missing observations is addressed it is usually assumed that the missing data are ‘missing at random’ (MAR). This assumption should be checked for plausibility, however it is untestable, thus inferences should be assessed for robustness to departures from missing at random. Methods: We highlight the method of pattern mixture sensitivity analysis after multiple imputation using colorectal cancer data as an example. We focus on the Dukes’ stage variable which has the highest proportion of missing observations. First, we find the probability of being in each Dukes’ stage given the MAR imputed dataset. We use these probabilities in a questionnaire to elicit prior beliefs from experts on what they believe the probability would be in the missing data. The questionnaire responses are then used in a Dirichlet draw to create a Bayesian ‘missing not at random’ (MNAR) prior to impute the missing observations. The model of interest is applied and inferences are compared to those from the MAR imputed data. Results: The inferences were largely insensitive to departure from MAR. Inferences under MNAR suggested a smaller association between Dukes’ stage and death, though the association remained positive and with similarly low p values. Conclusions: We conclude by discussing the positives and negatives of our method and highlight the importance of making people aware of the need to test the MAR assumption.

Type: Article
Title: What impact do assumptions about missing data have on conclusions? A practical sensitivity analysis for a cancer survival registry
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1186/s12874-017-0301-0
Publisher version: http://doi.org/10.1186/s12874-017-0301-0
Language: English
Additional information: Copyright © The Author(s). 2017. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Keywords: Elicitation, Missing at random, Missing data, Missing not at random, Pattern-mixture model, Sensitivity analysis
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 > 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/1540785
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