Missing data in randomized clinical trials for weight loss: scope of the problem, state of the field, and performance of statistical methods.

BACKGROUND: Dropouts and missing data are nearly-ubiquitous in obesity randomized controlled trails, threatening validity and generalizability of conclusions. Herein, we meta-analytically evaluate the extent of missing data, the frequency with which various analytic methods are employed to accommodate dropouts, and the performance of multiple statistical methods. METHODOLOGY/PRINCIPAL FINDINGS: We searched PubMed and Cochrane databases (2000-2006) for articles published in English and manually searched bibliographic references. Articles of pharmaceutical randomized controlled trials with weight loss or weight gain prevention as major endpoints were included. Two authors independently reviewed each publication for inclusion. 121 articles met the inclusion criteria. Two authors independently extracted treatment, sample size, drop-out rates, study duration, and statistical method used to handle missing data from all articles and resolved disagreements by consensus. In the meta-analysis, drop-out rates were substantial with the survival (non-dropout) rates being approximated by an exponential decay curve (e(-lambdat)) where lambda was estimated to be .0088 (95% bootstrap confidence interval: .0076 to .0100) and t represents time in weeks. The estimated drop-out rate at 1 year was 37%. Most studies used last observation carried forward as the primary analytic method to handle missing data. We also obtained 12 raw obesity randomized controlled trial datasets for empirical analyses. Analyses of raw randomized controlled trial data suggested that both mixed models and multiple imputation performed well, but that multiple imputation may be more robust when missing data are extensive. CONCLUSION/SIGNIFICANCE: Our analysis offers an equation for predictions of dropout rates useful for future study planning. Our raw data analyses suggests that multiple imputation is better than other methods for handling missing data in obesity randomized controlled trials, followed closely by mixed models. We suggest these methods supplant last observation carried forward as the primary method of analysis.

Methods for Imputing Missing Values and Synthesizing Confidential Values for Continuous and Magnitude Data

Abstract

Continuous variable is one of the major data types collected by the survey organizations. It can be incomplete such that the data collectors need to fill in the missingness. Or, it can contain sensitive information which needs protection from re-identification. One of the approaches to protect continuous microdata is to sum them up according to different cells of features. In this thesis, I represents novel methods of multiple imputation (MI) that can be applied to impute missing values and synthesize confidential values for continuous and magnitude data.

The first method is for limiting the disclosure risk of the continuous microdata whose marginal sums are fixed. The motivation for developing such a method comes from the magnitude tables of non-negative integer values in economic surveys. I present approaches based on a mixture of Poisson distributions to describe the multivariate distribution so that the marginals of the synthetic data are guaranteed to sum to the original totals. At the same time, I present methods for assessing disclosure risks in releasing such synthetic magnitude microdata. The illustration on a survey of manufacturing establishments shows that the disclosure risks are low while the information loss is acceptable.

The second method is for releasing synthetic continuous micro data by a nonstandard MI method. Traditionally, MI fits a model on the confidential values and then generates multiple synthetic datasets from this model. Its disclosure risk tends to be high, especially when the original data contain extreme values. I present a nonstandard MI approach conditioned on the protective intervals. Its basic idea is to estimate the model parameters from these intervals rather than the confidential values. The encouraging results of simple simulation studies suggest the potential of this new approach in limiting the posterior disclosure risk.

The third method is for imputing missing values in continuous and categorical variables. It is extended from a hierarchically coupled mixture model with local dependence. However, the new method separates the variables into non-focused (e.g., almost-fully-observed) and focused (e.g., missing-a-lot) ones. The sub-model structure of focused variables is more complex than that of non-focused ones. At the same time, their cluster indicators are linked together by tensor factorization and the focused continuous variables depend locally on non-focused values. The model properties suggest that moving the strongly associated non-focused variables to the side of focused ones can help to improve estimation accuracy, which is examined by several simulation studies. And this method is applied to data from the American Community Survey.