Missing data techniques for multilevel data: implications of model misspecification

When modeling multilevel data, it is important to accurately represent the interdependence of observations within clusters. Ignoring data clustering may result in parameter misestimation. However, it is not well established to what degree parameter estimates are affected by model misspecification when applying missing data techniques (MDTs) to incomplete multilevel data. We compare the performance of three MDTs with incomplete hierarchical data. We consider the impact of imputation model misspecification on the quality of parameter estimates by employing multiple imputation under assumptions of a normal model (MI/NM) with two-level cross-sectional data when values are missing at random on the dependent variable at rates of 10%, 30%, and 50%. Five criteria are used to compare estimates from MI/NM to estimates from MI assuming a linear mixed model (MI/LMM) and maximum likelihood estimation to the same incomplete data sets. With 10% missing data (MD), techniques performed similarly for fixed-effects estimates, but variance components were biased with MI/NM. Effects of model misspecification worsened at higher rates of MD, with the hierarchical structure of the data markedly underrepresented by biased variance component estimates. MI/LMM and maximum likelihood provided generally accurate and unbiased parameter estimates but performance was negatively affected by increased rates of MD.     

Using multiple imputation to estimate cumulative distribution functions in longitudinal data analysis with data missing at random

In longitudinal clinical studies, after randomization at baseline, subjects are followed for a period of time for development of symptoms. The interested inference could be the mean change from baseline to a particular visit in some lab values, the proportion of responders to some threshold category at a particular visit post baseline, or the time to some important event. However, in some applications, the interest may be in estimating the cumulative distribution function (CDF) at a fixed time point post baseline. When the data are fully observed, the CDF can be estimated by the empirical CDF. When patients discontinue prematurely during the course of the study, the empirical CDF cannot be directly used. In this paper, we use multiple imputation as a way to estimate the CDF in longitudinal studies when data are missing at random. The validity of the method is assessed on the basis of the bias and the Kolmogorov–Smirnov distance. The results suggest that multiple imputation yields less bias and less variability than the often used last observation carried forward method. Copyright © 2013 John Wiley & Sons, Ltd.     

The impact of missing data and how it is handled on the rate of false-positive results in drug development

In drug development, a common choice for the primary analysis is to assess mean changes via analysis of (co)variance with missing data imputed by carrying the last or baseline observations forward (LOCF, BOCF). These approaches assume that data are missing completely at random (MCAR). Multiple imputation (MI) and likelihood-based repeated measures (MMRM) are less restrictive as they assume data are missing at random (MAR). Nevertheless, LOCF and BOCF remain popular, perhaps because it is thought that the bias in these methods lead to protection against falsely concluding that a drug is more effective than the control. We conducted a simulation study that compared the rate of false positive results or regulatory risk error (RRE) from BOCF, LOCF, MI, and MMRM in 32 scenarios that were generated from a 2(5) full factorial arrangement with data missing due to a missing not at random (MNAR) mechanism. Both BOCF and LOCF inflated RRE were compared to MI and MMRM. In 12 of the 32 scenarios, BOCF yielded inflated RRE compared with eight scenarios for LOCF, three scenarios for MI and four scenarios for MMRM. In no situation did BOCF or LOCF provide adequate control of RRE when MI and MMRM did not. Both MI and MMRM are better choices than either BOCF or LOCF for the primary analysis.     

A numerical study of multiple imputation methods using nonparametric multivariate outlier identifiers and depth-based performance criteria with clinical laboratory data

It is well known that if a multivariate outlier has one or more missing component values, then multiple imputation (MI) methods tend to impute nonextreme values and make the outlier become less extreme and less likely to be detected. In this paper, nonparametric depth-based multivariate outlier identifiers are used as criteria in a numerical study comparing several established methods of MI as well as a new proposed one, nine in all, in a setting of several actual clinical laboratory data sets of different dimensions. Two criteria, an ‘outlier recovery probability’ and a ‘relative accuracy measure’, are developed, based on depth functions. Three outlier identifiers, based on Mahalanobis distance, robust Mahalanobis distance, and generalized principle component analysis are also included in the study. Consequently, not only the comparison of imputation methods but also the comparison of outlier detection methods is accomplished in this study. Our findings show that the performance of an MI method depends on the choice of depth-based outlier detection criterion, as well as the size and dimension of the data and the fraction of missing components. By taking these features into account, an MI method for a given data set can be selected more optimally.     

Control‐based imputation for sensitivity analyses in informative censoring for recurrent event data

In clinical trials, missing data commonly arise through nonadherence to the randomized treatment or to study procedure. For trials in which recurrent event endpoints are of interests, conventional analyses using the proportional intensity model or the count model assume that the data are missing at random, which cannot be tested using the observed data alone. Thus, sensitivity analyses are recommended. We implement the control‐based multiple imputation as sensitivity analyses for the recurrent event data. We model the recurrent event using a piecewise exponential proportional intensity model with frailty and sample the parameters from the posterior distribution. We impute the number of events after dropped out and correct the variance estimation using a bootstrap procedure. We apply the method to an application of sitagliptin study.     

A comparison of various software tools for dealing with missing data via imputation

In real-life situations, we often encounter data sets containing missing observations. Statistical methods that address missingness have been extensively studied in recent years. One of the more popular approaches involves imputation of the missing values prior to the analysis, thereby rendering the data complete. Imputation broadly encompasses an entire scope of techniques that have been developed to make inferences about incomplete data, ranging from very simple strategies (e.g. mean imputation) to more advanced approaches that require estimation, for instance, of posterior distributions using Markov chain Monte Carlo methods. Additional complexity arises when the number of missingness patterns increases and/or when both categorical and continuous random variables are involved. Implementation of routines, procedures, or packages capable of generating imputations for incomplete data are now widely available. We review some of these in the context of a motivating example, as well as in a simulation study, under two missingness mechanisms (missing at random and missing not at random). Thus far, evaluation of existing implementations have frequently centred on the resulting parameter estimates of the prescribed model of interest after imputing the missing data. In some situations, however, interest may very well be on the quality of the imputed values at the level of the individual – an issue that has received relatively little attention. In this paper, we focus on the latter to provide further insight about the performance of the different routines, procedures, and packages in this respect.     

Sensitivity to imputation models and assumptions in receiver operating characteristic analysis with incomplete data

Modern statistical methods using incomplete data have been increasingly applied in a wide variety of substantive problems. Similarly, receiver operating characteristic (ROC) analysis, a method used in evaluating diagnostic tests or biomarkers in medical research, has also been increasingly popular problem in both its development and application. While missing-data methods have been applied in ROC analysis, the impact of model mis-specification and/or assumptions (e.g. missing at random) underlying the missing data has not been thoroughly studied. In this work, we study the performance of multiple imputation (MI) inference in ROC analysis. Particularly, we investigate parametric and non-parametric techniques for MI inference under common missingness mechanisms. Depending on the coherency of the imputation model with the underlying data generation mechanism, our results show that MI generally leads to well-calibrated inferences under ignorable missingness mechanisms.     

A multiple imputation approach to nonlinear mixed-effects models with covariate measurement errors and missing values

In longitudinal studies, nonlinear mixed-effects models have been widely applied to describe the intra- and the inter-subject variations in data. The inter-subject variation usually receives great attention and it may be partially explained by time-dependent covariates. However, some covariates may be measured with substantial errors and may contain missing values. We proposed a multiple imputation method, implemented by a Markov Chain Monte-Carlo method along with Gibbs sampler, to address the covariate measurement errors and missing data in nonlinear mixed-effects models. The multiple imputation method is illustrated in a real data example. Simulation studies show that the multiple imputation method outperforms the commonly used naive methods.     

Missing data: Discussion points from the PSI missing data expert group

The Points to Consider Document on Missing Data was adopted by the Committee of Health and Medicinal Products (CHMP) in December 2001. In September 2007 the CHMP issued a recommendation to review the document, with particular emphasis on summarizing and critically appraising the pattern of drop‐outs, explaining the role and limitations of the ‘last observation carried forward’ method and describing the CHMP's cautionary stance on the use of mixed models. In preparation for the release of the updated guidance document, statisticians in the Pharmaceutical Industry held a one‐day expert group meeting in September 2008. Topics that were debated included minimizing the extent of missing data and understanding the missing data mechanism, defining the principles for handling missing data and understanding the assumptions underlying different analysis methods. A clear message from the meeting was that at present, biostatisticians tend only to react to missing data. Limited pro‐active planning is undertaken when designing clinical trials. Missing data mechanisms for a trial need to be considered during the planning phase and the impact on the objectives assessed. Another area for improvement is in the understanding of the pattern of missing data observed during a trial and thus the missing data mechanism via the plotting of data; for example, use of Kaplan–Meier curves looking at time to withdrawal. Copyright © 2009 John Wiley & Sons, Ltd.     

The impact of dichotomization in longitudinal data analysis: a simulation study

In this paper, a simulation study is conducted to systematically investigate the impact of dichotomizing longitudinal continuous outcome variables under various types of missing data mechanisms. Generalized linear models (GLM) with standard generalized estimating equations (GEE) are widely used for longitudinal outcome analysis, but these semi‐parametric approaches are only valid under missing data completely at random (MCAR). Alternatively, weighted GEE (WGEE) and multiple imputation GEE (MI‐GEE) were developed to ensure validity under missing at random (MAR). Using a simulation study, the performance of standard GEE, WGEE and MI‐GEE on incomplete longitudinal dichotomized outcome analysis is evaluated. For comparisons, likelihood‐based linear mixed effects models (LMM) are used for incomplete longitudinal original continuous outcome analysis. Focusing on dichotomized outcome analysis, MI‐GEE with original continuous missing data imputation procedure provides well controlled test sizes and more stable power estimates compared with any other GEE‐based approaches. It is also shown that dichotomizing longitudinal continuous outcome will result in substantial loss of power compared with LMM. Copyright © 2009 John Wiley & Sons, Ltd.     

Multiple imputation of missing data with ante-dependence covariance structure

A controlled clinical trial was conducted to investigate the efficacy effect of a chemical compound in the treatment of Premenstrual Dysphoric Disorder (PMDD). The data from the trial showed a non-monotone pattern of missing data and an ante-dependence covariance structure. A new analytical method for imputing the missing data with the ante-dependence covariance is proposed. The PMDD data are analysed by the non-imputation method and two imputation methods: the proposed method and the MCMC method.     

The estimation of R 2 and adjusted R 2 in incomplete data sets using multiple imputation

The coefficient of determination, known also as the R ², is a common measure in regression analysis. Many scientists use the R ² and the adjusted R ² on a regular basis. In most cases, the researchers treat the coefficient of determination as an index of ‘usefulness’ or ‘goodness of fit,’ and in some cases, they even treat it as a model selection tool. In cases in which the data is incomplete, most researchers and common statistical software will use complete case analysis in order to estimate the R ², a procedure that might lead to biased results. In this paper, I introduce the use of multiple imputation for the estimation of R ² and adjusted R ² in incomplete data sets. I illustrate my methodology using a biomedical example.     

Generating missing values for simulation purposes: a multivariate amputation procedure

Missing data form a ubiquitous problem in scientific research, especially since most statistical analyses require complete data. To evaluate the performance of methods dealing with missing data, researchers perform simulation studies. An important aspect of these studies is the generation of missing values in a simulated, complete data set: the amputation procedure. We investigated the methodological validity and statistical nature of both the current amputation practice and a newly developed and implemented multivariate amputation procedure. We found that the current way of practice may not be appropriate for the generation of intuitive and reliable missing data problems. The multivariate amputation procedure, on the other hand, generates reliable amputations and allows for a proper regulation of missing data problems. The procedure has additional features to generate any missing data scenario precisely as intended. Hence, the multivariate amputation procedure is an efficient method to accurately evaluate missing data methodology.     

Use of multiple imputation in supersampled nested case-control and case-cohort studies

Nested case-control and case-cohort studies are useful for studying associations between covariates and time-to-event when some covariates are expensive to measure. Full covariate information is collected in the nested case-control or case-cohort sample only, while cheaply measured covariates are often observed for the full cohort. Standard analysis of such case-control samples ignores any full cohort data. Previous work has shown how data for the full cohort can be used efficiently by multiple imputation of the expensive covariate(s), followed by a full-cohort analysis. For large cohorts this is computationally expensive or even infeasible. An alternative is to supplement the case-control samples with additional controls on which cheaply measured covariates are observed. We show how multiple imputation can be used for analysis of such supersampled data. Simulations show that this brings efficiency gains relative to a traditional analysis and that the efficiency loss relative to using the full cohort data is not substantial.     

Missing data in principal component analysis of questionnaire data: a comparison of methods

Principal component analysis (PCA) is a widely used statistical technique for determining subscales in questionnaire data. As in any other statistical technique, missing data may both complicate its execution and interpretation. In this study, six methods for dealing with missing data in the context of PCA are reviewed and compared: listwise deletion (LD), pairwise deletion, the missing data passive approach, regularized PCA, the expectation-maximization algorithm, and multiple imputation. Simulations show that except for LD, all methods give about equally good results for realistic percentages of missing data. Therefore, the choice of a procedure can be based on the ease of application or purely the convenience of availability of a technique.     

Asymptotic theory and inference of predictive mean matching imputation using a superpopulation model framework

Predictive mean matching imputation is popular for handling item nonresponse in survey sampling. In this article, we study the asymptotic properties of the predictive mean matching estimator for finite-population inference using a superpopulation model framework. We also clarify conditions for its robustness. For variance estimation, the conventional bootstrap inference is invalid for matching estimators with a fixed number of matches due to the nonsmoothness nature of the matching estimator. We propose a new replication variance estimator, which is asymptotically valid. The key strategy is to construct replicates directly based on the linear terms of the martingale representation for the matching estimator, instead of individual records of variables. Simulation studies confirm that the proposed method provides valid inference.     

基于数据缺失率和缺失模式的多重插补误差研究

文章通过多重插补方法对不同缺失率和缺失模式的多变量缺失样本进行插补,研究了多重插补误差与缺失率和缺失模式的依赖关系。结果表明,当缺失率为0~15%时,多重插补误差与缺失率呈线性关系;当缺失率大于15%时,两者呈偏离线性关系。多重插补误差与缺失模式的方差均值比呈正相关性,当方差均值比越大时,误差也越大。     

Multiple imputation of censored survival data in the presence of missing covariates using restricted mean survival time

Missing covariates data with censored outcomes put a challenge in the analysis of clinical data especially in small sample settings. Multiple imputation (MI) techniques are popularly used to impute missing covariates and the data are then analyzed through methods that can handle censoring. However, techniques based on MI are available to impute censored data also but they are not much in practice. In the present study, we applied a method based on multiple imputation by chained equations to impute missing values of covariates and also to impute censored outcomes using restricted survival time in small sample settings. The complete data were then analyzed using linear regression models. Simulation studies and a real example of CHD data show that the present method produced better estimates and lower standard errors when applied on the data having missing covariate values and censored outcomes than the analysis of the data having censored outcome but excluding cases with missing covariates or the analysis when cases with missing covariate values and censored outcomes were excluded from the data (complete case analysis).     

Missing data in clinical trials: from clinical assumptions to statistical analysis using pattern mixture models

The need to use rigorous, transparent, clearly interpretable, and scientifically justified methodology for preventing and dealing with missing data in clinical trials has been a focus of much attention from regulators, practitioners, and academicians over the past years. New guidelines and recommendations emphasize the importance of minimizing the amount of missing data and carefully selecting primary analysis methods on the basis of assumptions regarding the missingness mechanism suitable for the study at hand, as well as the need to stress‐test the results of the primary analysis under different sets of assumptions through a range of sensitivity analyses. Some methods that could be effectively used for dealing with missing data have not yet gained widespread usage, partly because of their underlying complexity and partly because of lack of relatively easy approaches to their implementation. In this paper, we explore several strategies for missing data on the basis of pattern mixture models that embody clear and realistic clinical assumptions. Pattern mixture models provide a statistically reasonable yet transparent framework for translating clinical assumptions into statistical analyses. Implementation details for some specific strategies are provided in an Appendix (available online as Supporting Information), whereas the general principles of the approach discussed in this paper can be used to implement various other analyses with different sets of assumptions regarding missing data. Copyright © 2013 John Wiley & Sons, Ltd.