Operational research in social security

In this paper we describe the work of the Department of Health and Social Security Operational Research (OR) Unit in Social Security. This work started in 1972 and with one break of eighteen months still continues. One of the authors (AFH) led the OR team from the beginning until September 1979 and the other (MJP) was the customer for much of its work. We describe briefly the organisation of social security work, and go on to talk about some of the projects attempted by the OR team. We will not shrink from describing some of the successes but we will concentrate most attention on the things which did not achieve the expected results. Readers will make their own judgements about the extent to which the failures were due to circumstances or to inadequacies of the team, or its leader.     

Testing the proportional odds assumption in multiply imputed ordinal longitudinal data

A popular choice when analyzing ordinal data is to consider the cumulative proportional odds model to relate the marginal probabilities of the ordinal outcome to a set of covariates. However, application of this model relies on the condition of identical cumulative odds ratios across the cut-offs of the ordinal outcome; the well-known proportional odds assumption. This paper focuses on the assessment of this assumption while accounting for repeated and missing data. In this respect, we develop a statistical method built on multiple imputation (MI) based on generalized estimating equations that allows to test the proportionality assumption under the missing at random setting. The performance of the proposed method is evaluated for two MI algorithms for incomplete longitudinal ordinal data. The impact of both MI methods is compared with respect to the type I error rate and the power for situations covering various numbers of categories of the ordinal outcome, sample sizes, rates of missingness, well-balanced and skewed data. The comparison of both MI methods with the complete-case analysis is also provided. We illustrate the use of the proposed methods on a quality of life data from a cancer clinical trial.     

A Simulation Study Comparing Multiple Imputation Methods for Incomplete Longitudinal Ordinal Data

Multiple imputation (MI) is now a reference solution for handling missing data. The default method for MI is the Multivariate Normal Imputation (MNI) algorithm that is based on the multivariate normal distribution. In the presence of longitudinal ordinal missing data, where the Gaussian assumption is no longer valid, application of the MNI method is questionable. This simulation study compares the performance of the MNI and ordinal imputation regression model for incomplete longitudinal ordinal data for situations covering various numbers of categories of the ordinal outcome, time occasions, sample sizes, rates of missingness, well-balanced, and skewed data.