Handling trial participants with missing outcome data when conducting a meta-analysis: a systematic survey of proposed approaches

Akl, Elie A.; Kahale, Lara A; Agoritsas, Thomas; Brignardello‐Petersen, Romina; Busse, Jason W.; Carrasco-Labra, Alonso; Ebrahim, Shanil; Johnston, Bradley C.; Neumann, Ignacio; Solà, Iván; Sun, Xin; Vandvik, Per Olav; Zhang, Yuqing; Alonso‐Coello, Pablo; Guyatt, Gordon

doi:10.1186/s13643-015-0083-6

Cited by 50 publications

(35 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We identified 69 citations that fulfilled our eligibility criteria on this HIV topic with only 24 studies addressing the missing data problem on the estimation of HIV prevalence during analysis. The same trend of fewer studies addressing the missing data problem is observed in other design like clinical trials and HIV longitudinal studies measuring different outcome [72]. The major reason for the missingness was reported to be a refusal to consent for an HIV test, and with complete case analysis be the primary method of analysis used.…”

Section: Discussionmentioning

confidence: 77%

Analytical methods used in estimating the prevalence of HIV/AIDS from demographic and cross-sectional surveys with missing data: a systematic review

Mosha

Aluko

Todd

et al. 2020

BMC Med Res Methodol

View full text Add to dashboard Cite

Background: Sero-prevalence studies often have a problem of missing data. Few studies report the proportion of missing data and even fewer describe the methods used to adjust the results for missing data. The objective of this review was to determine the analytical methods used for analysis in HIV surveys with missing data. Methods:We searched for population, demographic and cross-sectional surveys of HIV published from January 2000 to April 2018 in Pub Med/Medline, Web of Science core collection, Latin American and Caribbean Sciences Literature, Africa-Wide Information and Scopus, and by reviewing references of included articles. All potential abstracts were imported into Covidence and abstracts screened by two independent reviewers using pre-specified criteria. Disagreements were resolved through discussion. A piloted data extraction tool was used to extract data and assess the risk of bias of the eligible studies. Data were analysed through a quantitative approach; variables were presented and summarised using figures and tables. Results: A total of 3426 citations where identified, 194 duplicates removed, 3232 screened and 69 full articles were obtained. Twenty-four studies were included. The response rate for an HIV test of the included studies ranged from 32 to 96% with the major reason for the missing data being refusal to consent for an HIV test. Complete case analysis was the primary method of analysis used, multiple imputations 11(46%) was the most advanced method used, followed by the Heckman's selection model 9(38%). Single Imputation and Instrumental variables method were used in only two studies each, with 13(54%) other different methods used in several studies. Forty-two percent of the studies applied more than two methods in the analysis, with a maximum of 4 methods per study. Only 6(25%) studies conducted a sensitivity analysis, while 11(46%) studies had a significant change of estimates after adjusting for missing data. Conclusion:Missing data in survey studies is still a problem in disease estimation. Our review outlined a number of methods that can be used to adjust for missing data on HIV studies; however, more information and awareness are needed to allow informed choices on which method to be applied for the estimates to be more reliable and representative.

show abstract

Section: Discussionmentioning

confidence: 77%

Analytical methods used in estimating the prevalence of HIV/AIDS from demographic and cross-sectional surveys with missing data: a systematic review

Mosha

Aluko

Todd

et al. 2020

BMC Med Res Methodol

View full text Add to dashboard Cite

show abstract

“…All missing data will be reported. We will conduct a sensitivity analysis with (1) best‐worst and (2) worst‐best scenarios if patients are lost to follow up: Best‐worst scenario: all patients lost to follow up in the intervention group have not had the outcome of interest, and all patients lost to follow up in the control group have had the outcome of interest Worst‐best scenario: all patients lost to follow up in the intervention group have had the outcome of interest, and all patients lost to follow up in the control group have not had the outcome of interest …”

Section: Methodsmentioning

confidence: 99%

Piperacillin/tazobactam vs carbapenems for patients with bacterial infection: Protocol for a systematic review

Petersen

Perner

Sjövall

et al. 2019

Acta Anaesthesiol Scand

View full text Add to dashboard Cite

Introduction Early empirical broad‐spectrum antimicrobial therapy is recommended for patients with severe infections, including sepsis. β‐lactam/β‐lactamase inhibitor combinations or carbapenems are often used to ensure coverage of likely pathogens. Piperacillin/tazobactam is proposed as a carbapenem‐sparing agent to reduce the incidence of multidrug‐resistant bacteria and superinfections. In the recently published MERINO trial, increased mortality from piperacillin/tazobactam was suggested in patients with bacteraemia with resistant Escherichia coli or Klebsiella species. Whether these findings also apply to empirical piperacillin/tazobactam in patients with other severe infections, including sepsis, is unknown. We aim to assess the benefits and harms of empirical and definitive piperacillin/tazobactam vs carbapenems for patients with severe bacterial infections. Methods and analysis This protocol has been prepared according to the Preferred Reporting Items for Systematic Review and Meta‐Analysis Protocols statement, the Cochrane Handbook and the Grading of Recommendations, Assessment, Development, and Evaluation approach. We will include randomised clinical trials assessing piperacillin/tazobactam vs carbapenems in patients with severe bacterial infections of any origin. The primary outcome will be all‐cause short‐term mortality ≤ 90 days. Secondary outcomes will include all‐cause long‐term mortality > 90 days, adverse events, quality of life, use of life support, secondary infections, antibiotic resistance, and length of stay. We will conduct meta‐analyses, including pre‐planned subgroup and sensitivity analyses for all assessed outcomes. The risk of random errors in the meta‐analyses will be assessed by trial sequential analysis.

show abstract

“…Corresponding authors of the included trials with incomplete data including unclear risk of bias ratings will be contacted for additional data. Imputation of missing data will be considered …”

Section: Methodsmentioning

confidence: 99%

Corticosteroids and risk of gastrointestinal bleeding in critically ill adults: Protocol for a systematic review

Butler

Møller

Granholm

et al. 2018

Acta Anaesthesiol Scand

View full text Add to dashboard Cite

show abstract

Handling trial participants with missing outcome data when conducting a meta-analysis: a systematic survey of proposed approaches

Cited by 50 publications

References 20 publications

Analytical methods used in estimating the prevalence of HIV/AIDS from demographic and cross-sectional surveys with missing data: a systematic review

Analytical methods used in estimating the prevalence of HIV/AIDS from demographic and cross-sectional surveys with missing data: a systematic review

Piperacillin/tazobactam vs carbapenems for patients with bacterial infection: Protocol for a systematic review

Corticosteroids and risk of gastrointestinal bleeding in critically ill adults: Protocol for a systematic review

Contact Info

Product

Resources

About