Three challenges described for identifying participants with missing data in trials reports, and potential solutions suggested to systematic reviewers
Por:
Akl, EA, Kahale, LA, Ebrahim, S, Alonso-Coello, P, Schunemann, HJ, Guyatt, GH
Publicada:
1 ago 2016
Resumen:
Objective: To categorize the challenges in determining the extent of missing participant data in randomized trials and suggest potential solutions for systematic review authors.
Study Design and Setting: During the process of updating a series of Cochrane systematic reviews on the topic of anticoagulation in patients with cancer, we identified challenges and used an iterative approach to improve, and a consensus process to agree on the challenges identified, and to suggest potential ways of dealing with them. The five systematic reviews included 58 trials and 75 meta-analyses for patient-important dichotomous outcomes with 27,037 randomized participants.
Results: We identified three categories of challenges: (1) Although systematic reviewers require information about missing data to be reported by outcome, trialists typically report the information by participant; (2) It is not always clear whether the trialists followed up participants in certain categories (e.g., noncompliers), that is, whether some categories of participants did or did not have missing data; (3) It is not always clear how the trialists dealt with missing data in their analysis (e.g., exclusion from the denominator vs. assumptions made for the numerator). We discuss potential solutions for each one of these challenges and suggest further research work.
Conclusion: Current reporting of missing data is often not explicit and transparent, and although our potential solutions to problems of suboptimal reporting may be helpful, reliable and valid characterization of the extent and nature of missing data remains elusive. Reporting of missing data in trials needs further improvement. (C) 2016 Elsevier Inc. All rights reserved.
Filiaciones:
Akl, EA:
Amer Univ Beirut, Dept Internal Med, Riad El Solh Beirut 1107, Beirut 2020, Lebanon
McMaster Univ, Dept Clin Epidemiol & Biostat, 1280 Main St W, Hamilton, ON L8S 4L8, Canada
Kahale, LA:
Amer Univ Beirut, Dept Internal Med, Riad El Solh Beirut 1107, Beirut 2020, Lebanon
Ebrahim, S:
McMaster Univ, Dept Clin Epidemiol & Biostat, 1280 Main St W, Hamilton, ON L8S 4L8, Canada
Univ Toronto, Inst Hlth Policy Management & Evaluat, 27 Kings Coll Cir, Toronto, ON M5S, Canada
Univ Toronto, Hosp Sick Children, Dept Anesthesia & Pain Med, 27 Kings Coll Cir, Toronto, ON M5S, Canada
Stanford Univ, Dept Med, 450 Serra Mall, Stanford, CA 94305 USA
Alonso-Coello, P:
Biomed Res Inst St Pau CIBERESP IIB St Pau, Iberoamer Cochrane Ctr, Pavello 18 Planta 0 St Antoni M Claret 167, Barcelona 08025, Spain
Schunemann, HJ:
McMaster Univ, Dept Clin Epidemiol & Biostat, 1280 Main St W, Hamilton, ON L8S 4L8, Canada
McMaster Univ, Dept Med, 1280 Main St W, Hamilton, ON L8S 4L8, Canada
Guyatt, GH:
McMaster Univ, Dept Clin Epidemiol & Biostat, 1280 Main St W, Hamilton, ON L8S 4L8, Canada
McMaster Univ, Dept Med, 1280 Main St W, Hamilton, ON L8S 4L8, Canada
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