Comparing the performance of different multiple imputation strategies for missing binary outcomes in cluster randomized trials: a simulation study
Bibliographic record
Abstract
Jinhui Ma,1–3 Parminder Raina,1,2 Joseph Beyene,1 Lehana Thabane1,3–51Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada; 2McMaster University Evidence-based Practice Center, Hamilton, ON, Canada; 3Biostatistics Unit, St Joseph's Healthcare Hamilton, Hamilton, ON, Canada; 4Centre for Evaluation of Medicines, St Joseph's Healthcare Hamilton, Hamilton, ON, Canada; 5Population Health Research Institute, Hamilton Health Sciences, Hamilton, ON, CanadaIntroduction: Although researchers have proposed various strategies to handle missing outcomes in cluster randomized trials (CRTs), limited attention has been paid to the performance of these strategies. Under the assumption of covariate-dependent missingness, the objective of this simulation study is to compare the performance of various strategies in handling missing binary outcomes in CRTs under different design settings.Methods: There are six missing data strategies investigated in this paper, which include complete case analysis, standard multiple imputation (MI) strategies using either logistic regression or Markov chain Monte Carlo (MCMC) method, within-cluster MI strategies using either logistic regression or MCMC method, and MI using logistic regression with cluster as a fixed effect. The performance of these strategies is evaluated through bias, empirical standard error, root mean squared error, and coverage probability.Results: Under the assumption of covariate-dependent missingness and applying the generalized estimating equations approach for fitting the logistic regression, it was shown that complete case analysis yields valid inferences when the percentage of missing outcomes is not large (<20%) for all the designs of CRTs considered in this paper. Standard MI strategies can be adopted when the design effect is small (variance inflation factor [VIF] ≤ 3); however, they tend to underestimate the standard error of treatment effect when the design effect is large. Within-cluster MI strategy using logistic regression is valid for imputation of missing data from CRTs, especially when the cluster size is large (>50) and the design effect is large (VIF > 3). In contrast, within-cluster MI strategy using MCMC method may yield biased estimates of treatment effect for CRTs with small cluster size (≤50). MI using logistic regression with cluster as a fixed effect may substantially overestimate the standard error of the estimated treatment effect when the intracluster correlation coefficient is small. It may also lead to biased estimated treatment effect.Conclusion: Findings from this simulation study provide researchers with quantitative evidence to guide selection of an appropriate strategy to deal with missing binary outcomes.Keywords: missing data, design effect, variance inflation factor
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.100 | 0.262 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.005 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.003 | 0.002 |
| Research integrity | 0.003 | 0.003 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".