Journal of Clinical Epidemiology
Volume 55, Issue 4 , Pages 329-337, April 2002

Attrition in longitudinal studies:

How to deal with missing data

  • Jos Twisk

      Affiliations

    • Corresponding Author InformationCorresponding author. Tel.: +31 20 4448405; fax: +31 20 4448181. E-mail address:(J. Twisk)
  • ,
  • Wieke de Vente

Institute for Research in Extramural Medicine, Vrije Universiteit, Vd Boechorststraat 7, 1081 BT Amsterdam, The Netherlands

Received 15 October 2000; received in revised form 20 July 2001; accepted 24 July 2001.

Abstract 

The purpose of this paper was to illustrate the influence of missing data on the results of longitudinal statistical analyses [i.e., MANOVA for repeated measurements and Generalised Estimating Equations (GEE)] and to illustrate the influence of using different imputation methods to replace missing data. Besides a complete dataset, four incomplete datasets were considered: two datasets with 10% missing data and two datasets with 25% missing data. In both situations missingness was considered independent and dependent on observed data. Imputation methods were divided into cross-sectional methods (i.e., mean of series, hot deck, and cross-sectional regression) and longitudinal methods (i.e., last value carried forward, longitudinal interpolation, and longitudinal regression). Besides these, also the multiple imputation method was applied and discussed. The analyses were performed on a particular (observational) longitudinal dataset, with particular missing data patterns and imputation methods. The results of this illustration shows that when MANOVA for repeated measurements is used, imputation methods are highly recommendable (because MANOVA as implemented in the software used, uses listwise deletion of cases with a missing value). Applying GEE analysis, imputation methods were not necessary. When imputation methods were used, longitudinal imputation methods were often preferable ab9ove cross-sectional imputation methods, in a way that the point estimates and standard errors were closer to the estimates derived from the complete dataset. Furthermore, this study showed that the theoretically more valid multiple imputation method did not lead to different point estimates than the more simple (longitudinal) imputation methods. However, the estimated standard errors appeared to be theoretically more adequate, because they reflect the uncertainty in estimation caused by missing values.

Keywords:  Attrition, Longitudinal studies, Missing data

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PII: S0895-4356(01)00476-0

Journal of Clinical Epidemiology
Volume 55, Issue 4 , Pages 329-337, April 2002