Development of guidelines to reduce, handle and report missing data in palliative care trials: a multi-stakeholder modified nominal group technique

Jamilla A Hussain, Ian R White*, Miriam J Johnson, Anthony Byrne, Nancy J Preston , Andy Haines, Kathy Seddon, TJ Peters

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

7 Citations (Scopus)
92 Downloads (Pure)

Abstract

Background: Missing data can introduce bias and reduce the power, precision and generalisability of study findings. Guidelines on how to address missing data are limited in scope and detail, and poorly implemented.

Aim: To develop guidelines on how best to (i) reduce, (ii) handle and (iii) report missing data in palliative care clinical trials.

Design: Modified nominal group technique.

Setting/participants: Patient and public research partners, palliative care clinicians, trialists, methodologists and statisticians attended a one-day workshop, following which a multi-stakeholder development group drafted the guidelines.

Results: Seven main recommendations for reducing missing data, nine for handling missing data and 12 for reporting missing data were developed. The top five recommendations were: (i) train all research staff on missing data, (ii) prepare for missing data at the trial design stage, (iii) address missing data in the statistical analysis plan, (iv) collect the reasons for missing data and (v) report descriptive statistics comparing the baseline characteristics of those with missing and observed data. Reducing missing data, preparing for missing data and understanding the reasons for missing data were greater priorities for stakeholders than how to deal with missing data once they had occurred.

Conclusion: Comprehensive guidelines on how to address missing data were developed by stakeholders involved in palliative care trials. Implementation of the guidelines will require endorsement of research funders and research journals.
Original languageEnglish
Pages (from-to) 59–70
Number of pages12
JournalPalliative Medicine
Volume36
Issue number1
Early online date17 Jan 2022
DOIs
Publication statusE-pub ahead of print - 17 Jan 2022

Bibliographical note

Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Funding for the workshop and administrative support was provided by Marie Curie. JAH was funded as part of a National Institute of Health Research Doctoral Research Fellowship (reference number DRF-2013-06-001) and NIHR Clinical Lectureship. The National Institute of Health Research was not involved in the study design, data collection, analysis, interpretation of data, writing of the report, or in the decision to submit the article for publication. IRW was supported by the Medical Research Council Programmes MC_UU_00004/07 and MC_UU_00004/09.

Publisher Copyright:
© The Author(s) 2022.

Keywords

  • Missing data
  • lost to follow up
  • randomised controlled trials
  • palliative care
  • palliative medicine
  • guidelines

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