Ahn Jaeil, Ahn Hye Seong
Department of Biostatistics, Bioinformatics, and Biomathematics, Georgetown University, USA.
Department of Surgery, Seoul National University Boramae Medical Center, Korea.
Stat Methods Med Res. 2020 May;29(5):1354-1367. doi: 10.1177/0962280219862001. Epub 2019 Jul 11.
Health-related quality of life consists of multi-dimensional measurements of physical and mental health domains. Health-related quality of life is often followed up to evaluate efficacy of treatments in clinical studies. During the follow-up period, a missing data problem inevitably arises. When missing data occur for reasons related to poor health-related quality of life, a complete-case only analysis can lead to invalid inferences. We propose a Bayesian approach to analyze longitudinal moderate to high-dimensional multivariate outcome data in the presence of non-ignorable missing data. To account for non-ignorable missing data, we employ a selection model for the joint likelihood factorization where we apply Bayesian spike and slab variable selection in the missing data mechanism to detect informative factors among multiple outcomes. We model the relationship between multiple outcomes and covariates using linear mixed effects models where multiple outcome correlations are captured by a hierarchical structure. We conduct simulation studies to evaluate the performance of the proposed method compared with the conventional last observation carried forward approach. We use a motivating example that originates from a longitudinal study of quality of life in gastric cancer patients who underwent distal gastrectomy. In this application, we demonstrate that our proposed method can offer efficiency gain in the marginal associations and provide the associations between outcomes and the absence of patients' information.
健康相关生活质量由身心健康领域的多维度测量组成。在临床研究中,健康相关生活质量常被用于跟踪评估治疗效果。在随访期间,不可避免地会出现数据缺失问题。当因与健康相关生活质量较差有关的原因出现数据缺失时,仅进行完整病例分析可能会导致无效推断。我们提出一种贝叶斯方法,用于在存在不可忽视的缺失数据的情况下分析纵向中高维多变量结局数据。为了处理不可忽视的缺失数据,我们采用选择模型进行联合似然分解,在缺失数据机制中应用贝叶斯尖峰和平板变量选择来检测多个结局中的信息性因素。我们使用线性混合效应模型对多个结局与协变量之间的关系进行建模,其中多个结局的相关性通过层次结构来捕捉。我们进行模拟研究,以评估所提出方法与传统的末次观察结转方法相比的性能。我们使用一个源于对接受远端胃切除术的胃癌患者生活质量进行纵向研究的实例。在这个应用中,我们证明我们提出的方法可以在边际关联方面提高效率,并提供结局与患者信息缺失之间的关联。