Bazo-Alvarez Juan Carlos, Morris Tim P, Carpenter James R, Petersen Irene
Research Department of Primary Care and Population Health, University College London (UCL), London, UK.
School of Medicine, Universidad Cesar Vallejo, Trujillo, Peru.
Clin Epidemiol. 2021 Jul 23;13:603-613. doi: 10.2147/CLEP.S314020. eCollection 2021.
Missing data can produce biased estimates in interrupted time series (ITS) analyses. We reviewed recent ITS investigations on health topics for determining 1) the data management strategies and statistical analysis performed, 2) how often missing data were considered and, if so, how they were evaluated, reported and handled.
This was a scoping review following standard recommendations from the PRISMA Extension for Scoping Reviews. We included a random sample of all ITS studies that assessed any intervention relevant to health care (eg, policies or programmes) with individual-level data, published in 2019, with abstracts indexed on MEDLINE.
From 732 studies identified, we finally reviewed 60. Reporting of missing data was rare. Data aggregation, statistical tools for modelling population-level data and complete case analyses were preferred, but these can lead to bias when data are missing at random. Seasonality and other time-dependent confounders were rarely accounted for and, when they were, missing data implications were typically ignored. Very few studies reflected on the consequences of missing data.
Handling and reporting of missing data in recent ITS studies performed for health research have many shortcomings compared with best practice.
在中断时间序列(ITS)分析中,缺失数据可能会产生有偏差的估计。我们回顾了近期关于健康主题的ITS调查,以确定:1)所采用的数据管理策略及进行的统计分析;2)考虑缺失数据的频率,若考虑了,又是如何对其进行评估、报告和处理的。
这是一项遵循PRISMA扩展范围综述标准建议的范围综述。我们纳入了2019年发表的、使用个体层面数据评估任何与医疗保健相关干预措施(如政策或项目)的所有ITS研究的随机样本,其摘要在MEDLINE上被索引。
从识别出的732项研究中,我们最终回顾了60项。对缺失数据的报告很少见。数据汇总、用于对总体层面数据进行建模的统计工具以及完整病例分析是首选方法,但当数据随机缺失时,这些方法可能会导致偏差。季节性和其他随时间变化的混杂因素很少被考虑,即便考虑了,通常也会忽略缺失数据的影响。很少有研究思考缺失数据的后果。
与最佳实践相比,近期用于健康研究的ITS研究中,缺失数据的处理和报告存在许多不足。