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Clinical Trials
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Direct likelihood analysis versus simple forms of imputation for missing data in randomized clinical trials

Caroline Beunckens

Center for Statistics, Limburgs Universitair Centrum, Diepenbeek, Belgium

Geert Molenberghs

Center for Statistics, Limburgs Universitair Centrum, Universitaire Campus, Building D, B–3590 Diepenbeek, Belgium; geert.molenberghs{at}luc.ac.be

Michael G Kenward

London School of Hygiene & Tropical Medicine, London, UK

Background In many clinical trials, data are collected longitudinally over time. In such studies, missingness, in particular dropout, is an often encountered phenomenon.

Methods We discuss commonly used but often problematic methods such as complete case analysis and last observation carried forward and contrast them with broadly valid and easy to implement direct-likelihood methods. We comment on alternatives such as multiple imputation and the expectation-maximization algorithm.

Results We apply these methods in particular to data from a study with continuous outcomes. The outcomes are modelled using a general linear mixed-effects model. The bias with CC and LOCF is established in the case study and the advantages of the direct-likelihood approach shown.

Conclusions We have established formal but easy to understand arguments for a shift towards a direct-likelihood paradigm when analysing incomplete data from longitudinal clinical trials, necessitating neither imputation nor deletion.

Clinical Trials, Vol. 2, No. 5, 379-386 (2005)
DOI: 10.1191/1740774505cn119oa


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