Inference in randomized trials with death and missingness

Biometrics. 2017 Jun;73(2):431-440. doi: 10.1111/biom.12594. Epub 2016 Oct 17.

Abstract

In randomized studies involving severely ill patients, functional outcomes are often unobserved due to missed clinic visits, premature withdrawal, or death. It is well known that if these unobserved functional outcomes are not handled properly, biased treatment comparisons can be produced. In this article, we propose a procedure for comparing treatments that is based on a composite endpoint that combines information on both the functional outcome and survival. We further propose a missing data imputation scheme and sensitivity analysis strategy to handle the unobserved functional outcomes not due to death. Illustrations of the proposed method are given by analyzing data from a recent non-small cell lung cancer clinical trial and a recent trial of sedation interruption among mechanically ventilated patients.

Keywords: Composite endpoint; Death-truncated data; Missing data; Sensitivity analysis.

MeSH terms

  • Carcinoma, Non-Small-Cell Lung
  • Female
  • Humans
  • Lung Neoplasms
  • Pregnancy
  • Premature Birth
  • Randomized Controlled Trials as Topic*