Cost-effectiveness analysis with informative missing data
Abstract: Missing data is a common issue in cost-effectiveness analysis (CEA) of randomised trials. Methods such as multiple imputation are now commonly used to account for the missing values assuming the data to be ‘missing at random’ (MAR). In many settings, it seems however plausible that the data may be ‘missing not at random’ (MNAR, or ‘informative’). For example, patients whose health status is relatively poor may be less likely to return quality-of-life questionnaires, even after conditioning on the observed data. In these circumstances, methodological guidance recommends assessing whether cost-effectiveness inferences are sensitive to different missing data assumptions, but most published CEA studies fail to do this. My PhD aims to develop a practical and accessible framework to analyse, report, and interpret cost-effectiveness analysis of randomised trials under informative missing data assumptions.
In the first part of this seminar, we will introduce the issue of missing data and informative missingness in cost-effectiveness analysis, and describe some possible methods to perform analysis under MNAR. We will illustrate these methods with the 10 Top Tips trial, evaluating an intervention for weight loss in primary care.
The presentation will be followed by an interactive discussion, for those interested. The aim will be to discuss practical issues and ensure the methods developed during the PhD are relevant to those who may be using them. In particular, we would like to have your views on: what do you think are the current barriers to wider use of MNAR sensitivity analyses? Which analytical approach(es) appear to be the most relevant for CEA? How to present the results in a way that is readily understood by analysts and decision makers?
Note that the seminar will be split into two parts. A 45 minutes presentation (12.45-13.30), followed by a 30 minutes group discussion (13.30-14.00). Feel free to attend either or both parts.
Contact Organisers:
Richard Iles ([email protected])
Stephen O’Neill ([email protected])
Slides of previous seminars can be found here.
Admission