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Missing data and the trouble with LOCF
  1. David L Streiner
  1. David L Streiner, Assistant VP, Research, and Director, Kunin-Lunenfeld Applied Research Unit, Baycrest Centre for Geriatric Care and Professor, Department of Psychiatry, University of Toronto, Canada; dstreiner{at}klaru-baycrest.on.ca

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Missing data are the bane of all clinical research. With the possible exception of the CAPRIE trial,1 in which the investigators went to extraordinary lengths that enabled them to followup 99.8% of their 19 000 participants over two years, it is highly unusual for a study to end with complete data on all subjects. There are many reasons for this: a person may omit an item on a questionnaire or refuse to complete it entirely; a vial of blood may be dropped or the analyser fail to function one day; or a participant may not appear for his or her appointment. Longitudinal studies (those that follow participants over time) can be subject to all of these mishaps, but now the problem is magnified in that they could happen at each of the assessment sessions; in addition to which, participants may drop out of the study entirely before all the data are collected. Furthermore, the more sophisticated, multivariable statistical techniques that use two or more variables in the same analysis, such as multiple regression or factor analysis, make the problem even worse, in that most of them require complete data for all of the subjects. If a person is missing one variable out of the, say, 10 that are being analysed, then that subject is dropped entirely from the analysis. Simulations have shown that if as little as 10% of the data is missing, as many as 60% of the subjects could be eliminated.2

One consequence of missing data is a loss of statistical power: differences between groups that would be statistically significant may no longer be so because of the reduced sample size. It may appear at first glance that this is a relatively simple problem to remedy—begin with more people to allow for missing data, or recruit more …

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