2014, Number 1
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VacciMonitor 2014; 23 (1)
Recommendations for the prevention and treatment of incomplete data in clinical assays
Robaina M, Uranga R, Fors MM, Viada C
Language: Spanish
References: 14
Page: 32-36
PDF size: 65.93 Kb.
ABSTRACT
Several researches in applied statistics show a broad theoretical development and diversity of perspectives to
address the problem of incomplete data in clinical trials. Recent publications show consensus and establish
guidelines to mitigate potential biases that causes this problem when data are analyzed. This article will summarize
some of the key recommendations to better address the prevention and treatment of incomplete data in clinical
trials presented in a report by international experts in 2010 and also referred to the provisions of the regulatory
bodies with emphasis on the most recent (2011). There is consensus that the main strategy is to prevent possible
incomplete data from the design and conduct of the study. Recommendations are also set to the time of analysis,
which basically emphasizes the need of using any available information of all randomized subjects, and implement
more sensitive strategies for the inference, that always includes assessing the sensitivity of the results. In 2011
was published a methodological guide -adopted by the European Medicines Agency (EMA)- which provides
necessary information from the regulatory perspective to ensure the quality of the results in confirmatory clinical
trials. The problem of incomplete data is sometimes unavoidable and should not be ignored, it is necessary to
apply appropriate design and analysis strategies. The quality in the presenting results is essential, to avoid
biased conclusions and interpretations of the study.
REFERENCES
Carpenter JR, Kenward MG. Missing data in randomised controlled trials—a practical guide. Birmingham: National Institute for Health Research, Publication RM03/JH17/MK. 2008. Disponible en: http://www.haps.bham.ac.uk/publichealth/ methodology/projects/ RM03_JH17_MK.shtml
International Conference on Harmonisation (ICH-E9): Statistical Principles for Clinical Trials. Tripartite Harmonised Guideline, ICH 1998. Disponible en: http://www.ich.org/cache/compo/276- 254-1.html.
Lachin JM. Statistical considerations in the intent-to-treat principle. Control Clin Trials 2000;21:167-89.
White IR, Carpenter J, Nicholas, HJ. Including all individuals is not enough: Lessons for intention-to-treat analysis. Clin Trials 2012;9:396-407.
Molenberghs G, Kenward M. Missing Data in Clinical Studies. New York: Springer-Verlag; 2007.
Rubin DB. Inference and missing data. Biometrika 1976;63(3):581-92.
Little RJ, D’Agostino R, Cohen ML, Dickersin K, Emerson SS, Farrar JT, et al. The Prevention and Treatment of Missing Data in Clinical Trials. N Engl J Med 2012;367:1355-60.
O’Neill RT, Temple R. The prevention and treatment of missing data in clinical trials: an FDA perspective on the importance of dealing with it. Clinical Pharmacology & Therapeutics 2012;91:550-4.
Wood MA, White RI, Thompson GS. Are missing outcome data adequately handled? A review of published randomized controlled trials in major medical journals. Clinical Trials 2004;1:368-76.
Molenberghs G, Thijs H, Jansen I, Beunckens C, Kenward MG, Mallinckrodt C, et al. Analyzing incomplete longitudinal clinical trial data. Biostatistics 2004;5:445-64.
National Research Council. The Prevention and Treatment of Missing Data in Clinical Trials. Panel on Handling Missing Data in Clinical Trials. Committee on National Statistics, Division of Behavioral and Social Sciences and Education. Washington, DC: National Academies; 2010.
Fleming TR. Addressing Missing Data in Clinical Trials. Ann Intern Med 2011;154:113-7 .
Agencia Europea de Medicamentos (EMA). Guideline on missing data in confirmatory clinical trials. (CPMP/EWP/1776/ 99); 2009. Disponible en: ww.ema.europa.eu/pdfs/human/ ewp/177699endraft.pdf.
Agencia Europea de Medicamentos (EMA). Points to consider on missing data; 2001. Disponible en: www.ema.europa.eu/ docs/en_GB/document.../09/WC500003641.pdf.