Approaches for missing covariate data in logistic regression with MNAR sensitivity analyses

Data with missing covariate values but fully observed binary outcomes are an important subset of the missing data challenge. Common approaches are complete case analysis (CCA) and multiple imputation (MI). While CCA relies on missing completely at random (MCAR), MI usually relies on a missing at random (MAR) assumption to produce unbiased results. For MI involving logistic regression models, it is also important to consider several missing not at random (MNAR) conditions under which CCA is asymptotically unbiased and, as we show, MI is also valid in some cases. We use a data application and simulation study to compare the performance of several machine learning and parametric MI methods under a fully conditional specification framework (MI-FCS). Our simulation includes five scenarios involving MCAR, MAR, and MNAR under predictable and nonpredictable conditions, where “predictable” indicates missingness is not associated with the outcome. We build on previous results in the literature to show MI and CCA can both produce unbiased results under more conditions than some analysts may realize. When both approaches were valid, we found that MI-FCS was at least as good as CCA in terms of estimated bias and coverage, and was superior when missingness involved a categorical covariate. We also demonstrate how MNAR sensitivity analysis can build confidence that unbiased results were obtained, including under MNAR-predictable, when CCA and MI are both valid. Since the missingness mechanism cannot be identified from observed data, investigators should compare results from MI and CCA when both are plausibly valid, followed by MNAR sensitivity analysis.     

Smoothed empirical likelihood inference for ROC curve in the presence of missing biomarker values

This paper considers statistical inference for the receiver operating characteristic (ROC) curve in the presence of missing biomarker values by utilizing estimating equations (EEs) together with smoothed empirical likelihood (SEL). Three approaches are developed to estimate ROC curve and construct its SEL-based confidence intervals based on the kernel-assisted EE imputation, multiple imputation, and hybrid imputation combining the inverse probability weighted imputation and multiple imputation. Under some regularity conditions, we show asymptotic properties of the proposed maximum SEL estimators for ROC curve. Simulation studies are conducted to investigate the performance of the proposed SEL approaches. An example is illustrated by the proposed methodologies. Empirical results show that the hybrid imputation method behaves better than the kernel-assisted and multiple imputation methods, and the proposed three SEL methods outperform existing nonparametric method.     

Cox regression with survival-time-dependent missing covariate values

Analysis with time-to-event data in clinical and epidemiological studies often encounters missing covariate values, and the missing at random assumption is commonly adopted, which assumes that missingness depends on the observed data, including the observed outcome which is the minimum of survival and censoring time. However, it is conceivable that in certain settings, missingness of covariate values is related to the survival time but not to the censoring time. This is especially so when covariate missingness is related to an unmeasured variable affected by the patient's illness and prognosis factors at baseline. If this is the case, then the covariate missingness is not at random as the survival time is censored, and it creates a challenge in data analysis. In this article, we propose an approach to deal with such survival-time-dependent covariate missingness based on the well known Cox proportional hazard model. Our method is based on inverse propensity weighting with the propensity estimated by nonparametric kernel regression. Our estimators are consistent and asymptotically normal, and their finite-sample performance is examined through simulation. An application to a real-data example is included for illustration.     

Score test for missing at random or not under logistic missingness models

Missing data are frequently encountered in various disciplines and can be divided into three categories: missing completely at random (MCAR), missing at random (MAR), and missing not at random (MNAR). Valid statistical approaches to missing data depend crucially on correct identification of the underlying missingness mechanism. Although the problem of testing whether this mechanism is MCAR or MAR has been extensively studied, there has been very little research on testing MAR versus MNAR. A critical challenge that is faced when dealing with this problem is the issue of model identification under MNAR. In this paper, under a logistic model for the missing probability, we develop two score tests for the problem of whether the missingness mechanism is MAR or MNAR under a parametric model and a semiparametric location model on the regression function. The implementation of the score tests circumvents the identification issue as it requires only parameter estimation under the null MAR assumption. Our simulations and analysis of human immunodeficiency virus data show that the score tests have well-controlled type I errors and desirable powers.     

Joint model selection of marginal mean regression and correlation structure for longitudinal data with missing outcome and covariates

This work develops a joint model selection criterion for simultaneously selecting the marginal mean regression and the correlation/covariance structure in longitudinal data analysis where both the outcome and the covariate variables may be subject to general intermittent patterns of missingness under the missing at random mechanism. The new proposal, termed “joint longitudinal information criterion” (JLIC), is based on the expected quadratic error for assessing model adequacy, and the second‐order weighted generalized estimating equation (WGEE) estimation for mean and covariance models. Simulation results reveal that JLIC outperforms existing methods performing model selection for the mean regression and the correlation structure in a two stage and hence separate manner. We apply the proposal to a longitudinal study to identify factors associated with life satisfaction in the elderly of Taiwan.     

A semiparametric empirical likelihood method for biased sampling schemes with auxiliary covariates

We consider a semiparametric inference procedure for data from epidemiologic studies conducted with a two-component sampling scheme where both a simple random sample and multiple outcome- or outcome-/auxiliary-dependent samples are observed. This sampling scheme allows the investigators to oversample certain subpopulations believed to have more information about the regression model while still gaining insights about the underlying population through the simple random sample. We focus on settings where there is no additional information about the parent cohort and the sampling probability is nonidentifiable. We motivate our problem with an ongoing study to assess the association between the mutation level of epidermal growth factor receptor (EGFR) and the antitumor response to EGFR-targeted therapy among nonsmall cell lung cancer patients. The proposed method applies to both binary and multicategorical outcome data and allows an arbitrary link function in the framework of generalized linear models. Simulation studies show that the proposed estimator has nice small sample properties. The proposed method is illustrated with a data example.     

Empirical‐likelihood‐based criteria for model selection on marginal analysis of longitudinal data with dropout missingness

Longitudinal data are common in clinical trials and observational studies, where missing outcomes due to dropouts are always encountered. Under such context with the assumption of missing at random, the weighted generalized estimating equation (WGEE) approach is widely adopted for marginal analysis. Model selection on marginal mean regression is a crucial aspect of data analysis, and identifying an appropriate correlation structure for model fitting may also be of interest and importance. However, the existing information criteria for model selection in WGEE have limitations, such as separate criteria for the selection of marginal mean and correlation structures, unsatisfactory selection performance in small‐sample setups, and so forth. In particular, there are few studies to develop joint information criteria for selection of both marginal mean and correlation structures. In this work, by embedding empirical likelihood into the WGEE framework, we propose two innovative information criteria named a joint empirical Akaike information criterion and a joint empirical Bayesian information criterion, which can simultaneously select the variables for marginal mean regression and also correlation structure. Through extensive simulation studies, these empirical‐likelihood‐based criteria exhibit robustness, flexibility, and outperformance compared to the other criteria including the weighted quasi‐likelihood under the independence model criterion, the missing longitudinal information criterion, and the joint longitudinal information criterion. In addition, we provide a theoretical justification of our proposed criteria, and present two real data examples in practice for further illustration.     

Estimating mean cost using auxiliary covariates

We study the estimation of mean medical cost when censoring is dependent and a large amount of auxiliary information is present. Under missing at random assumption, we propose semiparametric working models to obtain low-dimensional summarized scores. An estimator for the mean total cost can be derived nonparametrically conditional on the summarized scores. We show that when either the two working models for cost-survival process or the model for censoring distribution is correct, the estimator is consistent and asymptotically normal. Small-sample performance of the proposed method is evaluated via simulation studies. Finally, our approach is applied to analyze a real data set in health economics.     

Marginalized zero‐inflated Poisson models with missing covariates

Unlike zero‐inflated Poisson regression, marginalized zero‐inflated Poisson (MZIP) models for counts with excess zeros provide estimates with direct interpretations for the overall effects of covariates on the marginal mean. In the presence of missing covariates, MZIP and many other count data models are ordinarily fitted using complete case analysis methods due to lack of appropriate statistical methods and software. This article presents an estimation method for MZIP models with missing covariates. The method, which is applicable to other missing data problems, is illustrated and compared with complete case analysis by using simulations and dental data on the caries preventive effects of a school‐based fluoride mouthrinse program.     

Maximum likelihood estimation in random effects cure rate models with nonignorable missing covariates

We introduce a method of parameter estimation for a random effects cure rate model. We also propose a methodology that allows us to account for nonignorable missing covariates in this class of models. The proposed method corrects for possible bias introduced by complete case analysis when missing data are not missing completely at random and is motivated by data from a pair of melanoma studies conducted by the Eastern Cooperative Oncology Group in which clustering by cohort or time of study entry was suspected. In addition, these models allow estimation of cure rates, which is desirable when we do not wish to assume that all subjects remain at risk of death or relapse from disease after sufficient follow-up. We develop an EM algorithm for the model and provide an efficient Gibbs sampling scheme for carrying out the E-step of the algorithm.     

Censored quantile regression model with time-varying covariates under length-biased sampling

Quantile regression is a flexible and effective tool for modeling survival data and its relationship with important covariates, which often vary over time. Informative right censoring of data from the prevalent cohort within the population often results in length-biased observations. We propose an estimating equation-based approach to obtain consistent estimators of the regression coefficients of interest based on length-biased observations with time-dependent covariates. In addition, inspired by Zeng and Lin 2008, we also develop a more numerically stable procedure for variance estimation. Large sample properties including consistency and asymptotic normality of the proposed estimator are established. Numerical studies presented demonstrate convincing performance of the proposed estimator under various settings. The application of the proposed method is demonstrated using the Oscar dataset.     

Cox regression model with randomly censored covariates

This paper deals with a Cox proportional hazards regression model, where some covariates of interest are randomly right‐censored. While methods for censored outcomes have become ubiquitous in the literature, methods for censored covariates have thus far received little attention and, for the most part, dealt with the issue of limit‐of‐detection. For randomly censored covariates, an often‐used method is the inefficient complete‐case analysis (CCA) which consists in deleting censored observations in the data analysis. When censoring is not completely independent, the CCA leads to biased and spurious results. Methods for missing covariate data, including type I and type II covariate censoring as well as limit‐of‐detection do not readily apply due to the fundamentally different nature of randomly censored covariates. We develop a novel method for censored covariates using a conditional mean imputation based on either Kaplan–Meier estimates or a Cox proportional hazards model to estimate the effects of these covariates on a time‐to‐event outcome. We evaluate the performance of the proposed method through simulation studies and show that it provides good bias reduction and statistical efficiency. Finally, we illustrate the method using data from the Framingham Heart Study to assess the relationship between offspring and parental age of onset of cardiovascular events.     

Estimation in regression models for longitudinal binary data with outcome-dependent follow-up

In many observational studies, individuals are measured repeatedly over time, although not necessarily at a set of pre-specified occasions. Instead, individuals may be measured at irregular intervals, with those having a history of poorer health outcomes being measured with somewhat greater frequency and regularity. In this paper, we consider likelihood-based estimation of the regression parameters in marginal models for longitudinal binary data when the follow-up times are not fixed by design, but can depend on previous outcomes. In particular, we consider assumptions regarding the follow-up time process that result in the likelihood function separating into two components: one for the follow-up time process, the other for the outcome measurement process. The practical implication of this separation is that the follow-up time process can be ignored when making likelihood-based inferences about the marginal regression model parameters. That is, maximum likelihood (ML) estimation of the regression parameters relating the probability of success at a given time to covariates does not require that a model for the distribution of follow-up times be specified. However, to obtain consistent parameter estimates, the multinomial distribution for the vector of repeated binary outcomes must be correctly specified. In general, ML estimation requires specification of all higher-order moments and the likelihood for a marginal model can be intractable except in cases where the number of repeated measurements is relatively small. To circumvent these difficulties, we propose a pseudolikelihood for estimation of the marginal model parameters. The pseudolikelihood uses a linear approximation for the conditional distribution of the response at any occasion, given the history of previous responses. The appeal of this approximation is that the conditional distributions are functions of the first two moments of the binary responses only. When the follow-up times depend only on the previous outcome, the pseudolikelihood requires correct specification of the conditional distribution of the current outcome given the outcome at the previous occasion only. Results from a simulation study and a study of asymptotic bias are presented. Finally, we illustrate the main results using data from a longitudinal observational study that explored the cardiotoxic effects of doxorubicin chemotherapy for the treatment of acute lymphoblastic leukemia in children.