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Avoiding bias in the analysis of longitudinal data

Data from repeated measurements or events are ubiquitous in trials and observational studies.

In many studies, data are collected on biomarkers, such as CD4 count in HIV infection, CA125 in ovarian cancer and PSA in prostate cancer. Biomarkers are often used to define different types of outcome measure, for example, the marker value or its change from baseline at fixed times after randomisation.

A single model for all the measurements gives a more complete picture of the effect of treatment over follow up, may reduce bias associated with missing data and may improve efficiency. However, we need to adapt or develop methodologies in this area as current methods are susceptible to bias. This is because they make strong and frequently unrealistic assumptions, and the bias may be severe in some circumstances.

Another methodological gap is the analysis of repeated events, such as adverse clinical events, in trials and observational studies. We typically wish to examine predictors of more serious events. The number of adverse events experienced by the patient varies and is frequently related to their severity (i.e. informative cluster size).

Standard methods such as random effects models or generalised estimating equations (GEE) can be appreciably biased and the methodology developed by others for informative cluster size data has not been explored thoroughly. The CTU collaborates with the MRC Biostatistics Unit in this area.

 

Key projects

  • Better analysis of repeated measurements data: better understanding of disease evolution and treatment comparisons in unit studies, investigation of bias in standard methods, development and promotion of methods that avoid bias and answer scientific questions of interest
  • Methods to analyse repeated events data where the number of events experienced by patients varies: better understanding of adverse events in studies, development and promotion of unbiased methods for analysis of these key outcome measures

 

Selected publications

  • Copas AJ, Seaman SR Bias from the use of generalised estimating equations to analyse incomplete longitudinal binary data J App Stats 2010 37: 911–922
  • Seaman S, Copas A. Doubly robust generalized estimating equations for longitudinal data. Statistics in Medicine 2009; 28:937-955
  • Harrison L, Dunn D, Green H, Copas AJ The Analysis of Change Over Time Accounting for Baseline Differences Stats in Med 2009 28: 3260-3275