Systematic reviews do not adequately report or address missing outcome data in their analyses: a methodological survey

J Clin Epidemiol. 2018 Jul:99:14-23. doi: 10.1016/j.jclinepi.2018.02.016. Epub 2018 Mar 2.


Objectives: To describe how systematic review authors report and address categories of participants with potential missing outcome data of trial participants.

Study design and setting: Methodological survey of systematic reviews reporting a group-level meta-analysis.

Results: We included a random sample of 50 Cochrane and 50 non-Cochrane systematic reviews. Of these, 25 reported in their methods section a plan to consider at least one of the 10 categories of missing outcome data; 42 reported in their results, data for at least one category of missing data. The most reported category in the methods and results sections was "unexplained loss to follow-up" (n = 34 in methods section and n = 6 in the results section). Only 19 reported a method to handle missing data in their primary analyses, which was most often complete case analysis. Few reviews (n = 9) reported in the methods section conducting sensitivity analysis to judge risk of bias associated with missing outcome data at the level of the meta-analysis; and only five of them presented the results of these analyses in the results section.

Conclusion: Most systematic reviews do not explicitly report sufficient information on categories of trial participants with potential missing outcome data or address missing data in their primary analyses.

Keywords: Imputation; Meta-analysis; Missing outcome data; Risk of bias; Systematic reviews; Trials.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Bias*
  • Data Accuracy
  • Data Interpretation, Statistical
  • Meta-Analysis as Topic*
  • Outcome Assessment, Health Care / methods
  • Outcome Assessment, Health Care / statistics & numerical data*
  • Systematic Reviews as Topic*