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Neuropsychological changes in children with cancer: The treatment of missing data in longitudinal studies

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Abstract

Researchers conducting longitudinal studies with children or adults are inevitably confronted with problems of attrition and missing data. Missing data in longitudinal studies is frequently handled by excluding from analyses those cases for whom data are incomplete. This approach to missing data is not optimal. On the one hand, if data are missing at random, then dropping incomplete cases ignores information collected on those cases that could be used to improve estimates of population parameters (e.g., means, variances, covariances, and growth rates) and improve the power of significance tests of statistical hypotheses. On the other hand, if data are not missing at random, then dropping incomplete cases leads to biased parameter estimates and hypothesis tests that may be internally and externally invalid. This study uses three years of follow-up data from a longitudinal investigation of neuropsychological outcomes of cancer in children to demonstrate the problems presented by missing data in repeated measures designs and some solutions. In evaluating potential biasing effects of attrition, the study extends previous research on neuropsychological outcomes in pediatric cancer by inclusion of patients whose disease had relapsed, and by comparison of surviving and nonsurviving patients. Although the data presented have specific relevance to the study of neuropsychological outcome in pediatric cancer, the problems of missing data and the solutions presented are relevant to a wide variety of diseases and conditions of interest to researchers in child and adult neuropsychology.

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References

  • Armitage, P., McPherson, C. K., and Rowe, B. C. (1969). Repeated significance tests on accumulating data.Journal of the Royal Statistical Society, Series A 132: 235–244.

    Google Scholar 

  • Beery, K., and Buktenica, N. (1967).Developmental Test of Visual-Motor Integration, Follett Education Co., Chicago.

    Google Scholar 

  • Bock, R. D. (1989).Multilevel Analysis of Educational Data, Academic Press, San Diego, CA.

    Google Scholar 

  • Brouwers, P. (9187). Neuropsychological abilities of long-term survivors of childhood leukemia. In Aaronson, N. K., and Bechman, J. (eds.),The Quality of Life of Cancer Patients, Raven Press, New York, pp. 154–165.

    Google Scholar 

  • Bryk, A. S., and Raudenbush, S. W. (1992).Hierarchical Linear Models: Applications and Data Analysis Methods, Sage Publications, Newbury Park, CA.

    Google Scholar 

  • Burchinal, M., and Appelbaum, M. I. (1991). Estimating individual developmental functions: Methods and their assumptions.Child Development 62: 23–43.

    Google Scholar 

  • Cousens, P., Waters, B., Said, J., and Stevens, M. (1988). Cognitive effects of cranial irradiation in leukemia: A survey and meta-analysis.Journal of Child Psychology and Psychiatry and Allied Disciplines 29: 839–852.

    Google Scholar 

  • Davidson, M. L. (1972). Univariate versus multivariate tests in repeated measures experiments.Psychological Bulletin 77: 446–452.

    Google Scholar 

  • Dixon, W. J. (1990).BMDP Statistical Software Manual, University of California Press, Berkeley.

    Google Scholar 

  • Dunn, L. M., and Markwardt, F. C. (1970).Peabody Individual Achievement Test, American Guidance Serivce, Inc., Circle Pines, MN.

    Google Scholar 

  • Engleman, L. (1990). Correlations with missing data. In Dixon, W. J., Brown, M. B., Engleman, L., and Jennrish, R. I. (eds.),BMDP Statistical Software Manual (Vol. 2), University of California Press, Berkeley, pp. 711–720.

    Google Scholar 

  • Fletcher, J. M., and Copeland, D. R. (1989). Neurobehavioral effects of central nervous system prophylactic treatment of cancer in children.Journal of Clinical and Experimental Neuropsychology 10: 495–537.

    Google Scholar 

  • Fletcher, J. M. Francis, D. J., Pequegnat, W., Raudenbush, S. W., Bornstein, M. H., Brouwers, P., Schmitt, F., and Stover, E. (1991). Neurodevelopment in HIV-1 infection and AIDS in infants and children: Application of individual growth curve models.American Psychologist 46: 1267–1277.

    Google Scholar 

  • Francis, D. J., Fletcher, J. M., Stuebing, K. K., Davidson, K. C., and Thompson, N. R. (1991). Analysis of change: Modeling individual growth.Journal of Consulting and Clinical Psychology 59: 27–37.

    Google Scholar 

  • Goldstein, H. I. (1987).Multilevel Models in Educational and Social Research, Oxford University Press, London.

    Google Scholar 

  • Huynh, H., and Feldt, L. S. (1976). Estimation of the Box correction for degrees of freedom from sample data in randomized block and split-plot designs.Journal of Educational Statistics 1: 69–82.

    Google Scholar 

  • Jastak, J. F. and Jastak, S. (1978).Wide Range Achievement Test—Revised, Jastak Associates, Wilmington, DE.

    Google Scholar 

  • Lee, J. W., and DeMets, D. L. (1991). Sequential comparison of changes with repeated measurements data. Journal of the American Statistical Association, 86: 757–762.

    Google Scholar 

  • Little, R. J. A., and Rubin, D. B. (1983). On jointly estimating parameters and missing data by maximizing the complete-data likelihood.American Statistician 37: 218–220.

    Google Scholar 

  • Little, R. J. A., and Rubin, D. B. (1987).Statistical Analysis with Missing Data, Wiley, New York.

    Google Scholar 

  • Madan-Swain, A., and Brown, R. T. (1991). Cognitive and psychosocial sequelae for children with acute lymphocytic leukemia and their families.Clinical Psychology Review 1: 113–127.

    Google Scholar 

  • McCarthy, D. (1972).McCarthy Scales of Children's Abilities, The Psychological Corporation, New York.

    Google Scholar 

  • Milliken, G. A., and Johnson, D. E. (1984).Analysis of Messy Data, Wadsworth, Belmont, CA.

    Google Scholar 

  • O'Brien, R. G., and Kaiser, M. K. (1985). MANOVA method for analyzing repeated-measures designs: An extensive primer.Psychological Bulletin 97: 316–333.

    Google Scholar 

  • Packer, R. J., Meadows, A. T., Rorke, L. B., et al., (1987). Long-term sequelae of cancer treatment on the central nervous system in childhood.Medical and Pediatric Oncology 15: 241–253.

    Google Scholar 

  • Rogosa, D. R., Brandt, D., and Zimowski, M. (1982). A growth curve approach to the measurement of change.Psychological Bulletin 90: 726–748.

    Google Scholar 

  • Rovine, M. J., and Delaney, M. (1990). Missing data estimation in developmental research. In von Eye, A. (ed.),Statistical Methods in Longitudinal Research, Vol. I: Principles and Structuring Change, Academic Press, New York, pp. 35–79.

    Google Scholar 

  • SAS Institute, Inc. (1991).SAS STAT Guide. Version 6.07, SAS Institute, Inc., Cary, NC.

    Google Scholar 

  • Schaie, K. W., and Herztzog, C. (1982). Longitudinal methods. In Wolman, B. B. (ed.),Handbook of Developmental Psychology, Prentice-Hall, Englewood Cliffs, NJ.

    Google Scholar 

  • Schluchter M. D. (1988).BMDP5V: Unbalanced repeated measures models with structured covariance matrices. Technical Report No. 86, BMDP Statistical Software, Los Angeles, CA.

    Google Scholar 

  • Stehbens, J. A., Kaleita, T. A., Noll, R. B., et al. (1991). CNS prophylaxis childhood leukemia: What are the long-term neurological, neuropsychological and behavioral effects?Neuropsychology Review 2: 147–177.

    Google Scholar 

  • Wechsler, D. (1974).Wechsler Intelligence Scale for Children—Revised, The Psychological Corporation, New York.

    Google Scholar 

  • Willett, J. B. (1988). Questions and answers in the measurement of change. In Rothkopf, E. Z. (ed.), Review of Research in Education (Vol. 15), pp. 345–422.

  • Williams, J. H., and Davis, K. S. (1986). Neuropsychological effects of central nervous system prophylaxis treatment of childhood leukemia.Cancer Treatment Review 13: 113–127.

    Google Scholar 

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Francis, D.J., Copeland, D.R. & Moore, B.D. Neuropsychological changes in children with cancer: The treatment of missing data in longitudinal studies. Neuropsychol Rev 4, 199–222 (1994). https://doi.org/10.1007/BF01874892

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