Use of multiple imputation to correct for nonresponse bias in a survey of urologic symptoms among African-American men.
The Flint Men's Health Study is an ongoing population-based study of African-American men designed to address questions related to prostate cancer and urologic symptoms. The initial phase of the study was conducted in 1996-1997 in two stages: an interviewer-administered survey followed by a clinical examination. The response rate in the clinical examination phase was 52%. Thus, some data were missing for clinical examination variables, diminishing the generalizability of the results to the general population. This paper is a case study demonstrating the application of multiple imputation to address important questions related to prostate cancer and urologic symptoms in a data set with missing values. On the basis of the observed clinical examination data, the American Urological Association Symptoms Score showed a surprising reduction in symptoms in the oldest age group, but after multiple imputation there was a monotonically increasing trend with age. It appeared that multiple imputation corrected for nonresponse bias associated with the observed data. For other outcome measures-namely, the age-adjusted 95th percentile of prostate-specific antigen level and the association between urologic symptoms and prostate volume-results from the observed data and the multiply imputed data were similar.
Taylor
Jeremy M G
JM
Department of Biostatistics, University of Michigan, Ann Arbor 48109, USA. jmgt@umich.edu
Cooper
Kristine L
KL
Wei
John T
JT
Sarma
Aruna V
AV
Raghunathan
Trivellore E
TE
Heeringa
Steve G
SG
D000328:Adult; D000367:Age Factors; D000368:Aged; D015982:Bias; D044383:Black People; D016021:Epidemiologic Studies; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D017430:Prostate-Specific Antigen / Q000032:analysis; D011471:Prostatic Neoplasms / Q000150:complications / Q000453:epidemiology*; D012016:Reference Values; D015203:Reproducibility of Results; D014570:Urologic Diseases / Q000453:epidemiology*; D001741:Black or African American
D017430:Prostate-Specific Antigen