title: Reporting and handling of missing data in predictive research for prevalent undiagnosed type 2 diabetes mellitus: a systematic review.
abstract: Missing values are common in health research and omitting participants with missing data often leads to loss of statistical power, biased estimates and, consequently, inaccurate inferences. We critically reviewed the challenges posed by missing data in medical research and approaches to address them. To achieve this more efficiently, these issues were analyzed and illustrated through a systematic review on the reporting of missing data and imputation methods (prediction of missing values through relationships within and between variables) undertaken in risk prediction studies of undiagnosed diabetes. Prevalent diabetes risk models were selected based on a recent comprehensive systematic review, supplemented by an updated search of English-language studies published between 1997 and 2014. Reporting of missing data has been limited in studies of prevalent diabetes prediction. Of the 48 articles identified, 62.5% (n = 30) did not report any information on missing data or handling techniques. In 21 (43.8%) studies, researchers opted out of imputation, completing case-wise deletion of participants missing any predictor values. Although imputation methods are encouraged to handle missing data and ensure the accuracy of inferences, this has seldom been the case in studies of diabetes risk prediction. Hence, we elaborated on the various types and patterns of missing data, the limitations of case-wise deletion and state-of the-art methods of imputations and their challenges. This review highlights the inexperience or disregard of investigators of the effect of missing data in risk prediction research. Formal guidelines may enhance the reporting and appropriate handling of missing data in scientific journals.
authors.affiliation: Division of Chemical Pathology, Faculty of Health Sciences, National Health Laboratory Service (NHLS) and University of Stellenbosch, Cape Town, South Africa ; Non-Communicable Diseases Research Unit, South African Medical Research Council, PO Box 19070, , Tygerberg, 7505 Cape Town, South Africa.
authors.forename: Katya L
authors.initials: KL
authors.lastname: Masconi
authors.affiliation: Department of Biomedical Technology, Faculty of Health and Wellness Sciences, Cape Peninsula University of Technology, Cape Town, South Africa.
authors.forename: Tandi E
authors.initials: TE
authors.lastname: Matsha
authors.affiliation: Hubert Department of Public Health, Rollins School of Public Health, Emory University, Atlanta, GA USA ; Department of Medicine, MedStar Health System, Baltimore, MD USA.
authors.forename: Justin B
authors.initials: JB
authors.lastname: Echouffo-Tcheugui
authors.affiliation: Division of Chemical Pathology, Faculty of Health Sciences, National Health Laboratory Service (NHLS) and University of Stellenbosch, Cape Town, South Africa.
authors.forename: Rajiv T
authors.initials: RT
authors.lastname: Erasmus
authors.affiliation: Non-Communicable Diseases Research Unit, South African Medical Research Council, PO Box 19070, , Tygerberg, 7505 Cape Town, South Africa ; Department of Medicine, University of Cape Town, Cape Town, South Africa.
authors.forename: Andre P
authors.initials: AP
authors.lastname: Kengne
keywords: Diabetes mellitus; Guidelines; Modeling; Patient Stratification; Patterns; Predictive; Preventive and Personalized Medicine; Risk; Screening
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