Propensity Scoring after Multiple Imputation in a Retrospective Study on Adjuvant Radiation Therapy in Lymph-Node Positive Vulvar Cancer.
Propensity scoring (PS) is an established tool to account for measured confounding in non-randomized studies. These methods are sensitive to missing values, which are a common problem in observational data. The combination of multiple imputation of missing values and different propensity scoring techniques is addressed in this work. For a sample of lymph node-positive vulvar cancer patients, we re-analyze associations between the application of radiotherapy and disease-related and non-related survival. Inverse-probability-of-treatment-weighting (IPTW) and PS stratification are applied after multiple imputation by chained equation (MICE). Methodological issues are described in detail. Interpretation of the results and methodological limitations are discussed.
Medical Statistics and Decision Making, Department for Epidemiology, University Medical Center Groningen, Groningen, The Netherlands.
Christine
http://orcid.org/0000-0001-9365-5548
C
Eulenburg
Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Anna
A
Suling
KKS Philipps University Marburg, Marburg, Germany.
Petra
P
Neuser
KKS Philipps University Marburg, Marburg, Germany.
Alexander
A
Reuss
Dept. of Gynecology and Obstetrics, University of Dresden, Dresden, Germany.
Ulrich
U
Canzler
Dept. of Gynecology University Medical Center Duesseldorf, Duesseldorf, Germany.|Dept. of Gynecology and Obstetrics, University Hospital Tuebingen, Tuebingen, Germany.
Tanja
T
Fehm
Dept. of Gynecology, Obstetrics and Gynecologic Oncology, Klinikum Wolfsburg, Wolfsburg, Germany.
Alexander
A
Luyten
Dept. of Gynecology, Georg-August-University Goettingen, Goettingen, Germany.
Martin
M
Hellriegel
Department of Gynecology and Gynecologic Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Linn
L
Woelber
Department of Gynecology and Obstetrics, Ludwig-Maximilians-University, Munich, Germany.
Sven
S
Mahner
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology* / Q000528:radiation effects; D008207:Lymphatic Metastasis / Q000175:diagnosis* / Q000473:pathology / Q000532:radiotherapy*; D008875:Middle Aged; D011379:Prognosis; D057216:Propensity Score; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D016019:Survival Analysis; D014844:Vulva / Q000473:pathology* / Q000528:radiation effects; D014846:Vulvar Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000532:radiotherapy*; D055815:Young Adult