Growth modeling with nonignorable dropout: alternative analyses of the STAR*D antidepressant trial.

Growth modeling with nonignorable dropout: alternative analyses of the STAR*D antidepressant trial.
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DOI:
10.1037/a0022634
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发表时间:
2011-03
影响因子:
7
通讯作者:
Leuchter, Andrew F.
Leuchter, Andrew F.
中科院分区:
心理学1区
文献类型:
--
作者:
Muthen, Bengt;Asparouhov, Tihomir;Hunter, Aimee M.;Leuchter, Andrew F.

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本文采用一个通用的潜变量框架,研究了一系列由于辍学而导致的不可解释的缺失模型。不可验证的缺失数据建模承认,缺失可能不仅取决于协变量和在先前时间点观察到的结果(如标准随机缺失(MAR)假设),而且还取决于潜在变量,如观察到的值(缺失结果),发育趋势(生长因子)和定性不同类型的发育(潜在轨迹类)。这些替代的预测缺失数据可以探索在一个一般的潜在变量框架使用Mplus程序。一个灵活的新模型使用扩展的模式混合方法,其中缺失是一个功能的潜在辍学类与增长的混合建模使用潜在的轨迹类相结合。一种新的选择模型不仅允许结果对缺失的影响,而且允许这种影响在潜在轨迹类之间变化。最后给出了模型选择的建议。缺失数据模型应用于星星 *D的纵向数据,这是美国迄今为止最大的抗抑郁药临床试验。尽管这项试验很重要,但迄今为止尚未探索使用不可忽略的缺失数据技术的星星 *D增长模型分析。显示星星 *D数据以不同的轨迹类别为特征,包括对应于抑郁症的实质性改善的低类别、具有对应于短暂改善的U形曲线的少数类别以及对应于无改善的高类别。该分析为在存在脱落的情况下评估药物效率提供了一种新的方法。
This paper uses a general latent variable framework to study a series of models for non-ignorable missingness due to dropout. Non-ignorable missing data modeling acknowledges that missingness may depend on not only covariates and observed outcomes at previous time points as with the standard missing at random (MAR) assumption, but also on latent variables such as values that would have been observed (missing outcomes), developmental trends (growth factors), and qualitatively different types of development (latent trajectory classes). These alternative predictors of missing data can be explored in a general latent variable framework using the Mplus program. A flexible new model uses an extended pattern-mixture approach where missingness is a function of latent dropout classes in combination with growth mixture modeling using latent trajectory classes. A new selection model allows not only an influence of the outcomes on missingness, but allows this influence to vary across latent trajectory classes. Recommendations are given for choosing models. The missing data models are applied to longitudinal data from STAR*D, the largest antidepressant clinical trial in the U.S. to date. Despite the importance of this trial, STAR*D growth model analyses using non-ignorable missing data techniques have not been explored until now. The STAR*D data are shown to feature distinct trajectory classes, including a low class corresponding to substantial improvement in depression, a minority class with a U-shaped curve corresponding to transient improvement, and a high class corresponding to no improvement. The analyses provide a new way to assess drug efficiency in the presence of dropout.
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