Universität zu Köln

Goldkuhle, Marius, Bender, Ralf, Akl, Elie A., van Dalen, Elvira C., Nevitt, Sarah, Mustafa, Reem A., Guyatt, Gordon H., Trivella, Marialene, Djulbegovic, Benjamin, Schunemann, Holger, Cinquini, Michela, Kreuzberger, Nina ORCID: 0000-0001-8922-0488 and Skoetz, Nicole (2021). GRADE Guidelines: 29. Rating the certainty in time-to-event outcomes-Study limitations due to censoring of participants with missing data in intervention studies. J. Clin. Epidemiol., 129. S. 126 - 138. NEW YORK: ELSEVIER SCIENCE INC. ISSN 1878-5921

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Abstract

Objectives: To provide Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) guidance for the consideration of study limitations (risk of bias) due to missing participant outcome data for time-to-event outcomes in intervention studies. Study Design and Setting: We developed this guidance through an iterative process that included membership consultation, feedback, presentation, and iterative discussion at meetings of the GRADE working group. Results: The GRADE working group has published guidance on how to account for missing participant outcome data in binary and continuous outcomes. When analyzing time-to-event outcomes (e.g., overall survival and time-to-treatment failure) data of participants for whom the outcome of interest (e.g., death and relapse) has not been observed are dealt with through censoring. To do so, standard methods require that censored individuals are representative for those remaining in the study. Two types of censoring can be distinguished, end of study censoring and censoring because of missing data, commonly named loss to follow-up censoring. However, both types are not distinguishable with the usual information on censoring available to review authors. Dealing with individuals for whom data are missing during follow-up in the same way as individuals for whom full follow-up is available at the end of the study increases the risk of bias. Considerable differences in the treatment arms in the distribution of censoring over time (early versus late censoring), the overall degree of missing follow-up data, and the reasons why individuals were lost to follow-up may reduce the certainty in the study results. With often only very limited data available, review and guideline authors are required to make transparent and well-considered judgments when judging risk of bias of individual studies and then come to an overall grading decision for the entire body of evidence. Conclusion: Concern for risk of bias resulting from censoring of participants for whom follow-up data are missing in the underlying studies of a body of evidence can be expressed in the study limitations (risk of bias) domain of the GRADE approach. (C) 2020 Elsevier Inc. All rights reserved.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Goldkuhle, Marius UNSPECIFIED UNSPECIFIED UNSPECIFIED Bender, Ralf UNSPECIFIED UNSPECIFIED UNSPECIFIED Akl, Elie A. UNSPECIFIED UNSPECIFIED UNSPECIFIED van Dalen, Elvira C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Nevitt, Sarah UNSPECIFIED UNSPECIFIED UNSPECIFIED Mustafa, Reem A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Guyatt, Gordon H. UNSPECIFIED UNSPECIFIED UNSPECIFIED Trivella, Marialene UNSPECIFIED UNSPECIFIED UNSPECIFIED Djulbegovic, Benjamin UNSPECIFIED UNSPECIFIED UNSPECIFIED Schunemann, Holger UNSPECIFIED UNSPECIFIED UNSPECIFIED Cinquini, Michela UNSPECIFIED UNSPECIFIED UNSPECIFIED Kreuzberger, Nina UNSPECIFIED orcid.org/0000-0001-8922-0488 UNSPECIFIED Skoetz, Nicole UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-600200
DOI:	10.1016/j.jclinepi.2020.09.017
Journal or Publication Title:	J. Clin. Epidemiol.
Volume:	129
Page Range:	S. 126 - 138
Date:	2021
Publisher:	ELSEVIER SCIENCE INC
Place of Publication:	NEW YORK
ISSN:	1878-5921
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language AIDS CLINICAL-TRIAL; AUXILIARY VARIABLES; INVERSE PROBABILITY; SURVIVAL ANALYSES; COMPETING RISKS; ADVERSE EVENTS; MODEL; QUALITY; ISSUES; IMPACT Multiple languages Health Care Sciences & Services; Public, Environmental & Occupational Health Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/60020