Bayesian second-order sensitivity of longitudinal inferences to non-ignorability: an application to antidepressant clinical trial data

• Published in: The international journal of biostatistics Vol. 20; no. 2; pp. 599 - 629
• Main Authors: Momeni Roochi, Elahe, Eftekhari Mahabadi, Samaneh
• Format: Journal Article
• Language: English
• Published: Germany De Gruyter 01.11.2024; Walter de Gruyter GmbH
• Subjects: Antidepressants; Antidepressive Agents - therapeutic use; Bayes Theorem; Bayesian analysis; Bayesian approach; Clinical trials; Clinical Trials as Topic - methods; Data Interpretation, Statistical; Humans; informative drop-out; linear mixed-effect model; Longitudinal Studies; Models, Statistical; normal longitudinal data; second-order local sensitivity; Sensitivity analysis; informative drop-out; second-order local sensitivity; Bayesian approach; linear mixed-effect model; normal longitudinal data
• ISSN: 1557-4679; 2194-573X; 1557-4679
• DOI: 10.1515/ijb-2022-0014

Incomplete data is a prevalent complication in longitudinal studies due to individuals’ drop-out before intended completion time. Currently available methods via commercial software for analyzing incomplete longitudinal data at best rely on the ignorability of the drop-outs. If the underlying missing mechanism was non-ignorable, potential bias arises in the statistical inferences. To remove the bias when the drop-out is non-ignorable, joint complete-data and drop-out models have been proposed which involve computational difficulties and untestable assumptions. Since the critical ignorability assumption is unverifiable based on the observed part of the sample, some local sensitivity indices have been proposed in the literature. Specifically, Eftekhari Mahabadi (Second-order local sensitivity to non-ignorability in Bayesian inferences. Stat Med 2018;59:55–95) proposed a second-order local sensitivity tool for Bayesian analysis of cross-sectional studies and show its better performance for handling bias compared with the first-order ones. In this paper, we aim to extend this index for the Bayesian sensitivity analysis of normal longitudinal studies with drop-outs. The index is driven based on a selection model for the drop-out mechanism and a Bayesian linear mixed-effect complete-data model. The presented formulas are calculated using the posterior estimation and draws from the simpler ignorable model. The method is illustrated via some simulation studies and sensitivity analysis of a real antidepressant clinical trial data. Overall, the numerical analysis showed that when repeated outcomes are subject to missingness, regression coefficient estimates are nearly approximated well by a linear function in the neighbourhood of MAR model, but there are a considerable amount of second-order sensitivity for the error term and random effect variances in Bayesian linear mixed-effect model framework.