Quality of Life Research

, Volume 14, Issue 6, pp 1533–1544 | Cite as

Analysis of incomplete quality of life data in advanced stage cancer: A practical application of multiple imputation

  • Satoshi Morita
  • Kunihiko Kobayashi
  • Kenji Eguchi
  • Taketoshi Matsumoto
  • Masahiko Shibuya
  • Yasufumi Yamaji
  • Yasuo Ohashi


This paper presents a practical approach to analyzing incomplete quality of life (QOL) data that contains non-ignorable dropouts in patients with advanced non-small-cell lung cancer (NSCLC). QOL scores for the physical domain at baseline and at the end of the first and second courses of chemotherapy were compared between two treatment groups in a phase III trial. One hundred and 103 eligible patients were randomized to receive cisplatin and irinotecan (CPT-P) or cisplatin and vindesine, respectively; of those two groups, 83 and 85, respectively, completed a QOL questionnaire at least at baseline. A multiple imputation incorporating auxiliary QOL variables was implemented as one of alternatives of sensitivity analyses; these were complete case, available case, and pattern mixture analyses. Although larger sensitivity to missing data was found for CPT-P treatment, none of the alternative analyses demonstrated a significant difference in estimated slopes over time between the groups. This study presents an analytical approach for dealing with the complex problem of missing QOL data. It must be noted, however, that the validity of the multiple imputation method we present is not certain unless we can specify sufficiently informative auxiliary variables to ensure the conversion of non-ignorable missingness to ignorable.


Balancing score Missing data Multiple imputation Quality of life Sensitivity analysis 



approximate Bayesian bootstrap


cisplatin + irinotecan


Eastern Cooperative Oncology Group


missing at random


missing completely at random


multiple imputation


missing not at random


non-small-cell lung cancer


pattern mixture


performance status


quality of life


Quality of Life Questionnaire for Cancer Patients Treated with Anticancer Drugs


cisplatin + vindesine


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Copyright information

© Springer 2005

Authors and Affiliations

  • Satoshi Morita
    • 1
    • 7
  • Kunihiko Kobayashi
    • 2
  • Kenji Eguchi
    • 3
  • Taketoshi Matsumoto
    • 4
  • Masahiko Shibuya
    • 5
  • Yasufumi Yamaji
    • 6
  • Yasuo Ohashi
    • 7
  1. 1.Department of Epidemiology and Health Care ResearchKyoto University Graduate School of MedicineKyotoJapan
  2. 2.The 2nd Department of Internal MedicineSaitama Medical SchoolSaitamaJapan
  3. 3.Division of Pulmonary MedicineTokai University School of MedicineKanagawaJapan
  4. 4.Department of Respiratory DiseaseMusashigaoka HospitalKumamotoJapan
  5. 5.Division of Respiratory MedicineTokyo Metropolitan Komagome HospitalTokyoJapan
  6. 6.Department of Internal MedicineMitoyo General HospitalKagawaJapan
  7. 7.Department of Biostatistics/Epidemiology and Preventive Health Sciences, School of Health Sciences and NursingUniversity of TokyoTokyoJapan

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