Poor Reporting Quality of Missing Data in Economic Evaluations Alongside Pragmatic Trials: A Cross-Sectional Survey

OBJECTIVES: The extent of missing data, handling approaches, and reporting quality in pragmatic randomized controlled trial (pRCT)-based economic evaluations remain poorly understood. This study aimed to assess the reporting quality of missing data in economic evaluations conducted alongside pragmatic randomized controlled trials (pRCTs).

METHODS: Data were extracted from PubMed and OVID (Embase, CENTRAL, HTA database, and NIH EED) from January 1, 2010, to April 24, 2022. Descriptive analyses were performed to assess characteristics of the included studies, missingness in the included studies, and handling of missing data.

RESULTS: In all, 715 studies were identified, of which 152 met the inclusion criteria. Overall, 113 articles reported missing data, 119 reported missing costs, and 132 reported missing effects. More than 50% (58/113) of the articles reported the proportion or quantity of overall missingness, and 64.71% and 54.55% reported missing costs and effects, respectively. In terms of the proportion of missing data, the overall missingness rate was 30.22% in 58 studies, whereas the median proportion of missing data was slightly higher than that of the missing effects (30.92% vs. 27.78%). In all, 56 (36.84%) studies conducted a sensitivity analysis on handling missing data. Of these studies, 12.50% reported missing mechanisms, and 83.93% examined handling methods.

CONCLUSIONS: Insufficient description and reporting of missing data, along with a high proportion of missing data in pRCT-based economic evaluations, could decrease the reliability and extrapolation of conclusions, leading to misleading decision-making.