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John B Carlin

Publications and source records attributed to John B Carlin.

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Multiple imputation for longitudinal data: A tutorial

Longitudinal studies are frequently used in medical research and involve collecting repeated measures on individuals over time. Observations from the same individual are invariably correlated and thus an analytic approach that accounts for this clustering by individual is required. While almost all research suffers from missing data, this can be particularly problematic in longitudinal studies as participation often becomes harder to maintain over time. Multiple imputation (MI) is widely used to handle missing data in such studies. When using MI, it is important that the imputation model is compatible with the proposed analysis model. In a longitudinal analysis, this implies that the clustering considered in the analysis model should be reflected in the imputation process. Several MI approaches have been proposed to impute incomplete longitudinal data, such as treating repeated measurements of the same variable as distinct variables or using generalized linear mixed imputation models. However, the uptake of these methods has been limited, as they require additional data manipulation and use of advanced imputation procedures. In this tutorial, we review the available MI approaches that can be used for handling incomplete longitudinal data, including where individuals are clustered within higher-level clusters. We illustrate implementation with replicable R and Stata code using a case study from the Childhood to Adolescence Transition Study.

stat.ME

Mediation effects that emulate a target randomised trial: Simulation-based evaluation of ill-defined interventions on multiple mediators

Many epidemiological questions concern potential interventions to alter the pathways presumed to mediate an association. For example, we consider a study that investigates the benefit of interventions in young adulthood for ameliorating the poorer mid-life psychosocial outcomes of adolescent self-harmers relative to their healthy peers. Two methodological challenges arise. Firstly, mediation methods have hitherto mostly focused on the elusive task of discovering pathways, rather than on the evaluation of mediator interventions. Secondly, the complexity of such questions is invariably such that there are no existing data on well-defined interventions (i.e. actual treatments, programs, etc.) capturing the populations, outcomes and time-spans of interest. Instead, researchers must rely on exposure (non-intervention) data to address these questions, such as self-reported substance use and employment. We address the resulting challenges by specifying a target trial addressing three policy-relevant questions, regarding the impacts of hypothetical (rather than actual) interventions that would shift the mediators' distributions (separately, jointly or sequentially) to user-specified distributions that can be emulated with the observed data. We then define novel interventional effects that map to this trial, emulating shifts by setting mediators to random draws from those distributions. We show that estimation using a g-computation method is possible under an expanded set of causal assumptions relative to inference with well-defined interventions. These expanded assumptions reflect the lower level of evidence that is inevitable with ill-defined interventions. Application to the self-harm example using data from the Victorian Adolescent Health Cohort Study illustrates the value of our proposal for informing the design and evaluation of actual interventions in the future.

stat.ME