98Framework for the Treatment And Reporting of Missing data in Observational Studies: The TARMOS framework

Focus of presentation Missing data are ubiquitous in medical research. Although there is increasing guidance on how to handle missing data, practice is changing slowly and misapprehensions abound, particularly in observational research. We present a practical framework for handling and reporting the analysis of incomplete data in observational studies, which we illustrate using a case study from the Avon Longitudinal Study of Parents and Children. Findings The framework consists of three steps: 1) Develop an analysis plan specifying the analysis model and how missing data are going to be addressed. Important considerations are whether a complete records analysis is likely to be valid, whether multiple imputation or an alternative approach is likely to offer benefits, and whether a sensitivity analysis regarding the missingness mechanism is required. 2) Explore the data, checking the methods outlined in the analysis plan are appropriate, and conduct the pre-planned analysis. 3) Report the results, including a description of the missing data, details on how missing data were addressed, and the results from all analyses, interpreted in light of the missing data and clinical relevance. Conclusions/Implications This framework encourages researchers to think carefully about their missing data and be transparent about the potential effect on the study results. This will increase confidence in the reliability and reproducibility of results from published papers. Key messages Researchers need to develop a plan for missing data prior to conducting their analysis, and be transparent about how they handled the missing data and its potential effect when reporting their results.