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Missing values in health services research

dr Benjamin Mayer

Health services research is a multidisciplinary scientific discipline with a comparatively young history [1]. The desired goals of this scientific discipline are of great importance for assessing the situation in the healthcare system - possibly with corresponding effects on practice, politics and science. According to Pfaff [2], health services research can be defined as an “interdisciplinary research area that describes and causally explains health care and health care and its framework conditions, as well as evaluates the effectiveness of care structures and processes under everyday conditions”. Particular emphasis should be placed on the analysis of medical questions or issues relating to healthcare in general under everyday conditions, which therefore differs significantly from the classic clinical study. In particular, the field of health services research is divided into different areas that arise from the subject matter of the study (e.g. needs research, quality research, health care epidemiology).

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First publication date: 24.02.2012
Dr. Benjamin Mayerdr Benjamin Mayer

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Abstract: Fehlende Werte in der Versorgungsforschung

Hintergrund: Die Untersuchung medizinischer Fragestellungen unter Alltagsbedingungen erschwert die vollständige Erhebung von Studiendaten in größerem Ausmaß als in klinischen Studien. Jedoch scheint gerade in der Versorgungsforschung das Problem fehlender Werte bisher zu wenig Beachtung zu finden. Methodik: Publikationen und Leitlinien aus dem Bereich der Versorgungsforschung wurden explizit auf die Erwähnung und die eventuell angegebene Behandlung fehlender Werte hin untersucht. Zudem wurden die grundlegenden Probleme fehlender Werte hinsichtlich der Datenanalyse und -interpretation zusammengefasst. Ergebnisse: Fehlende Werte finden in der Versorgungsforschung zu selten Erwähnung und werden nicht angemessen behandelt. Zudem können bestimmte Gegebenheiten der Versorgungsforschung einen zusätzlichen Nachteil für die grundlegenden Missing Value Probleme bedeuten. Schlussfolgerung: Es scheint im Bereich der Versorgungsforschung ein fehlendes Bewusstsein hinsichtlich der Problematik fehlender Werte zu geben. Diesem Umstand sollte durch explizite Forschung begegnet werden.

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Summary
Background: Investigating medical questions under everyday conditions makes the complete collection of study data more difficult than in clinical studies. However, the problem of missing values seems to have received too little attention, especially in health services research. Methodology: Publications and guidelines from the field of health services research were explicitly examined for the mention and any specified treatment of missing values. In addition, the fundamental problems of missing values with regard to data analysis and interpretation were summarized. Results: Missing values are rarely mentioned in health services research and are not treated appropriately. In addition, certain circumstances of health services research can represent an additional disadvantage for the fundamental missing value problems. Conclusion: There seems to be a lack of awareness of the problem of missing values in the field of health services research. This circumstance should be addressed through explicit research.

Missing values in health services research
Background: The investigation of medical questions under daily routine conditions impedes the complete survey of study data much more than in clinical trials. However, just in health services research it seems that the problem of missing data does not attract enough attention. Methods: Publications and guidelines in the field of health services research have been explicitly examined if the existence of missings is mentioned and how they are eventually are handled. Furthermore, the basic missing data problems with respect to data analysis and interpretation have been summarized. Results: Missing values are rarely mentioned in health services research and are handled inappropriately. Certain aspects of health services research may have an additional disadvantage for the basic missing value problems.
Conclusion: There seems to be an absent awareness of the missing value problem in the field of health services research. This circumstance should be encountered by explicit research.

keywords
Missing values; health services research; Missing value replacement

Missing values; Health services research; Missing value imputation

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