Addressing Missing Data in Patient‐Reported Outcome Measures (PROMS): Implications for the Use of PROMS for Comparing Provider Performance
研究了英国国家医疗服务体系中患者报告结局测量数据缺失的问题，提出用多重插补方法处理缺失数据，并发现缺失数据假设会影响对医院绩效的比较结果。
Patient-reported outcome measures (PROMs) are now routinely collected in the English National Health Service and used to compare and reward hospital performance within a high-powered pay-for-performance scheme. However, PROMs are prone to missing data. For example, hospitals often fail to administer the pre-operative questionnaire at hospital admission, or patients may refuse to participate or fail to return their post-operative questionnaire. A key concern with missing PROMs is that the individuals with complete information tend to be an unrepresentative sample of patients within each provider and inferences based on the complete cases will be misleading. This study proposes a strategy for addressing missing data in the English PROM survey using multiple imputation techniques and investigates its impact on assessing provider performance. We find that inferences about relative provider performance are sensitive to the assumptions made about the reasons for the missing data.