Pediatric rheumatology

Health Equity Implications of Missing Data Among Youths With Childhood‐Onset Systemic Lupus Erythematosus: A Proof‐of‐Concept Study in the Childhood Arthritis and Rheumatology Research Alliance Registry

Arthritis Care Res (Hoboken)Published Registry-based cross-sectional study

Main finding · Missing dataResult — go to the resultOdds ratio 2.04 95% CI 1.22–3.41

Authors' conclusion

Our results support intentional evaluation of missing data to inform effect estimate interpretation and critical assessment of causal statements that might otherwise misrepresent health inequities.

Study context

Population
Participants with childhood-onset systemic lupus erythematosus (SLE) in the CARRA Registry, enrollment data 2015–2022
Participants
766 participants
Exposure
Government-assisted vs private health insurance
Outcome
Missing data (co-missingness of 12 variables) and missing disease-related indices (SLEDAI-2K and/or SDI) at enrollment
Follow-up
Enrollment
Methodological detailsproof-of-concept, logistic regression, linear regression, complete case analysis, multiple imputation and nonprobabilistic bias analyses
  • Proof-of-concept
  • Logistic regression
  • Linear regression
  • Complete case analysis, multiple imputation and nonprobabilistic bias analyses

Main finding

Missing data

Odds ratio

2.04

95% CI 1.22–3.41

Government-assisted health insurancevs Private health insurance
OR 2.04 (95% CI 1.22–3.41)

As reported in the abstract

Average proportion of data missing per participant
6.2%
Participants missing at least 1 variable
over 50%

Observational data: associations, not effects.

Further findings

Association between socioeconomic factors and SLEDAI-2K at enrollment by missing-data method

Different analytic approaches gave varying analytic sample sizes and fundamentally conflicting estimated associations

Original publication

Health Equity Implications of Missing Data Among Youths With Childhood‐Onset Systemic Lupus Erythematosus: A Proof‐of‐Concept Study in the Childhood Arthritis and Rheumatology Research Alliance Registry. Arthritis Care Res (Hoboken). Published 30 May 2023. doi:10.1002/acr.25136

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