Evidence map›Paper›PMID 27770833›Full record

ArticleBMC research notes2016

Handling missing items in the Hospital Anxiety and Depression Scale (HADS): a simulation study.

Melanie L Bell, Diane L Fairclough, Mallorie H Fiero, Phyllis N Butow

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC research notes, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 97 papers.

0numbers the graph read from it
0cells of the map it votes in
97citing papers in PubMed
3.9field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

97 citing papers in PubMed, 178 citations in OpenAlex.

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37 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 3 institutions in 2 countries.

Melanie L BellDepartment of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295N. Martin Ave., P.O. Box 245163, Tucson, AZ, 85724, USA. melaniebell@email.arizona.edu.ORCID http://orcid.org/0000-0003-4821-4094
Diane L FaircloughDepartment of Biostatistics and Informatics, Colorado School of Public Health, 13001 E. 17th Place, Campus Box B119, Aurora, CO, 80045, USA.
Mallorie H FieroDepartment of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295N. Martin Ave., P.O. Box 245163, Tucson, AZ, 85724, USA.
Phyllis N ButowPsycho-Oncology Co-Operative Research Group, School of Psychology, The University of Sydney, Level 6-North, The Lifehouse, 119-143 Missenden Rd, Sydney, NSW, 2006, Australia.
University of Arizona · USColorado School of Public Health · USThe University of Sydney · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe Hospital Anxiety and Depression Scale (HADS) is a widely used questionnaire in health research, but there is little guidance on how to handle missing items. We aimed to investigate approaches to handling item non-response, varying sample size, proportion of subjects with missing items, proportion of missing items per subject, and the missingness mechanism.

methodsWe performed a simulation study based on anxiety and depression data among cancer survivors and patients. Item level data were deleted according to random, demographic, and subscale dependent missingness mechanisms. Seven methods for handling missing items were assessed for bias and imprecision. Imputation, imputation conditional on the number of non-missing items, and complete case approaches were used. One thousand datasets were simulated for each parameter combination.

resultsAll methods were most sensitive when missingness was dependent on the subscale (i.e., higher values of depression leads to higher levels of missingness). The worst performing approach was to analyze only individuals with complete data. The best performing imputation methods depended on whether inference was targeted at the individual or at the population.

conclusionsWe recommend the 'half rule' using individual subscale means when using the HADS scores at the individual level (e.g. screening). For population inference, we recommend relaxing the requirement that at least half the items be answered to minimize missing scores.

Indexed as

AnxietyDepressionPsychiatric Status Rating ScalesHumansSurveys and QuestionnairesAnxietyDepressionDistressImputationMissing dataQuestionnairesSimulation

Identifiers

PMID27770833
PMCPMC5075158
OpenAlexW2535700967

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.