Use of multiple imputation to correct for nonresponse bias in a survey of urologic symptoms among African-American men

Am J Epidemiol. 2002 Oct 15;156(8):774-82. doi: 10.1093/aje/kwf110.

Abstract

The Flint Men's Health Study is an ongoing population-based study of African-American men designed to address questions related to prostate cancer and urologic symptoms. The initial phase of the study was conducted in 1996-1997 in two stages: an interviewer-administered survey followed by a clinical examination. The response rate in the clinical examination phase was 52%. Thus, some data were missing for clinical examination variables, diminishing the generalizability of the results to the general population. This paper is a case study demonstrating the application of multiple imputation to address important questions related to prostate cancer and urologic symptoms in a data set with missing values. On the basis of the observed clinical examination data, the American Urological Association Symptoms Score showed a surprising reduction in symptoms in the oldest age group, but after multiple imputation there was a monotonically increasing trend with age. It appeared that multiple imputation corrected for nonresponse bias associated with the observed data. For other outcome measures-namely, the age-adjusted 95th percentile of prostate-specific antigen level and the association between urologic symptoms and prostate volume-results from the observed data and the multiply imputed data were similar.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Bias*
  • Black People*
  • Black or African American
  • Epidemiologic Studies
  • Health Surveys
  • Humans
  • Male
  • Middle Aged
  • Patient Compliance
  • Prostate-Specific Antigen / analysis
  • Prostatic Neoplasms / complications
  • Prostatic Neoplasms / epidemiology*
  • Reference Values
  • Reproducibility of Results
  • Urologic Diseases / epidemiology*

Substances

  • Prostate-Specific Antigen