Missing data in trauma registries: A systematic review

  • Gowri Shivasabesan
    Correspondence
    Corresponding author at: National Trauma Research Institute, 85-89 Commercial Rd., Melbourne, VIC 3004, Australia.
    Affiliations
    Emergency & Trauma Centre, The Alfred Hospital, Melbourne, Australia

    National Trauma Research Institute, The Alfred Hospital, Melbourne, Australia

    Department of Epidemiology & Preventive Medicine, Monash University, Melbourne, Australia
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  • Biswadev Mitra
    Affiliations
    Emergency & Trauma Centre, The Alfred Hospital, Melbourne, Australia

    National Trauma Research Institute, The Alfred Hospital, Melbourne, Australia

    Department of Epidemiology & Preventive Medicine, Monash University, Melbourne, Australia
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  • Gerard M. O’Reilly
    Affiliations
    Emergency & Trauma Centre, The Alfred Hospital, Melbourne, Australia

    National Trauma Research Institute, The Alfred Hospital, Melbourne, Australia

    Department of Epidemiology & Preventive Medicine, Monash University, Melbourne, Australia
    Search for articles by this author

      Abstract

      Background

      Trauma registries play an integral role in trauma systems but their valid use hinges on data quality. The aim of this study was to determine, among contemporary publications using trauma registry data, the level of reporting of data completeness and the methods used to deal with missing data.

      Methods

      A systematic review was conducted of all trauma registry-based manuscripts published from 01 January 2015 to current date (17 March 2017). Studies were identified by searching MEDLINE, EMBASE, and CINAHL using relevant subject headings and keywords. Included manuscripts were evaluated based on previously published recommendations regarding the reporting and discussion of missing data. Manuscripts were graded on their degree of characterization of such observations. In addition, the methods used to manage missing data were examined.

      Results

      There were 539 manuscripts that met inclusion criteria. Among these, 208 (38.6%) manuscripts did not mention data completeness and 88 (16.3%) mentioned missing data but did not quantify the extent. Only a handful (n = 26; 4.8%) quantified the ‘missingness’ of all variables. Most articles (n = 477; 88.5%) contained no details such as a comparison between patient characteristics in cohorts with and without missing data. Of the 331 articles which made at least some mention of data completeness, the method of managing missing data was unknown in 34 (10.3%). When method(s) to handle missing data were identified, 234 (78.8%) manuscripts used complete case analysis only, 18 (6.1%) used multiple imputation only and 34 (11.4%) used a combination of these.

      Conclusion

      Most manuscripts using trauma registry data did not quantify the extent of missing data for any variables and contained minimal discussion regarding missingness. Out of the studies which identified a method of managing missing data, most used complete case analysis, a method that may bias results. The lack of standardization in the reporting and management of missing data questions the validity of conclusions from research based on trauma registry data.

      Keywords

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