Missing data
What question does this help answer?
“Could incomplete data change the study population, reduce precision, or bias the estimated association?”
Why it matters
Dropping every participant with any missing value may waste information and can bias results when completeness is related to exposure, outcome, or other predictors.
How to think about it
The traditional labels MCAR, MAR, and MNAR describe assumptions about the missingness process: missing completely at random means whether a value is missing depends on nothing in the data; missing at random means it depends only on information that was observed; missing not at random means it depends on the unobserved value itself. In practice, researchers should focus on what predicts missingness, what information is available, how the substantive analysis works, and which missingness scenarios are scientifically plausible.
What each mechanism depends on
How Mallard may use this concept
Mallard may flag missing data when the plan relies on EHR variables with incomplete measurement, longitudinal follow-up, survey nonresponse, or covariates that are not universally collected. It may recommend multiple imputation or sensitivity analyses.
Good practice
- Report how much is missing for important variables.
- Compare missingness patterns by key study characteristics.
- Avoid automatic single-value or mean imputation.
- Make the missing-data assumptions explicit.
- Align the missing-data method with the substantive analysis.
- Perform sensitivity analysis when departures from the main assumption are plausible.
Common mistake
“Less than 5% missing” is not automatically ignorable. Bias depends on why values are missing, not only how many are missing.
Clinical example
If follow-up lab testing occurs more often among sicker patients, simply analyzing patients with observed labs can select a systematically different subgroup.
- Multiple imputation for missing data in epidemiological and clinical research: potential and pitfalls (opens in a new tab) · BMJ · doi 10.1136/bmj.b2393
- Missing Data in Clinical Research: A Tutorial on Multiple Imputation (opens in a new tab) · Can J Cardiol · doi 10.1016/j.cjca.2020.11.010