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Future studies should consider maximizing the case sample, improving the data quality by minimizing the proportion of missing data, increasing the information accuracy, and collecting additional information such as genetic factors, which may increase the value of the NHANES data sets to better address these questions.
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At the seventh day of administration, missing data increased to 20.4% of overnight data and 21%to22%2% of daytime data; at the last day of diary administration, 26% (overnight) to 27% (daytime) of responses were missing.
Rates of missing data increased with increasing score complexity reaching 10.3% in the SICK score.
Missing data increase the chance of selection bias and hinder the interpretation of results.
Sensitivity analysis for missing data increased from 21%to37%95 (95% CI for difference 1% to 31%; P = 0.04).
Imputation of missing data increased the number of analysable PPQs to 3055 and 12MQs to 3039.
During follow-up, the number of completed questionnaires decreased and missing data increased.
However, the presence of missing data increased the widths of the presented confidence intervals and some non-statistically significant predictors (ethnicity and income) have confidence intervals which do not rule out important associations.
The proportion of patients with responses within the normal range and in each disordered state generally decreased over the course of the study (data not shown), but changes were small and the amount of missing data increased (overall: anxiety 5.1% at baseline, 16.0% at 24 months; depression 5.4% at baseline, 17.4% at 24 months).
In both omission mechanisms, the computation time decreases as the portion of missing data increases.
Thus, these methods are mostly effective for cases with a relatively low number of missing data points, they are easy to compute but quickly become less accurate as the amount of missing data increases.
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