Assessing the impact of missing data in youth overweight and obesity research: complete case analysis versus multiple imputation

ABSTRACT

Youth overweight and obesity (OWOB) surveillance often uses body mass index (BMI) derived from self-reported height and weight, but these measures can suffer from high proportions of missing data. Complete case analysis (CCA) is the most common approach to handle missing data, but this approach can introduce bias if missing data are not missing completely at random. Using BMI and related covariate data from 36,546 female and 37,126 male youth aged 12–19 years who participated in the COMPASS study in 2018/19, where approximately 30% of BMI data were missing, results and inference were compared between CCA and multiple imputation (MI) approaches to examine associations with youth BMI. Results of regression joint models showed contrasting findings between MI and CCA, highlighting that appropriate methodological choices in the handling of missing data are essential in youth OWOB research and that choices can impact research inference and thereby associated policy and programming recommendations.

KEYWORDS:

• Missingness
• listwise deletion
• imputation
• obesity
• adolescents
• epidemiology

Disclosure statement

No potential conflict of interest was reported by the author(s).

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/13645579.2024.2368345

Additional information

Funding

The COMPASS study has been supported by a bridge grant from the CIHR Institute of Nutrition, Metabolism and Diabetes (INMD) through the “Obesity – Interventions to Prevent or Treat” priority funding awards (OOP-110788; awarded to SL), an operating grant from the CIHR Institute of Population and Public Health (IPPH) (MOP-114875; awarded to SL), a CIHR project grant (PJT-148562; awarded to SL), a CIHR bridge grant (PJT-149092; awarded to KP/SL), a CIHR project grant (PJT-159693; awarded to KP), by a research funding arrangement with Health Canada (#1617-HQ-000012; contract awarded to SL), a CIHR-Canadian Centre on Substance Abuse (CCSA) team grant (OF7 B1-PCPEGT 410-10-9633; awarded to SL), and a SickKids Foundation New Investigator Grant, in partnership with CIHR Institute of Human Development, Child and Youth Health (IHDCYH) (Grant No. NI21-1193; awarded to KAP) funds a mixed methods study examining the impact of the COVID-19 pandemic on youth mental health, leveraging COMPASS study data. The COMPASS-Quebec project additionally benefits from funding from the Ministère de la Santé et des Services sociaux of the province of Québec, and the Direction régionale de santé publique du CIUSSS de la Capitale-Nationale.

Notes on contributors

Amanda Doggett

Amanda Doggett research focuses on the epidemiology of health behaviours, primarily substance use. She has a particular interest in the methodological aspects of research studies, including the impacts of missing data.

Ashok Chaurasia

Ashok Chaurasia is an assistant professor within the School of Public Health Sciences at the University of Waterloo. His research interests pertain to innovative application of statistical methods in health research, including application of existing statistical methods or development of (new) analytical (statistical) tools as warranted by the health research topic.

Jean-Philippe Chaput

Jean-Philippe Chaput is a senior scientist with the Healthy Active Living and Obesity Research Group at the CHEO Research Institute, whose research focuses on health promotion and the prevention of chronic diseases.

Scott T. Leatherdale

Scott Leatherdale is a professor within the School of Public Health Sciences at the University of Waterloo. His research focuses on advancing a systems approach to primary prevention activities, evaluating population-level health interventions across multiple risk factor domains, and creating research infrastructure to facilitate large population studies in chronic disease prevention.