What's missing in missing data? Omissions in survey responses among parents of children with advanced cancer.

TitleWhat's missing in missing data? Omissions in survey responses among parents of children with advanced cancer.
Publication TypeJournal Article
Year of Publication2014
AuthorsRosenberg AR, Dussel V, Orellana L, Kang T, Geyer JR, Feudtner C, Wolfe J
JournalJ Palliat Med
Date Published2014 Aug
KeywordsAdolescent, Adult, Biomedical Research, Cross-Sectional Studies, Disease Progression, Female, Humans, Life Expectancy, Male, Neoplasms, Parents, Prognosis, Quality of Life, Surveys and Questionnaires

BACKGROUND: Missing data is a common phenomenon with survey-based research; patterns of missing data may elucidate why participants decline to answer certain questions.

OBJECTIVE: To describe patterns of missing data in the Pediatric Quality of Life and Evaluation of Symptoms Technology (PediQUEST) study, and highlight challenges in asking sensitive research questions.

DESIGN: Cross-sectional, survey-based study embedded within a randomized controlled trial.

SETTING: Three large children's hospitals: Dana-Farber/Boston Children's Cancer and Blood Disorders Center (DF/BCCDC); Children's Hospital of Philadelphia (CHOP); and Seattle Children's Hospital (SCH).

MEASUREMENTS: At the time of their child's enrollment, parents completed the Survey about Caring for Children with Cancer (SCCC), including demographics, perceptions of prognosis, treatment goals, quality of life, and psychological distress.

RESULTS: Eighty-six of 104 parents completed surveys (83% response). The proportion of missing data varied by question type. While 14 parents (16%) left demographic fields blank, over half (n=48; 56%) declined to answer at least one question about their child's prognosis, especially life expectancy. The presence of missing data was unrelated to the child's diagnosis, time from progression, time to death, or parent distress (p>0.3 for each). Written explanations in survey margins suggested that addressing a child's life expectancy is particularly challenging for parents.

CONCLUSIONS AND RELEVANCE: Parents of children with cancer commonly refrain from answering questions about their child's prognosis, however, they may be more likely to address general cure likelihood than explicit life expectancy. Understanding acceptability of sensitive questions in survey-based research will foster higher quality palliative care research.

Alternate JournalJ Palliat Med
PubMed ID24865204
PubMed Central IDPMC4118710
Grant List1K07 CA096746-01 / CA / NCI NIH HHS / United States
L40 CA170049 / CA / NCI NIH HHS / United States