A transitional model of barrier methods compliance with unbalanced loss to follow-up

Differential loss to follow-up can substantially influence the evaluation of treatment effects on a dichotomous outcome of interest in longitudinal trials. The use of transitional models incorporating loss to follow-up as an additional category of response and the nature of the correlated responses can provide a comprehensive view of a trial with unbalanced loss to follow-up. Under the Markov assumption, transitional models estimate the probability of changing from one outcome to another outcome between follow-up visits. Patterns of the response variable can be described by the estimated transition probabilities. The effects of intervention and covariates on the outcome of interest can also be estimated using a conditional likelihood function or a multinomial logit regression. Data from a randomized barrier method study designed to compare the proportion of participants using barrier methods consistently in two counselling groups are used to illustrate the proposed model.