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Design Example: Vintage Mixing Console01:17

Design Example: Vintage Mixing Console

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Updated: Jun 27, 2026

Using Rapid Serial Visual Presentation to Measure Set-Specific Capture, a Consequence of Distraction While Multitasking
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Implementing response-adaptive designs when responses are missing: Impute or ignore?

Mia S Tackney1, Sofía S Villar1

  • 1MRC-Biostatistics Unit, University of Cambridge, UK.

Statistical Methods in Medical Research
|August 29, 2025
PubMed
Summary
This summary is machine-generated.

Handling missing data in digital health trials is crucial. A new online imputation strategy can improve accuracy by re-imputing data, impacting the exploration-exploitation tradeoff and reducing bias in estimated success probabilities.

Keywords:
Multi-armed banditimputationmissing dataresponse adaptive proceduressequential allocationtruncation

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Area of Science:

  • Clinical Trials
  • Digital Health
  • Biostatistics

Background:

  • Missing data is a significant challenge in clinical trials, especially for digital health interventions.
  • Disengagement in digital health trials often leads to missing outcomes, frequently missing not at random (MNAR).
  • Response-adaptive designs require online handling of missing data, not just post-trial imputation.

Purpose of the Study:

  • To propose and evaluate a novel online imputation strategy for handling missing data in response-adaptive clinical trials.
  • To assess the impact of missing data strategies on the exploration-exploitation tradeoff and bias in estimated success probabilities.
  • To investigate the influence of MNAR mechanisms on trial outcomes.

Main Methods:

  • Developed a novel online imputation strategy allowing re-imputation of previous estimates.
  • Incorporated truncation of deterministic algorithms and modification of semi-randomised algorithms.
  • Conducted a simulation study based on a digital smoking cessation intervention trial.

Main Results:

  • The chosen missing data strategy significantly affects the exploration-exploitation tradeoff, especially with differing missingness rates between arms.
  • Identified problematic combinations of response-adaptive designs and missingness handling strategies.
  • Estimated success probabilities can be biased by optimistic sampling and MNAR mechanisms.

Conclusions:

  • Online imputation strategies are vital for managing missing data in adaptive digital health trials.
  • Careful selection of missingness handling methods is necessary to avoid biased estimates and maintain trial integrity.
  • The study highlights the complex interplay between adaptive designs, missing data, and outcome estimation.