`smdi`

In this article, we want to briefly highlight two aspect regarding
**multivariate missingness**:

How does

`smdi`

handle multivariate missingness?What is the link between missing data patterns and missing data mechanisms and how does this affect the behavior and performance of the

`smdi`

functionality?

In general, there are two classic established missing data taxonomies:

Mechanisms: Missing completely at random (MCAR), at random (MAR) and not at random (MNAR)

Patterns: Monotone versus Non-monotone missingness

`smdi`

handle multivariate missingness?In all `smdi`

functions, except
`smdi_little()`

, binary missing indicator variables are
created for each partially observed variable (either specified by the
analyst using the `covar`

parameter or automatically
identified via `smdi_check_covar()`

if `covar`

=
NULL) and the columns with the actual variable values are dropped. For
the variable importance visualization in `smdi_rf()`

, these
variables are indicated with a *“_NA”* suffix. Missing values are
accordingly indicated with a *1* and complete observations with a
*0*. This functionality is controlled via the
`smdi_na_indicator()`

utility function.

```
smdi_data %>%
smdi_na_indicator(
drop_NA_col = FALSE # usually TRUE, but for demonstration purposes set to FALSE
) %>%
select(
ecog_cat, ecog_cat_NA,
egfr_cat, egfr_cat_NA,
pdl1_num, pdl1_num_NA
) %>%
head() %>%
gt()
```

ecog_cat | ecog_cat_NA | egfr_cat | egfr_cat_NA | pdl1_num | pdl1_num_NA |
---|---|---|---|---|---|

1 | 0 | NA | 1 | 45.03 | 0 |

NA | 1 | 0 | 0 | NA | 1 |

0 | 0 | 1 | 0 | 41.74 | 0 |

1 | 0 | NA | 1 | 45.51 | 0 |

NA | 1 | 1 | 0 | 31.28 | 0 |

0 | 0 | NA | 1 | NA | 1 |

Now, let’s assume we have three partially observed covariates
*X*, *Y* and *Z*, which we would like to include in
our missingness diagnostics. All `smdi_diagnose()`

functions,
except `smdi_little()`

, create *X_NA*, *Y_NA*
and *Z_NA* and *X*, *Y* and *Z* are
discarded from the dataset. The functions will then iterate the
diagnostics through all *X_NA*, *Y_NA* and *Z_NA*
one-by-one. That is, if, for example, *X_NA* is assessed,
*Y_NA* and *Z_NA* serve as predictor variables along with
all other covariates in the dataset. If *Y_NA* is assessed,
*X_NA* and *Z_NA* are included as predictor variables, and
so forth.

**Important!** It is important to notice that this
strategy is the default to deal with multivariate missingness in the
`smdi`

package, however, another possible approach could be
to *not* consider the other partially observed variables in the
first place (e.g. by dropping them before applying any `smdi`

function) and stacking the diagnostics focusing on one partially
observed variable at a time. Such a strategy would be advisable in
scenarios of monotone missing data patterns (see next section).

`smdi`

in case of monotone missing data patternsWhile in the `smdi`

package we mainly focus on missing
data mechanisms, missing data patterns always need to be considered,
too. Please refer to the routine
structural missing data diagnostics article, where we highlight the
importance of describing missingness proportions and patterns before
running any of the `smdi`

diagnostics.

As mentioned in the section before, in case of monotone missing data
patterns, the `smdi`

functionality may be misleading.

**Monotonicity** A missing data pattern is said to be
monotone if the variables Yj can be ordered such that if Yj is missing
then all variables Yk with k > j are also missing (taken from Stef
van Buuren ^{1}).

A good example for monotone missing data could be clinical blood laboratory tests (“labs”) which are often tested together in a lab panel. If one lab is missing, typically the other labs of this panel are also missing.

```
# we simulatea monotone missingness pattern
# following an MCAR mechanism
data_monotone <- smdi_data_complete %>%
mutate(
lab1 = rnorm(nrow(smdi_data_complete), mean = 5, sd = 0.5),
lab2 = rnorm(nrow(smdi_data_complete), mean = 10, sd = 2.25)
)
data_monotone[3:503, "lab1"] <- NA
data_monotone[1:500, "lab2"] <- NA
```

```
smdi::md.pattern(data_monotone[, c("lab1", "lab2")], plot = FALSE)
#> lab2 lab1
#> 1997 1 1 0
#> 3 1 0 1
#> 2 0 1 1
#> 498 0 0 2
#> 500 501 1001
```

In extreme cases of perfect linearity, this can lead to multiple
warnings and errors such as `system is exactly singular`

or
`-InfWarning: Variable has only NA's in at least one stratum`

.

In cases in which monotonicity is still clearly present but not as
extreme (like in the example above), `smdi`

will prompt a
message to the analyst to raise awareness of this issue as the
`smdi`

output can be **highly misleading** in
such instances.

```
diagnostics_jointly <- smdi_diagnose(
data = data_monotone,
covar = NULL, # NULL includes all covariates with at least one NA
model = "cox",
form_lhs = "Surv(eventtime, status)"
)
#> Important note:
#> AUC for predicting covariate lab1 is very high (>0.9).
#> Predictor with highest importance: lab2_NA.
#> Check for potentially underlying monotone missing data pattern.
#> Important note:
#> AUC for predicting covariate lab2 is very high (>0.9).
#> Predictor with highest importance: lab1_NA.
#> Check for potentially underlying monotone missing data pattern.
```

Covariate | ASMD (min/max)^{1} |
p Hotelling^{1} |
AUC^{2} |
beta univariate (95% CI)^{3} |
beta (95% CI)^{3} |
---|---|---|---|---|---|

lab1 | 0.060 (0.008, 0.730) | <.001 | 0.998 | -0.01 (95% CI -0.12, 0.09) | 1.06 (95% CI 0.01, 2.11) |

lab2 | 0.054 (0.003, 0.170) | <.001 | 0.993 | -0.03 (95% CI -0.14, 0.08) | -1.11 (95% CI -2.16, -0.05) |

p little: 0.146, Abbreviations: ASMD = Median absolute standardized mean difference across all covariates, AUC = Area under the curve, beta = beta coefficient, CI = Confidence interval, max = Maximum, min = Minimum | |||||

^{1} Group 1 diagnostic: Differences in patient characteristics between patients with and without covariate |
|||||

^{2} Group 2 diagnostic: Ability to predict missingness |
|||||

^{3} Group 3 diagnostic: Assessment if missingness is associated with the outcome (univariate, adjusted) |

In such cases, it may be advisable to *not* consider including
*lab2* in the missingness diagnostics of *lab1* and vice
versa and stack the diagnostics focusing on one partially observed
variable at a time.

```
# lab 1
lab1_diagnostics <- smdi_diagnose(
data = data_monotone %>% select(-lab2),
model = "cox",
form_lhs = "Surv(eventtime, status)"
)
lab1_diagnostics %>%
smdi_style_gt()
```

Covariate | ASMD (min/max)^{1} |
p Hotelling^{1} |
AUC^{2} |
beta univariate (95% CI)^{3} |
beta (95% CI)^{3} |
---|---|---|---|---|---|

lab1 | 0.050 (0.008, 0.083) | 0.296 | 0.500 | -0.01 (95% CI -0.12, 0.09) | -0.04 (95% CI -0.15, 0.07) |

p little: 0.236, Abbreviations: ASMD = Median absolute standardized mean difference across all covariates, AUC = Area under the curve, beta = beta coefficient, CI = Confidence interval, max = Maximum, min = Minimum | |||||

^{1} Group 1 diagnostic: Differences in patient characteristics between patients with and without covariate |
|||||

^{2} Group 2 diagnostic: Ability to predict missingness |
|||||

^{3} Group 3 diagnostic: Assessment if missingness is associated with the outcome (univariate, adjusted) |

```
# lab 2
lab2_diagnostics <- smdi_diagnose(
data = data_monotone %>% select(-lab1),
model = "cox",
form_lhs = "Surv(eventtime, status)"
)
lab2_diagnostics %>%
smdi_style_gt()
```

Covariate | ASMD (min/max)^{1} |
p Hotelling^{1} |
AUC^{2} |
beta univariate (95% CI)^{3} |
beta (95% CI)^{3} |
---|---|---|---|---|---|

lab2 | 0.051 (0.003, 0.082) | 0.291 | 0.500 | -0.03 (95% CI -0.14, 0.08) | -0.05 (95% CI -0.16, 0.06) |

p little: 0.233, Abbreviations: ASMD = Median absolute standardized mean difference across all covariates, AUC = Area under the curve, beta = beta coefficient, CI = Confidence interval, max = Maximum, min = Minimum | |||||

^{1} Group 1 diagnostic: Differences in patient characteristics between patients with and without covariate |
|||||

^{2} Group 2 diagnostic: Ability to predict missingness |
|||||

^{3} Group 3 diagnostic: Assessment if missingness is associated with the outcome (univariate, adjusted) |

`smdi_style_gt()`

We can also combine the output of individually stacked
`smdi_diagnose`

tables and enhance it with a global Little’s
test that takes into account the multivariate missingness of the entire
dataset.

```
# computing a gloabl p-value for Little's test including both lab1 and lab2
little_global <- smdi_little(data = data_monotone)
# combining two individual lab smdi tables and global Little's test
smdi_style_gt(
smdi_object = rbind(lab1_diagnostics$smdi_tbl, lab2_diagnostics$smdi_tbl),
include_little = little_global
)
```

Covariate | ASMD (min/max)^{1} |
p Hotelling^{1} |
AUC^{2} |
beta univariate (95% CI)^{3} |
beta (95% CI)^{3} |
---|---|---|---|---|---|

lab1 | 0.050 (0.008, 0.083) | 0.296 | 0.500 | -0.01 (95% CI -0.12, 0.09) | -0.04 (95% CI -0.15, 0.07) |

lab2 | 0.051 (0.003, 0.082) | 0.291 | 0.500 | -0.03 (95% CI -0.14, 0.08) | -0.05 (95% CI -0.16, 0.06) |

p little: 0.146, Abbreviations: ASMD = Median absolute standardized mean difference across all covariates, AUC = Area under the curve, beta = beta coefficient, CI = Confidence interval, max = Maximum, min = Minimum | |||||

^{1} Group 1 diagnostic: Differences in patient characteristics between patients with and without covariate |
|||||

^{2} Group 2 diagnostic: Ability to predict missingness |
|||||

^{3} Group 3 diagnostic: Assessment if missingness is associated with the outcome (univariate, adjusted) |

Since the missingness follows an MCAR mechanism,
`smdi_diagnose()`

now shows the expected missingness
diagnostics patterns one would expect from an MCAR mechanism.

For more information on missing data patterns see https://stefvanbuuren.name/fimd/missing-data-pattern.html↩︎