Passive imputation and parcel summaries are both valid to handle missing items in studies with many multi-item scales

Iris Eekhout*, Henrica C.W. de Vet, Michiel R. de Boer, Jos W.R. Twisk, Martijn W. Heymans

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Previous studies showed that missing data in multi-item scales can best be handled by multiple imputation of item scores. However, when many scales are used, the number of items will become too large for the imputation model to reliably estimate imputations. A solution is to use passive imputation or a parcel summary score that combine and consequently reduce the number of variables in the imputation model. The performance of these methods was evaluated in a simulation study and illustrated in an example. Passive imputation, which updated scale scores from imputed items, and parcel summary scores that use the average over available item scores were compared to using all items simultaneously, imputing total scores of scales and complete-case analysis. Scale scores and coefficient estimates from linear regression were compared to “true” parameters on bias and precision. Passive imputation and using parcel summaries showed smaller bias and more precision than imputing total scores and complete-case analyses. Passive imputation or using parcel summary scores are valid missing data solutions in studies that include many multi-item scales.

Original languageEnglish
Pages (from-to)1128-1140
Number of pages13
JournalStatistical Methods in Medical Research
Issue number4
Publication statusPublished - 1 Apr 2018

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