How to analyze work productivity loss due to health problems in randomized controlled trials? A simulation study

BMC Medical Research Methodology

Huiying Sun¹  Wei Zhang² 

[1]Centre for Health Evaluation and Outcome Sciences, 588-1081 Burrard Street, V6Z 1Y6, Vancouver, British Columbia, Canada

[2]School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada

[3]Centre for Health Evaluation and Outcome Sciences, 588-1081 Burrard Street, V6Z 1Y6, Vancouver, British Columbia, Canada

关键词: Productivity loss;    Absenteeism;    Presenteeism;    Zero-inflated data;    Simulation studies;    Randomized controlled trial;    Two-part model;    Three-part model;   

DOI  :  10.1186/s12874-021-01330-w

来源: Springer

【 摘 要 】

BackgroundAn increasing number of randomized controlled trials (RCTs) have measured the impact of interventions on work productivity loss. Productivity loss outcome is inflated at zero and max loss values. Our study was to compare the performance of five commonly used methods in analysis of productivity loss outcomes in RCTs.MethodsWe conducted a simulation study to compare Ordinary Least Squares (OLS), Negative Binominal (NB), two-part models (the non-zero part following truncated NB distribution or gamma distribution) and three-part model (the middle part between zero and max values following Beta distribution). The main number of observations each arm, Nobs, that we considered were 50, 100 and 200. Baseline productivity loss was included as a covariate.ResultsAll models performed similarly well when baseline productivity loss was set at the mean value. When baseline productivity loss was set at other values and Nobs = 50 with ≤5 subjects having max loss, two-part models performed best if the proportion of zero loss> 50% in at least one arm and otherwise, OLS performed best. When Nobs = 100 or 200, the three-part model performed best if the two arms had equal scale parameters for their productivity loss outcome distributions between zero and max values.ConclusionsOur findings suggest that when treatment effect at any given values of one single covariate is of interest, the model selection depends on the sample size, the proportions of zero loss and max loss, and the scale parameter for the productivity loss outcome distribution between zero and max loss in each arm of RCTs.

【 授权许可】

CC BY