Impact of definitions of loss to follow-up (LTFU) in antiretroviral therapy program evaluation: variation in the definition can have an appreciable impact on estimated proportions of LTFU

Grimsrud, Anna Thora; Cornell, Morna; Egger, Matthias; Boulle, Andrew; Myer, Landon (2013). Impact of definitions of loss to follow-up (LTFU) in antiretroviral therapy program evaluation: variation in the definition can have an appreciable impact on estimated proportions of LTFU. Journal of clinical epidemiology, 66(9), pp. 1006-1013. New York, N.Y.: Elsevier 10.1016/j.jclinepi.2013.03.013

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OBJECTIVE To examine the impact of different definitions of loss to follow-up (LTFU) on estimates of program outcomes in cohort studies of patients on antiretroviral therapy (ART). STUDY DESIGN AND SETTING We examined the impact of different definitions of LTFU using data from the International Epidemiological Databases to Evaluate AIDS-Southern Africa. The reference approach, Definition A, was compared with five alternative scenarios that differed in eligibility for analysis and the date assigned to the LTFU outcome. Kaplan-Meier estimates of LTFU were calculated up to 2 years after starting ART. RESULTS Estimated cumulative LTFU were 14% and 22% at 12 and 24 months, respectively, using the reference approach. Differences in the proportion LTFU were reported in the alternative scenarios with 12-month estimates of LTFU varying by up to 39% compared with Definition A. Differences were largest when the date assigned to the LTFU outcome was 6 months after the date of last contact and when the site-specific definition of LTFU was used. CONCLUSION Variation in the definitions of LTFU within cohort analyses can have an appreciable impact on estimated proportions of LTFU over 2 years of follow-up. Use of a standardized definition of LTFU is needed to accurately measure program effectiveness and comparability between programs.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine

UniBE Contributor:

Egger, Matthias

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

0895-4356

Publisher:

Elsevier

Language:

English

Submitter:

Doris Kopp Heim

Date Deposited:

15 Jan 2014 09:37

Last Modified:

01 Mar 2015 19:33

Publisher DOI:

10.1016/j.jclinepi.2013.03.013

PubMed ID:

23774112

Uncontrolled Keywords:

Antiretroviral therapy Cohort Loss to follow-up Program outcomes Retention Survival analysis

BORIS DOI:

10.7892/boris.39057

URI:

https://boris.unibe.ch/id/eprint/39057

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