Where have all the patients gone?


Nancy S. Padian, Charles B. Holmes


The Lancet HIV Published Online: 27 January 2015 DOI: http://dx.doi.org/10.1016/S2352-3018(15)00015-6


Evaluations of health-care programmes are only as good as the data and methods used, and as in all longitudinal research, loss to follow-up is among the prime spoilers. For cohort studies including randomised controlled trials, loss to follow-up attenuates the ability to examine outcomes or the effect of an intervention and predictors of these outcomes. Patient-level data from health facilities are subject to the same biases. Most patients are probably not lost at random and reasons for loss to follow-up could be inherently linked to the effectiveness of clinical services.

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