Choosing the frequency of follow-up in longitudinal studies: Is more necessarily better?

Abstract

Background Follow-up frequency is an important design parameter in longitudinal studies. We quantified the impact of reducing follow-up frequency on the precision of estimated regression parameters, and investigated the impact of incorrectly assuming an exchangeable correlation structure on estimates of the loss of precision resulting from reduced follow-up. Methods We estimated the loss in precision on deleting every second observation from three longitudinal cohorts: patients with Childhood Systemic Lupus Erythematosus (cSLE), the Canadian Haemophilia Prophylaxis Study (CHPS), and patients with Juvenile Dermatomyositis (JDM). We compared these results with those from a theoretical formula assuming an exchangeable correlation structure. Results The increase in sample size needed to compensate for halving follow-up frequency was 9%, 6% and 28% for the cSLE, CHPS and JDM cohorts respectively. Under the assumption of an exchangeable correlation, the estimated increases in sample size were 22%, 11% and 10% respectively. Conclusions Reducing follow-up frequency can result in minimal loss of information, as seen in the CHPS cohort. While using a theoretical formula based on an exchangeable correlation structure is convenient, it can be inaccurate when the true correlation structure is not exchangeable.