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A joint modeling approach for analyzing marker data in the presence of a terminal event
Authors:Jie Zhou  Xin Chen  Xinyuan Song  Liuquan Sun
Abstract:In many medical studies, markers are contingent on recurrent events and the cumulative markers are usually of interest. However, the recurrent event process is often interrupted by a dependent terminal event, such as death. In this article, we propose a joint modeling approach for analyzing marker data with informative recurrent and terminal events. This approach introduces a shared frailty to specify the explicit dependence structure among the markers, the recurrent, and terminal events. Estimation procedures are developed for the model parameters and the degree of dependence, and a prediction of the covariate‐specific cumulative markers is provided. The finite sample performance of the proposed estimators is examined through simulation studies. An application to a medical cost study of chronic heart failure patients from the University of Virginia Health System is illustrated.
Keywords:joint modeling  longitudinal data analysis  marker process  medical costs  recurrent events  terminal event
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