Marginalized models for moderate to long series of longitudinal binary response data

Marginalized models (Heagerty, 1999, Biometrics 55, 688-698) permit likelihood-based inference when interest lies in marginal regression models for longitudinal binary response data. Two such models are the marginalized transition and marginalized latent variable models. The former captures within-subject serial dependence among repeated measurements with transition model terms while the latter assumes exchangeable or nondiminishing response dependence using random intercepts. In this article, we extend the class of marginalized models by proposing a single unifying model that describes both serial and long-range dependence. This model will be particularly useful in longitudinal analyses with a moderate to large number of repeated measurements per subject, where both serial and exchangeable forms of response correlation can be identified. We describe maximum likelihood and Bayesian approaches toward parameter estimation and inference, and we study the large sample operating characteristics under two types of dependence model misspecification. Data from the Madras Longitudinal Schizophrenia Study (Thara et al., 1994, Acta Psychiatrica Scandinavica 90, 329-336) are analyzed.     

Dynamic prediction of time to a clinical event with sparse and irregularly measured longitudinal biomarkers

In clinical research and practice, landmark models are commonly used to predict the risk of an adverse future event, using patients' longitudinal biomarker data as predictors. However, these data are often observable only at intermittent visits, making their measurement times irregularly spaced and unsynchronized across different subjects. This poses challenges to conducting dynamic prediction at any post-baseline time. A simple solution is the last-value-carry-forward method, but this may result in bias for the risk model estimation and prediction. Another option is to jointly model the longitudinal and survival processes with a shared random effects model. However, when dealing with multiple biomarkers, this approach often results in high-dimensional integrals without a closed-form solution, and thus the computational burden limits its software development and practical use. In this article, we propose to process the longitudinal data by functional principal component analysis techniques, and then use the processed information as predictors in a class of flexible linear transformation models to predict the distribution of residual time-to-event occurrence. The measurement schemes for multiple biomarkers are allowed to be different within subject and across subjects. Dynamic prediction can be performed in a real-time fashion. The advantages of our proposed method are demonstrated by simulation studies. We apply our approach to the African American Study of Kidney Disease and Hypertension, predicting patients' risk of kidney failure or death by using four important longitudinal biomarkers for renal functions.     

A penalized spline approach to functional mixed effects model analysis

In this article, we propose penalized spline (P-spline)-based methods for functional mixed effects models with varying coefficients. We decompose longitudinal outcomes as a sum of several terms: a population mean function, covariates with time-varying coefficients, functional subject-specific random effects, and residual measurement error processes. Using P-splines, we propose nonparametric estimation of the population mean function, varying coefficient, random subject-specific curves, and the associated covariance function that represents between-subject variation and the variance function of the residual measurement errors which represents within-subject variation. Proposed methods offer flexible estimation of both the population- and subject-level curves. In addition, decomposing variability of the outcomes as a between- and within-subject source is useful in identifying the dominant variance component therefore optimally model a covariance function. We use a likelihood-based method to select multiple smoothing parameters. Furthermore, we study the asymptotics of the baseline P-spline estimator with longitudinal data. We conduct simulation studies to investigate performance of the proposed methods. The benefit of the between- and within-subject covariance decomposition is illustrated through an analysis of Berkeley growth data, where we identified clearly distinct patterns of the between- and within-subject covariance functions of children's heights. We also apply the proposed methods to estimate the effect of antihypertensive treatment from the Framingham Heart Study data.     

Character process model for semen volume in AI rams: evaluation of correlation structures for long and short-term environmental effects

The objective of this study was to build a character process model taking into account serial correlations for the analysis of repeated measurements of semen volume in AI rams. For each ram, measurements were repeated within and across years. Therefore, we considered a model including three environmental effects: the long-term environmental effect, which is a random year* subject effect, the short-term environmental effect, which is a random within year subject* collection effect, and the classical measurement error. We used a four-step approach to build the model. The first step explored graphically the serial correlations. The second step compared four models with different correlation structures for the short-term environmental effect. We selected fixed effects in the third step. In the fourth step, we compared four correlation structures for the long-term environmental effect. The model, which fitted best the data, used a spatial power correlation structure for the short-term environmental effect and a first order autoregressive process for the long-term environmental effect. The heritability estimate was 0.27 (0.04), the within year repeatability decreased from 0.56 to 0.44 and the repeatability across years decreased from 0.43 to 0.37.     

Statistical significance analysis of longitudinal gene expression data

MOTIVATION: Time-course microarray experiments are designed to study biological processes in a temporal fashion. Longitudinal gene expression data arise when biological samples taken from the same subject at different time points are used to measure the gene expression levels. It has been observed that the gene expression patterns of samples of a given tumor measured at different time points are likely to be much more similar to each other than are the expression patterns of tumor samples of the same type taken from different subjects. In statistics, this phenomenon is called the within-subject correlation of repeated measurements on the same subject, and the resulting data are called longitudinal data. It is well known in other applications that valid statistical analyses have to appropriately take account of the possible within-subject correlation in longitudinal data. RESULTS: We apply estimating equation techniques to construct a robust statistic, which is a variant of the robust Wald statistic and accounts for the potential within-subject correlation of longitudinal gene expression data, to detect genes with temporal changes in expression. We associate significance levels to the proposed statistic by either incorporating the idea of the significance analysis of microarrays method or using the mixture model method to identify significant genes. The utility of the statistic is demonstrated by applying it to an important study of osteoblast lineage-specific differentiation. Using simulated data, we also show pitfalls in drawing statistical inference when the within-subject correlation in longitudinal gene expression data is ignored.     

Joint models for a primary endpoint and multiple longitudinal covariate processes

Summary .   Joint models are formulated to investigate the association between a primary endpoint and features of multiple longitudinal processes. In particular, the subject-specific random effects in a multivariate linear random-effects model for multiple longitudinal processes are predictors in a generalized linear model for primary endpoints. Li, Zhang, and Davidian (2004, Biometrics 60 , 1–7) proposed an estimation procedure that makes no distributional assumption on the random effects but assumes independent within-subject measurement errors in the longitudinal covariate process. Based on an asymptotic bias analysis, we found that their estimators can be biased when random effects do not fully explain the within-subject correlations among longitudinal covariate measurements. Specifically, the existing procedure is fairly sensitive to the independent measurement error assumption. To overcome this limitation, we propose new estimation procedures that require neither a distributional or covariance structural assumption on covariate random effects nor an independence assumption on within-subject measurement errors. These new procedures are more flexible, readily cover scenarios that have multivariate longitudinal covariate processes, and can be implemented using available software. Through simulations and an analysis of data from a hypertension study, we evaluate and illustrate the numerical performances of the new estimators.     

Dynamic conditionally linear mixed models for longitudinal data

We develop a new class of models, dynamic conditionally linear mixed models, for longitudinal data by decomposing the within-subject covariance matrix using a special Cholesky decomposition. Here 'dynamic' means using past responses as covariates and 'conditional linearity' means that parameters entering the model linearly may be random, but nonlinear parameters are nonrandom. This setup offers several advantages and is surprisingly similar to models obtained from the first-order linearization method applied to nonlinear mixed models. First, it allows for flexible and computationally tractable models that include a wide array of covariance structures; these structures may depend on covariates and hence may differ across subjects. This class of models includes, e.g., all standard linear mixed models, antedependence models, and Vonesh-Carter models. Second, it guarantees the fitted marginal covariance matrix of the data is positive definite. We develop methods for Bayesian inference and motivate the usefulness of these models using a series of longitudinal depression studies for which the features of these new models are well suited.     

Joint modeling of longitudinal and survival data via a common frailty

We develop a joint model for the analysis of longitudinal and survival data in the presence of data clustering. We use a mixed effects model for the repeated measures that incorporates both subject- and cluster-level random effects, with subjects nested within clusters. A Cox frailty model is used for the survival model in order to accommodate the clustering. We then link the two responses via the common cluster-level random effects, or frailties. This model allows us to simultaneously evaluate the effect of covariates on the two types of responses, while accounting for both the relationship between the responses and data clustering. The model was motivated by a study of end-stage renal disease patients undergoing hemodialysis, where we wished to evaluate the effect of iron treatment on both the patients' hemoglobin levels and survival times, with the patients clustered by enrollment site.     

Semiparametric regression for periodic longitudinal hormone data from multiple menstrual cycles

We consider semiparametric regression for periodic longitudinal data. Parametric fixed effects are used to model the covariate effects and a periodic nonparametric smooth function is used to model the time effect. The within-subject correlation is modeled using subject-specific random effects and a random stochastic process with a periodic variance function. We use maximum penalized likelihood to estimate the regression coefficients and the periodic nonparametric time function, whose estimator is shown to be a periodic cubic smoothing spline. We use restricted maximum likelihood to simultaneously estimate the smoothing parameter and the variance components. We show that all model parameters can be easily obtained by fitting a linear mixed model. A common problem in the analysis of longitudinal data is to compare the time profiles of two groups, e.g., between treatment and placebo. We develop a scaled chi-squared test for the equality of two nonparametric time functions. The proposed model and the test are illustrated by analyzing hormone data collected during two consecutive menstrual cycles and their performance is evaluated through simulations.     

A time-heterogeneous D-vine copula model for unbalanced and unequally spaced longitudinal data

In many longitudinal studies, the number and timing of measurements differ across study subjects. Statistical analysis of such data requires accounting for both the unbalanced study design and the unequal spacing of repeated measurements. This paper proposes a time-heterogeneous D-vine copula model that allows for time adjustment in the dependence structure of unequally spaced and potentially unbalanced longitudinal data. The proposed approach not only offers flexibility over its time-homogeneous counterparts but also allows for parsimonious model specifications at the tree or vine level for a given D-vine structure. It further provides a robust strategy to specify the joint distribution of non-Gaussian longitudinal data. The performance of the time-heterogeneous D-vine copula models are evaluated through simulation studies and by a real data application. Our findings suggest improved predictive performance of the proposed approach over the linear mixed-effects model and time-homogeneous D-vine copula model.     

Continuous time Markov models for binary longitudinal data

Longitudinal data usually consist of a number of short time series. A group of subjects or groups of subjects are followed over time and observations are often taken at unequally spaced time points, and may be at different times for different subjects. When the errors and random effects are Gaussian, the likelihood of these unbalanced linear mixed models can be directly calculated, and nonlinear optimization used to obtain maximum likelihood estimates of the fixed regression coefficients and parameters in the variance components. For binary longitudinal data, a two state, non-homogeneous continuous time Markov process approach is used to model serial correlation within subjects. Formulating the model as a continuous time Markov process allows the observations to be equally or unequally spaced. Fixed and time varying covariates can be included in the model, and the continuous time model allows the estimation of the odds ratio for an exposure variable based on the steady state distribution. Exact likelihoods can be calculated. The initial probability distribution on the first observation on each subject is estimated using logistic regression that can involve covariates, and this estimation is embedded in the overall estimation. These models are applied to an intervention study designed to reduce children's sun exposure.     

Parametric survival models for interval-censored data with time-dependent covariates

We present a parametric family of regression models for interval-censored event-time (survival) data that accomodates both fixed (e.g. baseline) and time-dependent covariates. The model employs a three-parameter family of survival distributions that includes the Weibull, negative binomial, and log-logistic distributions as special cases, and can be applied to data with left, right, interval, or non-censored event times. Standard methods, such as Newton-Raphson, can be employed to estimate the model and the resulting estimates have an asymptotically normal distribution about the true values with a covariance matrix that is consistently estimated by the information function. The deviance function is described to assess model fit and a robust sandwich estimate of the covariance may also be employed to provide asymptotically robust inferences when the model assumptions do not apply. Spline functions may also be employed to allow for non-linear covariates. The model is applied to data from a long-term study of type 1 diabetes to describe the effects of longitudinal measures of glycemia (HbA1c) over time (the time-dependent covariate) on the risk of progression of diabetic retinopathy (eye disease), an interval-censored event-time outcome.     

Simulation‐based evaluation of the linear‐mixed model in the presence of an increasing proportion of singletons

Data in medical sciences often have a hierarchical structure with lower level units (e.g. children) nested in higher level units (e.g. departments). Several specific but frequently studied settings, mainly in longitudinal and family research, involve a large number of units that tend to be quite small, with units containing only one element referred to as singletons. Regardless of sparseness, hierarchical data should be analyzed with appropriate methodology such as, for example linear‐mixed models. Using a simulation study, based on the structure of a data example on Ceftriaxone consumption in hospitalized children, we assess the impact of an increasing proportion of singletons (0–95%), in data with a low, medium, or high intracluster correlation, on the stability of linear‐mixed models parameter estimates, confidence interval coverage and F test performance. Some techniques that are frequently used in the presence of singletons include ignoring clustering, dropping the singletons from the analysis and grouping the singletons into an artificial unit. We show that both the fixed and random effects estimates and their standard errors are stable in the presence of an increasing proportion of singletons. We demonstrate that ignoring clustering and dropping singletons should be avoided as they come with biased standard error estimates. Grouping the singletons into an artificial unit might be considered, although the linear‐mixed model performs better even when the proportion of singletons is high. We conclude that the linear‐mixed model is stable in the presence of singletons when both lower‐ and higher level sample sizes are fixed. In this setting, the use of remedial measures, such as ignoring clustering and grouping or removing singletons, should be dissuaded.     

Semiparametric bayesian inference for multilevel repeated measurement data

We discuss inference for data with repeated measurements at multiple levels. The motivating example is data with blood counts from cancer patients undergoing multiple cycles of chemotherapy, with days nested within cycles. Some inference questions relate to repeated measurements over days within cycle, while other questions are concerned with the dependence across cycles. When the desired inference relates to both levels of repetition, it becomes important to reflect the data structure in the model. We develop a semiparametric Bayesian modeling approach, restricting attention to two levels of repeated measurements. For the top-level longitudinal sampling model we use random effects to introduce the desired dependence across repeated measurements. We use a nonparametric prior for the random effects distribution. Inference about dependence across second-level repetition is implemented by the clustering implied in the nonparametric random effects model. Practical use of the model requires that the posterior distribution on the latent random effects be reasonably precise.     

Fitting semiparametric random effects models to large data sets

For large data sets, it can be difficult or impossible to fit models with random effects using standard algorithms due to memory limitations or high computational burdens. In addition, it would be advantageous to use the abundant information to relax assumptions, such as normality of random effects. Motivated by data from an epidemiologic study of childhood growth, we propose a 2-stage method for fitting semiparametric random effects models to longitudinal data with many subjects. In the first stage, we use a multivariate clustering method to identify G相似文献   

A conditional Markov model for clustered progressive multistate processes under incomplete observation

Clustered progressive chronic disease processes arise when interest lies in modeling damage in paired organ systems (e.g., kidneys, eyes), in diseases manifest in different organ systems, or in systemic conditions for which damage may occur in several locations of the body. Multistate Markov models have considerable appeal for modeling damage in such settings, particularly when patients are only under intermittent observation. Generalizations are necessary, however, to deal with the fact that processes within subjects may not be independent. We describe a conditional Markov model in which the clustering in processes within subjects is addressed by the use of multiplicative random effects for each transition intensity. The random effects for the different transition intensities may be correlated within subjects, but are assumed to be independent for different subjects. We apply the mixed Markov model to a motivating data set of patients with psoriatic arthritis, and characterize the progressive course of damage in joints of the hand. A generalization to accommodate a subpopulation of "stayers" and extensions which facilitate regression are indicated and illustrated.     

Detection and modelling of time-dependent QTL in animal populations

A longitudinal approach is proposed to map QTL affecting function-valued traits and to estimate their effect over time. The method is based on fitting mixed random regression models. The QTL allelic effects are modelled with random coefficient parametric curves and using a gametic relationship matrix. A simulation study was conducted in order to assess the ability of the approach to fit different patterns of QTL over time. It was found that this longitudinal approach was able to adequately fit the simulated variance functions and considerably improved the power of detection of time-varying QTL effects compared to the traditional univariate model. This was confirmed by an analysis of protein yield data in dairy cattle, where the model was able to detect QTL with high effect either at the beginning or the end of the lactation, that were not detected with a simple 305 day model.     

Directly parameterized regression conditioning on being alive: analysis of longitudinal data truncated by deaths

For observational longitudinal studies of geriatric populations, outcomes such as disability or cognitive functioning are often censored by death. Statistical analysis of such data may explicitly condition on either vital status or survival time when summarizing the longitudinal response. For example a pattern-mixture model characterizes the mean response at time t conditional on death at time S = s (for s > t), and thus uses future status as a predictor for the time t response. As an alternative, we define regression conditioning on being alive as a regression model that conditions on survival status, rather than a specific survival time. Such models may be referred to as partly conditional since the mean at time t is specified conditional on being alive (S > t), rather than using finer stratification (S = s for s > t). We show that naive use of standard likelihood-based longitudinal methods and generalized estimating equations with non-independence weights may lead to biased estimation of the partly conditional mean model. We develop a taxonomy for accommodation of both dropout and death, and describe estimation for binary longitudinal data that applies selection weights to estimating equations with independence working correlation. Simulation studies and an analysis of monthly disability status illustrate potential bias in regression methods that do not explicitly condition on survival.     

An approach to the analysis of repeated measurements

A linear model for repeated measurements is proposed in which the correlation structure within each time sequence of measurements includes parameters for measurement error, variation between experimental units, and serial correlation within units. An approach to data analysis is presented which involves preliminary analysis by ordinary least squares, use of the empirical semi-variogram of residuals to suggest a suitable correlation structure, and formal inference using likelihood-based methods. Applications to two biological data sets are described.     

Optimal weight in estimating and comparing areas under the receiver operating characteristic curve using longitudinal data

In the setting of longitudinal study, subjects are followed for the occurrence of some dichotomous outcome. In many of these studies, some markers are also obtained repeatedly during the study period. Emir et al. introduced a non-parametric approach to the estimation of the area under the ROC curve of a repeated marker. Their non-parametric estimate involves assigning a weight to each subject. There are two weighting schemes suggested in their paper: one for the case when within-patient correlation is low, and the other for the case when within-subject correlation is high. However, it is not clear how to assign weights to marker measurements when within-patient correlation is modest. In this paper, we consider the optimal weights that minimize the variance of the estimate of the area under the ROC curve (AUC) of a repeated marker, as well as the optimal weights that minimize the variance of the AUC difference between two repeated markers. Our results in this paper show that the optimal weights depend not only on the within-patient control--case correlation in the longitudinal data, but also on the proportion of subjects that become cases. More importantly, we show that the loss of efficiency by using the two weighting schemes suggested by Emir et al. instead of our optimal weights can be severe when there is a large within-subject control--case correlation and the proportion of subjects that become cases is small, which is often the case in longitudinal study settings.