A mixed model for two-state Markov processes under panel observation

Many chronic medical conditions can be meaningfully characterized in terms of a two-state stochastic process. Here we consider the problem in which subjects make transitions among two such states in continuous time but are only observed at discrete, irregularly spaced time points that are possibly unique to each subject. Data arising from such an observation scheme are called panel data, and methods for related analyses are typically based on Markov assumptions. The purpose of this article is to present a conditionally Markov model that accommodates subject-to-subject variation in the model parameters by the introduction of random effects. We focus on a particular random effects formulation that generates a closed-form expression for the marginal likelihood. The methodology is illustrated by application to a data set from a parasitic field infection survey.     

A spatiotemporal stochastic process model for species spread

We use a spatiotemporal Markov process to model the spread of an ecological population through its environment over time. Available habitat is divided into sites, and a parametric function of spatial variables is used to model the probability that one site is colonized from another. This allows us both to make predictions about the future spread of a population, and to determine which are the important factors governing colonizations. The model evolves in discrete time, allowing the population distribution to change seasonally in accordance with breeding patterns. Discrete time formulations are natural for ecological populations, but are problematic due to difficulties of fitting and predicting over irregular time intervals. The model described here can accommodate years of missing data and can therefore fit and predict at irregular intervals. Two methods of approximating the likelihood are described and applied to ornithological survey data for the woodlark, Lullula arborea, from Thetford Forest in the U.K.     

Maximum likelihood estimation of two-level latent variable models with mixed continuous and polytomous data

Two-level data with hierarchical structure and mixed continuous and polytomous data are very common in biomedical research. In this article, we propose a maximum likelihood approach for analyzing a latent variable model with these data. The maximum likelihood estimates are obtained by a Monte Carlo EM algorithm that involves the Gibbs sampler for approximating the E-step and the M-step and the bridge sampling for monitoring the convergence. The approach is illustrated by a two-level data set concerning the development and preliminary findings from an AIDS preventative intervention for Filipina commercial sex workers where the relationship between some latent quantities is investigated.     

A transitional model for longitudinal binary data subject to nonignorable missing data

Binary longitudinal data are often collected in clinical trials when interest is on assessing the effect of a treatment over time. Our application is a recent study of opiate addiction that examined the effect of a new treatment on repeated urine tests to assess opiate use over an extended follow-up. Drug addiction is episodic, and a new treatment may affect various features of the opiate-use process such as the proportion of positive urine tests over follow-up and the time to the first occurrence of a positive test. Complications in this trial were the large amounts of dropout and intermittent missing data and the large number of observations on each subject. We develop a transitional model for longitudinal binary data subject to nonignorable missing data and propose an EM algorithm for parameter estimation. We use the transitional model to derive summary measures of the opiate-use process that can be compared across treatment groups to assess treatment effect. Through analyses and simulations, we show the importance of properly accounting for the missing data mechanism when assessing the treatment effect in our example.     

A generalized mover-stayer model for panel data

A generalized mover-stayer model is described for conditionally Markov processes under panel observation. Marginally the model represents a mixture of nested continuous-time Markov processes in which sub-models are defined by constraining some transition intensities to zero between two or more states of a full model. A Fisher scoring algorithm is described which facilitates maximum likelihood estimation based only on the first derivatives of the transition probability matrices. The model is fit to data from a smoking prevention study and is shown to provide a significant improvement in fit over a time-homogeneous Markov model. Extensions are developed which facilitate examination of covariate effects on both the transition intensities and the mover-stayer probabilities.     

A two-component model for counts of infectious diseases

We propose a stochastic model for the analysis of time series of disease counts as collected in typical surveillance systems on notifiable infectious diseases. The model is based on a Poisson or negative binomial observation model with two components: a parameter-driven component relates the disease incidence to latent parameters describing endemic seasonal patterns, which are typical for infectious disease surveillance data. An observation-driven or epidemic component is modeled with an autoregression on the number of cases at the previous time points. The autoregressive parameter is allowed to change over time according to a Bayesian changepoint model with unknown number of changepoints. Parameter estimates are obtained through the Bayesian model averaging using Markov chain Monte Carlo techniques. We illustrate our approach through analysis of simulated data and real notification data obtained from the German infectious disease surveillance system, administered by the Robert Koch Institute in Berlin. Software to fit the proposed model can be obtained from http://www.statistik.lmu.de/ approximately mhofmann/twins.     

Alternative implementations of Monte Carlo EM algorithms for likelihood inferences

Two methods of computing Monte Carlo estimators of variance components using restricted maximum likelihood via the expectation-maximisation algorithm are reviewed. A third approach is suggested and the performance of the methods is compared using simulated data.     

A queueing model for chronic recurrent conditions under panel observation

In many chronic conditions, subjects alternate between an active and an inactive state, and sojourns into the active state may involve multiple lesions, infections, or other recurrences with different times of onset and resolution. We present a biologically interpretable model of such chronic recurrent conditions based on a queueing process. The model has a birth-death process describing recurrences and a semi-Markov process describing the alternation between active and inactive states, and can be fit to panel data that provide only a binary assessment of the active or inactive state at a series of discrete time points using a hidden Markov approach. We accommodate individual heterogeneity and covariates using a random effects model, and simulate the posterior distribution of unknowns using a Markov chain Monte Carlo algorithm. Application to a clinical trial of genital herpes shows how the method can characterize the biology of the disease and estimate treatment efficacy.     

Simultaneous inference for semiparametric nonlinear mixed-effects models with covariate measurement errors and missing responses

Semiparametric nonlinear mixed-effects (NLME) models are flexible for modeling complex longitudinal data. Covariates are usually introduced in the models to partially explain interindividual variations. Some covariates, however, may be measured with substantial errors. Moreover, the responses may be missing and the missingness may be nonignorable. We propose two approximate likelihood methods for semiparametric NLME models with covariate measurement errors and nonignorable missing responses. The methods are illustrated in a real data example. Simulation results show that both methods perform well and are much better than the commonly used naive method.     

A mover-stayer model for longitudinal marker data

Studies of chronic disease often focus on estimating prevalence and incidence in which the presence of active disease is based on dichotomizing a continuous marker variable measured with error. Examples include hypertension, asthma, and depression, where active disease is defined by setting a threshold on a continuous measure of blood pressure, respiratory function, and mood, respectively. This paper proposes a model for inference about prevalence and incidence when active disease is determined by dichotomizing a continuous marker variable in a population-based study. In this formulation, it is postulated that there are three groups of people, those that are not susceptible to the disease, those who are always in the disease state, and those who have the potential to transition between the disease and the disease-free states over time. The model is used to estimate the prevalence and incidence of the disease in the population while accounting for measurement error in the marker. An EM algorithm is used for parameter estimation and the methodology is illustrated on Framingham heart study hypertension data. A simulation study is conducted in order to demonstrate the importance of accounting for measurement error in estimating prevalence and incidence for this example.     

A multistate model for bivariate interval-censored failure time data

SUMMARY: Interval-censored life-history data arise when the events of interest are only detectable at periodic assessments. When interest lies in the occurrence of two such events, bivariate-interval censored event time data are obtained. We describe how to fit a four-state Markov model useful for characterizing the association between two interval-censored event times when the assessment times for the two events may be generated by different inspection processes. The approach treats the two events symmetrically and enables one to fit multiplicative intensity models that give estimates of covariate effects as well as relative risks characterizing the association between the two events. An expectation-maximization (EM) algorithm is described for estimation in which the maximization step can be carried out with standard software. The method is illustrated by application to data from a trial of HIV patients where the events are the onset of viral shedding in the blood and urine among individuals infected with cytomegalovirus.     

A mixture model for longitudinal data with application to assessment of noncompliance

In clinical trials of a self-administered drug, repeated measures of a laboratory marker, which is affected by study medication and collected in all treatment arms, can provide valuable information on population and individual summaries of compliance. In this paper, we introduce a general finite mixture of nonlinear hierarchical models that allows estimates of component membership probabilities and random effect distributions for longitudinal data arising from multiple subpopulations, such as from noncomplying and complying subgroups in clinical trials. We outline a sampling strategy for fitting these models, which consists of a sequence of Gibbs, Metropolis-Hastings, and reversible jump steps, where the latter is required for switching between component models of different dimensions. Our model is applied to identify noncomplying subjects in the placebo arm of a clinical trial assessing the effectiveness of zidovudine (AZT) in the treatment of patients with HIV, where noncompliance was defined as initiation of AZT during the trial without the investigators' knowledge. We fit a hierarchical nonlinear change-point model for increases in the marker MCV (mean corpuscular volume of erythrocytes) for subjects who noncomply and a constant mean random effects model for those who comply. As part of our fully Bayesian analysis, we assess the sensitivity of conclusions to prior and modeling assumptions and demonstrate how external information and covariates can be incorporated to distinguish subgroups.     

A quantitative approach for polymerase chain reactions based on a hidden Markov model

Polymerase chain reaction (PCR) is a major DNA amplification technology from molecular biology. The quantitative analysis of PCR aims at determining the initial amount of the DNA molecules from the observation of typically several PCR amplifications curves. The mainstream observation scheme of the DNA amplification during PCR involves fluorescence intensity measurements. Under the classical assumption that the measured fluorescence intensity is proportional to the amount of present DNA molecules, and under the assumption that these measurements are corrupted by an additive Gaussian noise, we analyze a single amplification curve using a hidden Markov model(HMM). The unknown parameters of the HMM may be separated into two parts. On the one hand, the parameters from the amplification process are the initial number of the DNA molecules and the replication efficiency, which is the probability of one molecule to be duplicated. On the other hand, the parameters from the observational scheme are the scale parameter allowing to convert the fluorescence intensity into the number of DNA molecules and the mean and variance characterizing the Gaussian noise. We use the maximum likelihood estimation procedure to infer the unknown parameters of the model from the exponential phase of a single amplification curve, the main parameter of interest for quantitative PCR being the initial amount of the DNA molecules. An illustrative example is provided. This research was financed by the Swedish foundation for Strategic Research through the Gothenburg Mathematical Modelling Centre.     

A joint model for longitudinal measurements and survival data in the presence of multiple failure types

Summary .   In this article we study a joint model for longitudinal measurements and competing risks survival data. Our joint model provides a flexible approach to handle possible nonignorable missing data in the longitudinal measurements due to dropout. It is also an extension of previous joint models with a single failure type, offering a possible way to model informatively censored events as a competing risk. Our model consists of a linear mixed effects submodel for the longitudinal outcome and a proportional cause-specific hazards frailty submodel ( Prentice et al., 1978 , Biometrics 34, 541–554) for the competing risks survival data, linked together by some latent random effects. We propose to obtain the maximum likelihood estimates of the parameters by an expectation maximization (EM) algorithm and estimate their standard errors using a profile likelihood method. The developed method works well in our simulation studies and is applied to a clinical trial for the scleroderma lung disease.     

QTL mapping in outbred half-sib families using Bayesian model selection

In this article, we propose a model selection method, the Bayesian composite model space approach, to map quantitative trait loci (QTL) in a half-sib population for continuous and binary traits. In our method, the identity-by-descent-based variance component model is used. To demonstrate the performance of this model, the method was applied to map QTL underlying production traits on BTA6 in a Chinese half-sib dairy cattle population. A total of four QTLs were detected, whereas only one QTL was identified using the traditional least square (LS) method. We also conducted two simulation experiments to validate the efficiency of our method. The results suggest that the proposed method based on a multiple-QTL model is efficient in mapping multiple QTL for an outbred half-sib population and is more powerful than the LS method based on a single-QTL model.     

Latent transition regression for mixed outcomes

Health status is a complex outcome, often characterized by multiple measures. When assessing changes in health status over time, multiple measures are typically collected longitudinally. Analytic challenges posed by these multivariate longitudinal data are further complicated when the outcomes are combinations of continuous, categorical, and count data. To address these challenges, we propose a fully Bayesian latent transition regression approach for jointly analyzing a mixture of longitudinal outcomes from any distribution. Health status is assumed to be a categorical latent variable, and the multiple outcomes are treated as surrogate measures of the latent health state, observed with error. Using this approach, both baseline latent health state prevalences and the probabilities of transitioning between the health states over time are modeled as functions of covariates. The observed outcomes are related to the latent health states through regression models that include subject-specific effects to account for residual correlation among repeated measures over time, and covariate effects to account for differential measurement of the latent health states. We illustrate our approach with data from a longitudinal study of back pain.