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Summary . In many longitudinal clinical studies, the level and progression rate of repeatedly measured biomarkers on each subject quantify the severity of the disease and that subject's susceptibility to progression of the disease. It is of scientific and clinical interest to relate such quantities to a later time-to-event clinical endpoint such as patient survival. This is usually done with a shared parameter model. In such models, the longitudinal biomarker data and the survival outcome of each subject are assumed to be conditionally independent given subject-level severity or susceptibility (also called frailty in statistical terms). In this article, we study the case where the conditional distribution of longitudinal data is modeled by a linear mixed-effect model, and the conditional distribution of the survival data is given by a Cox proportional hazard model. We allow unknown regression coefficients and time-dependent covariates in both models. The proposed estimators are maximizers of an exact correction to the joint log likelihood with the frailties eliminated as nuisance parameters, an idea that originated from correction of covariate measurement error in measurement error models. The corrected joint log likelihood is shown to be asymptotically concave and leads to consistent and asymptotically normal estimators. Unlike most published methods for joint modeling, the proposed estimation procedure does not rely on distributional assumptions of the frailties. The proposed method was studied in simulations and applied to a data set from the Hemodialysis Study. 相似文献
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Existing distributions for modeling fetal response data in developmental toxicology such as the beta-binomial distribution have a tendency of inflating the probability of no malformed fetuses, and hence understating the risk of having at least one malformed fetus within a litter. As opposed to a shared probability extra-binomial model, we advocate a shared response model that allows a random number of fetuses within the same litter to share a common response. An explicit formula is given for the probability function and graphical plots suggest that it does not suffer from the problem of assigning too much probability to the event of no malformed fetuses. The EM algorithm can be used to estimate the model parameters. Results of a simulation study show that the EM estimates are nearly unbiased and the associated confidence intervals based on the usual standard error estimates have coverage close to the nominal level. Simulation results also suggest that the shared response model estimates of the marginal malformation probabilities are robust to misspecification of the distributional form, but not so for the estimates of intralitter correlation and the litter-level probability of having at least one malformed fetus. The proposed model is fitted to a set of data from the U.S. National Toxicology Program. For the same dose-response relationship, the fit based on the shared response distribution is superior to that based on the beta-binomial, and comparable to that based on the recently proposed q-power distribution (Kuk, 2004, Applied Statistics53, 369-386). An advantage of the shared response model over the q-power distribution is that it is more interpretable and can be extended more easily to the multivariate case. To illustrate this, a bivariate shared response model is fitted to fetal response data involving visceral and skeletal malformation. 相似文献