Inference methods for the conditional logistic regression model with longitudinal data

This paper considers inference methods for case-control logistic regression in longitudinal setups. The motivation is provided by an analysis of plains bison spatial location as a function of habitat heterogeneity. The sampling is done according to a longitudinal matched case-control design in which, at certain time points, exactly one case, the actual location of an animal, is matched to a number of controls, the alternative locations that could have been reached. We develop inference methods for the conditional logistic regression model in this setup, which can be formulated within a generalized estimating equation (GEE) framework. This permits the use of statistical techniques developed for GEE-based inference, such as robust variance estimators and model selection criteria adapted for non-independent data. The performance of the methods is investigated in a simulation study and illustrated with the bison data analysis.     

Semi-parametric ROC regression analysis with placement values

Advances in technology provide new diagnostic tests for early detection of disease. Frequently, these tests have continuous outcomes. One popular method to summarize the accuracy of such a test is the Receiver Operating Characteristic (ROC) curve. Methods for estimating ROC curves have long been available. To examine covariate effects, Pepe (1997, 2000) and Alonzo and Pepe (2002) proposed distribution-free approaches based on a parametric regression model for the ROC curve. Cai and Pepe (2002) extended the parametric ROC regression model by allowing an arbitrary non-parametric baseline function. In this paper, while we follow the same semi-parametric setting as in that paper, we highlight a new estimator that offers several improvements over the earlier work: superior efficiency, the ability to estimate the covariate effects without estimating the non-parametric baseline function and easy implementation with standard software. The methodology is applied to a case control dataset where we evaluate the accuracy of the prostate-specific antigen as a biomarker for early detection of prostate cancer. Simulation studies suggest that the new estimator under the semi-parametric model, while always being more robust, has efficiency that is comparable to or better than the Alonzo and Pepe (2002) estimator from the parametric model.     

A model with space-varying regression coefficients for clustering multivariate spatial count data

Multivariate spatial count data are often segmented by unobserved space-varying factors that vary across space. In this setting, regression models that assume space-constant covariate effects could be too restrictive. Motivated by the analysis of cause-specific mortality data, we propose to estimate space-varying effects by exploiting a multivariate hidden Markov field. It models the data by a battery of Poisson regressions with spatially correlated regression coefficients, which are driven by an unobserved spatial multinomial process. It parsimoniously describes multivariate count data by means of a finite number of latent classes. Parameter estimation is carried out by composite likelihood methods, that we specifically develop for the proposed model. In a case study of cause-specific mortality data in Italy, the model was capable to capture the spatial variation of gender differences and age effects.     

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.     

Regression analysis when covariates are regression parameters of a random effects model for observed longitudinal measurements

We consider regression analysis when covariate variables are the underlying regression coefficients of another linear mixed model. A naive approach is to use each subject's repeated measurements, which are assumed to follow a linear mixed model, and obtain subject-specific estimated coefficients to replace the covariate variables. However, directly replacing the unobserved covariates in the primary regression by these estimated coefficients may result in a significantly biased estimator. The aforementioned problem can be evaluated as a generalization of the classical additive error model where repeated measures are considered as replicates. To correct for these biases, we investigate a pseudo-expected estimating equation (EEE) estimator, a regression calibration (RC) estimator, and a refined version of the RC estimator. For linear regression, the first two estimators are identical under certain conditions. However, when the primary regression model is a nonlinear model, the RC estimator is usually biased. We thus consider a refined regression calibration estimator whose performance is close to that of the pseudo-EEE estimator but does not require numerical integration. The RC estimator is also extended to the proportional hazards regression model. In addition to the distribution theory, we evaluate the methods through simulation studies. The methods are applied to analyze a real dataset from a child growth study.     

Time-varying Markov regression random-effect model with Bayesian estimation procedures: Application to dynamics of functional recovery in patients with stroke

The rates of functional recovery after stroke tend to decrease with time. Time-varying Markov processes (TVMP) may be more biologically plausible than time-invariant Markov process for modeling such data. However, analysis of such stochastic processes, particularly tackling reversible transitions and the incorporation of random effects into models, can be analytically intractable. We make use of ordinary differential equations to solve continuous-time TVMP with reversible transitions. The proportional hazard form was used to assess the effects of an individual’s covariates on multi-state transitions with the incorporation of random effects that capture the residual variation after being explained by measured covariates under the concept of generalized linear model. We further built up Bayesian directed acyclic graphic model to obtain full joint posterior distribution. Markov chain Monte Carlo (MCMC) with Gibbs sampling was applied to estimate parameters based on posterior marginal distributions with multiple integrands. The proposed method was illustrated with empirical data from a study on the functional recovery after stroke.     

Median regression with censored cost data

Because of the skewness of the distribution of medical costs, we consider modeling the median as well as other quantiles when establishing regression relationships to covariates. In many applications, the medical cost data are also right censored. In this article, we propose semiparametric procedures for estimating the parameters in median regression models based on weighted estimating equations when censoring is present. Numerical studies are conducted to show that our estimators perform well with small samples and the resulting inference is reliable in circumstances of practical importance. The methods are applied to a dataset for medical costs of patients with colorectal cancer.     

A frailty mixture cure model with application to hospital admission data [corrected

Mixture cure models have been utilized to analyze survival data with possible cure. This paper considers the inclusion of frailty into the mixture cure model to model recurrent event data with a cure fraction. An attractive feature of the proposed model is the allowance for heterogeneity in risk among those individuals experiencing the event of interest in addition to the incorporation of a cured component. Maximum likelihood estimates can be obtained using the Expectation Maximization algorithm and standard errors are calculated from the Bootstrap method. The model is applied to hospital readmission data among colorectal cancer patients.     

A semiparametric mixture cure survival model for left‐truncated and right‐censored data

In follow‐up studies, the disease event time can be subject to left truncation and right censoring. Furthermore, medical advancements have made it possible for patients to be cured of certain types of diseases. In this article, we consider a semiparametric mixture cure model for the regression analysis of left‐truncated and right‐censored data. The model combines a logistic regression for the probability of event occurrence with the class of transformation models for the time of occurrence. We investigate two techniques for estimating model parameters. The first approach is based on martingale estimating equations (EEs). The second approach is based on the conditional likelihood function given truncation variables. The asymptotic properties of both proposed estimators are established. Simulation studies indicate that the conditional maximum‐likelihood estimator (cMLE) performs well while the estimator based on EEs is very unstable even though it is shown to be consistent. This is a special and intriguing phenomenon for the EE approach under cure model. We provide insights into this issue and find that the EE approach can be improved significantly by assigning appropriate weights to the censored observations in the EEs. This finding is useful in overcoming the instability of the EE approach in some more complicated situations, where the likelihood approach is not feasible. We illustrate the proposed estimation procedures by analyzing the age at onset of the occiput‐wall distance event for patients with ankylosing spondylitis.