Simultaneous Inference and Bias Analysis for Longitudinal Data with Covariate Measurement Error and Missing Responses

Summary Longitudinal data arise frequently in medical studies and it is common practice to analyze such data with generalized linear mixed models. Such models enable us to account for various types of heterogeneity, including between‐ and within‐subjects ones. Inferential procedures complicate dramatically when missing observations or measurement error arise. In the literature, there has been considerable interest in accommodating either incompleteness or covariate measurement error under random effects models. However, there is relatively little work concerning both features simultaneously. There is a need to fill up this gap as longitudinal data do often have both characteristics. In this article, our objectives are to study simultaneous impact of missingness and covariate measurement error on inferential procedures and to develop a valid method that is both computationally feasible and theoretically valid. Simulation studies are conducted to assess the performance of the proposed method, and a real example is analyzed with the proposed method.     

A Semiparametric Joint Model for Longitudinal and Survival Data with Application to Hemodialysis Study

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.     

Semiparametric approaches for joint modeling of longitudinal and survival data with time-varying coefficients

Summary .   We study joint modeling of survival and longitudinal data. There are two regression models of interest. The primary model is for survival outcomes, which are assumed to follow a time-varying coefficient proportional hazards model. The second model is for longitudinal data, which are assumed to follow a random effects model. Based on the trajectory of a subject's longitudinal data, some covariates in the survival model are functions of the unobserved random effects. Estimated random effects are generally different from the unobserved random effects and hence this leads to covariate measurement error. To deal with covariate measurement error, we propose a local corrected score estimator and a local conditional score estimator. Both approaches are semiparametric methods in the sense that there is no distributional assumption needed for the underlying true covariates. The estimators are shown to be consistent and asymptotically normal. However, simulation studies indicate that the conditional score estimator outperforms the corrected score estimator for finite samples, especially in the case of relatively large measurement error. The approaches are demonstrated by an application to data from an HIV clinical trial.     

Conditional estimation for generalized linear models when covariates are subject-specific parameters in a mixed model for longitudinal measurements

The relationship between a primary endpoint and features of longitudinal profiles of a continuous response is often of interest, and a relevant framework is that of a generalized linear model with covariates that are subject-specific random effects in a linear mixed model for the longitudinal measurements. Naive implementation by imputing subject-specific effects from individual regression fits yields biased inference, and several methods for reducing this bias have been proposed. These require a parametric (normality) assumption on the random effects, which may be unrealistic. Adapting a strategy of Stefanski and Carroll (1987, Biometrika74, 703-716), we propose estimators for the generalized linear model parameters that require no assumptions on the random effects and yield consistent inference regardless of the true distribution. The methods are illustrated via simulation and by application to a study of bone mineral density in women transitioning to menopause.     

Estimation of Growth Norms from Incomplete Longitudinal Data

Longitudinal studies are rarely complete due to attrition, mistimed visits and observations missing at random. When the data are missing at random it is possible to estimate the primary location parameters of interest by constructing a modification of Zellner's (1962) seemingly unrelated regression estimator. Such a procedure is developed in this paper and is applied to a longitudinal study of coronary risk factors in children. The method consists of two stages in which the covariance matrix is estimated at the first stage. Using the estimated covariance matrix a generalized least squares estimator of the regression parameter vector is then determined at the second stage. Limitations of the procedure are also discussed.     

Empirical Likelihood Semiparametric Regression Analysis for Longitudinal Data

A semiparametric regression model for longitudinal data is considered.The empirical likelihood method is used to estimate the regressioncoefficients and the baseline function, and to construct confidenceregions and intervals. It is proved that the maximum empiricallikelihood estimator of the regression coefficients achievesasymptotic efficiency and the estimator of the baseline functionattains asymptotic normality when a bias correction is made.Two calibrated empirical likelihood approaches to inferencefor the baseline function are developed. We propose a groupwiseempirical likelihood procedure to handle the inter-series dependencefor the longitudinal semiparametric regression model, and employbias correction to construct the empirical likelihood ratiofunctions for the parameters of interest. This leads us to provea nonparametric version of Wilks' theorem. Compared with methodsbased on normal approximations, the empirical likelihood doesnot require consistent estimators for the asymptotic varianceand bias. A simulation compares the empirical likelihood andnormal-based methods in terms of coverage accuracies and averageareas/lengths of confidence regions/intervals.     

Variable Selection for Semiparametric Mixed Models in Longitudinal Studies

Summary .  We propose a double-penalized likelihood approach for simultaneous model selection and estimation in semiparametric mixed models for longitudinal data. Two types of penalties are jointly imposed on the ordinary log-likelihood: the roughness penalty on the nonparametric baseline function and a nonconcave shrinkage penalty on linear coefficients to achieve model sparsity. Compared to existing estimation equation based approaches, our procedure provides valid inference for data with missing at random, and will be more efficient if the specified model is correct. Another advantage of the new procedure is its easy computation for both regression components and variance parameters. We show that the double-penalized problem can be conveniently reformulated into a linear mixed model framework, so that existing software can be directly used to implement our method. For the purpose of model inference, we derive both frequentist and Bayesian variance estimation for estimated parametric and nonparametric components. Simulation is used to evaluate and compare the performance of our method to the existing ones. We then apply the new method to a real data set from a lactation study.     

Modelling Heterogeneous Dispersion in Marginal Models for Longitudinal Proportional Data

Continuous proportional data is common in biomedical research, e.g., the pre‐post therapy percent change in certain physiological and molecular variables such as glomerular filtration rate, certain gene expression level, or telomere length. As shown in (Song and Tan, 2000) such data requires methods beyond the common generalised linear models. However, the original marginal simplex model of (Song and Tan, 2000) for such longitudinal continuous proportional data assumes a constant dispersion parameter. This assumption of dispersion homogeneity is imposed mainly for mathematical convenience and may be violated in some situations. For example, the dispersion may vary in terms of drug treatment cohorts or follow‐up times. This paper extends their original model so that the heterogeneity of the dispersion parameter can be assessed and accounted for in order to conduct a proper statistical inference for the model parameters. A simulation study is given to demonstrate that statistical inference can be seriously affected by mistakenly assuming a varying dispersion parameter to be constant in the application of the available GEEs method. In addition, residual analysis is developed for checking various assumptions made in the modelling process, e.g., assumptions on error distribution. The methods are illustrated with the same eye surgery data in (Song and Tan, 2000) for ease of comparison. (© 2004 WILEY‐VCH Verlag GmbH & Co. KGaA, Weinheim)     

Semiparametric Bayesian Analysis of Nutritional Epidemiology Data in the Presence of Measurement Error

Summary : We propose a semiparametric Bayesian method for handling measurement error in nutritional epidemiological data. Our goal is to estimate nonparametrically the form of association between a disease and exposure variable while the true values of the exposure are never observed. Motivated by nutritional epidemiological data, we consider the setting where a surrogate covariate is recorded in the primary data, and a calibration data set contains information on the surrogate variable and repeated measurements of an unbiased instrumental variable of the true exposure. We develop a flexible Bayesian method where not only is the relationship between the disease and exposure variable treated semiparametrically, but also the relationship between the surrogate and the true exposure is modeled semiparametrically. The two nonparametric functions are modeled simultaneously via B‐splines. In addition, we model the distribution of the exposure variable as a Dirichlet process mixture of normal distributions, thus making its modeling essentially nonparametric and placing this work into the context of functional measurement error modeling. We apply our method to the NIH‐AARP Diet and Health Study and examine its performance in a simulation study.     

Semiparametric estimation for joint modeling of colorectal cancer risk and functional biomarkers measured with errors

This research is motivated by a pilot colorectal adenoma study, where the outcome of interest is the presence of colorectal adenoma representing risk for colorectal cancer, and the predictors of interest are protein biomarkers that are repeatedly measured with errors along the length of a microscopic structure in the human colon, the colon crypt. Biomarkers of this type are referred to as functional biomarkers. The investigators are interested in identifying features of functional biomarkers that are associated with risk for colorectal cancer. In this paper, we investigate a joint modeling approach, where the binary clinical outcome is modeled using a logistic regression model with the unobserved true functional biomarkers as the predictors. Most existing methods are developed either for linear models or for functional biomarkers measured without errors and cannot be directly applied to our data. The applicable methods include a two-step method and a maximum likelihood method, which have some limitations. We propose a robust semiparametric method to overcome the limitations of the existing methods. We study the properties of the proposed method, and show in simulations that it compares favorably with other methods and also offers significant savings in CPU time. We analyze the pilot colorectal adenoma data and show that expression levels of AFC, a tumor suppressor gene, in the transitional area from the proliferation zone to the differentiation zone of colon crypts are likely to be associated with risk for colorectal cancer. Given the relatively small sample size in the pilot study, our results need to be validated in the future full-scale studies.     

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.     

A General Framework for Longitudinal Data through Marked Point Processes

This paper reviews a general framework for the modelling of longitudinal data with random measurement times based on marked point processes and presents a worked example. We construct a quite general regression models for longitudinal data, which may in particular include censoring that only depend on the past and outside random variation, and dependencies between measurement times and measurements. The modelling also generalises statistical counting process models. We review a non-parametric Nadarya-Watson kernel estimator of the regression function, and a parametric analysis that is based on a conditional least squares (CLS) criterion. The parametric analysis presented, is a conditional version of the generalised estimation equations of LIANG and ZEGER (1986). We conclude that the usual nonparametric and parametric regression modelling can be applied to this general set-up, with some modifications. The presented framework provides an easily implemented and powerful tool for model building for repeated measurements.     

Bayesian Inference in Semiparametric Mixed Models for Longitudinal Data

Summary .  We consider Bayesian inference in semiparametric mixed models (SPMMs) for longitudinal data. SPMMs are a class of models that use a nonparametric function to model a time effect, a parametric function to model other covariate effects, and parametric or nonparametric random effects to account for the within-subject correlation. We model the nonparametric function using a Bayesian formulation of a cubic smoothing spline, and the random effect distribution using a normal distribution and alternatively a nonparametric Dirichlet process (DP) prior. When the random effect distribution is assumed to be normal, we propose a uniform shrinkage prior (USP) for the variance components and the smoothing parameter. When the random effect distribution is modeled nonparametrically, we use a DP prior with a normal base measure and propose a USP for the hyperparameters of the DP base measure. We argue that the commonly assumed DP prior implies a nonzero mean of the random effect distribution, even when a base measure with mean zero is specified. This implies weak identifiability for the fixed effects, and can therefore lead to biased estimators and poor inference for the regression coefficients and the spline estimator of the nonparametric function. We propose an adjustment using a postprocessing technique. We show that under mild conditions the posterior is proper under the proposed USP, a flat prior for the fixed effect parameters, and an improper prior for the residual variance. We illustrate the proposed approach using a longitudinal hormone dataset, and carry out extensive simulation studies to compare its finite sample performance with existing methods.     

Correction for Covariate Measurement Error in Nonparametric Longitudinal Regression

Summary We introduce a correction for covariate measurement error in nonparametric regression applied to longitudinal binary data arising from a study on human sleep. The data have been surveyed to investigate the association of some hormonal levels and the probability of being asleep. The hormonal effect is modeled flexibly while we account for the error‐prone measurement of its concentration in the blood and the longitudinal character of the data. We present a fully Bayesian treatment utilizing Markov chain Monte Carlo inference techniques, and also introduce block updating to improve sampling and computational performance in the binary case. Our model is partly inspired by the relevance vector machine with radial basis functions, where usually very few basis functions are automatically selected for fitting the data. In the proposed approach, we implement such data‐driven complexity regulation by adopting the idea of Bayesian model averaging. Besides the general theory and the detailed sampling scheme, we also provide a simulation study for the Gaussian and the binary cases by comparing our method to the naive analysis ignoring measurement error. The results demonstrate a clear gain when using the proposed correction method, particularly for the Gaussian case with medium and large measurement error variances, even if the covariate model is misspecified.     

Regression Calibration in Semiparametric Accelerated Failure Time Models

Summary In large cohort studies, it often happens that some covariates are expensive to measure and hence only measured on a validation set. On the other hand, relatively cheap but error‐prone measurements of the covariates are available for all subjects. Regression calibration (RC) estimation method ( Prentice, 1982 , Biometrika 69 , 331–342) is a popular method for analyzing such data and has been applied to the Cox model by Wang et al. (1997, Biometrics 53 , 131–145) under normal measurement error and rare disease assumptions. In this article, we consider the RC estimation method for the semiparametric accelerated failure time model with covariates subject to measurement error. Asymptotic properties of the proposed method are investigated under a two‐phase sampling scheme for validation data that are selected via stratified random sampling, resulting in neither independent nor identically distributed observations. We show that the estimates converge to some well‐defined parameters. In particular, unbiased estimation is feasible under additive normal measurement error models for normal covariates and under Berkson error models. The proposed method performs well in finite‐sample simulation studies. We also apply the proposed method to a depression mortality study.     

Multiple-Imputation-Based Residuals and Diagnostic Plots for Joint Models of Longitudinal and Survival Outcomes

Summary .  The majority of the statistical literature for the joint modeling of longitudinal and time-to-event data has focused on the development of models that aim at capturing specific aspects of the motivating case studies. However, little attention has been given to the development of diagnostic and model-assessment tools. The main difficulty in using standard model diagnostics in joint models is the nonrandom dropout in the longitudinal outcome caused by the occurrence of events. In particular, the reference distribution of statistics, such as the residuals, in missing data settings is not directly available and complex calculations are required to derive it. In this article, we propose a multiple-imputation-based approach for creating multiple versions of the completed data set under the assumed joint model. Residuals and diagnostic plots for the complete data model can then be calculated based on these imputed data sets. Our proposals are exemplified using two real data sets.