Analysis of multi-type recurrent events in longitudinal studies; application to a skin cancer prevention trial

We consider the statistical modeling and analysis of replicated multi-type point process data with covariates. Such data arise when heterogeneous subjects experience repeated events or failures which may be of several distinct types. The underlying processes are modeled as nonhomogeneous mixed Poisson processes with random (subject) and fixed (covariate) effects. The method of maximum likelihood is used to obtain estimates and standard errors of the failure rate parameters and regression coefficients. Score tests and likelihood ratio statistics are used for covariate selection. A graphical test of goodness of fit of the selected model is based on generalized residuals. Measures for determining the influence of an individual observation on the estimated regression coefficients and on the score test statistic are developed. An application is described to a large ongoing randomized controlled clinical trial for the efficacy of nutritional supplements of selenium for the prevention of two types of skin cancer.     

Group Testing Regression Models with Fixed and Random Effects

Summary Group testing, where subjects are tested in pools rather than individually, has a long history of successful application in infectious disease screening. In this article, we develop group testing regression models to include covariate effects that are best regarded as random. We present approaches to fit mixed effects models using maximum likelihood, investigate likelihood ratio and score tests for variance components, and evaluate small sample performance using simulation. We illustrate our methods using chlamydia and gonorrhea data collected by the state of Nebraska as part of the Infertility Prevention Project.     

An alternative derivation of Harville's restricted log likelihood function for variance component estimation

Estimation of variance components in linear mixed models is important in clinical trial and longitudinal data analysis. It is also important in animal and plant breeding for accurately partitioning total phenotypic variance into genetic and environmental variances. Restricted maximum likelihood (REML) method is often preferred over the maximum likelihood (ML) method for variance component estimation because REML takes into account the lost degree of freedom resulting from estimating the fixed effects. The original restricted likelihood function involves a linear transformation of the original response variable (a collection of error contrasts). Harville's final form of the restricted likelihood function does not involve the transformation and thus is much easier to manipulate than the original restricted likelihood function. There are several different ways to show that the two forms of the restricted likelihood are equivalent. In this study, I present a much simpler way to derive Harville's restricted likelihood function. I first treat the fixed effects as random effects and call such a mixed model a pseudo random model (PDRM). I then construct a likelihood function for the PDRM. Finally, I let the variance of the pseudo random effects be infinity and show that the limit of the likelihood function of the PDRM is the restricted likelihood function.     

Functional mixed effects models

In this article, a new class of functional models in which smoothing splines are used to model fixed effects as well as random effects is introduced. The linear mixed effects models are extended to nonparametric mixed effects models by introducing functional random effects, which are modeled as realizations of zero-mean stochastic processes. The fixed functional effects and the random functional effects are modeled in the same functional space, which guarantee the population-average and subject-specific curves have the same smoothness property. These models inherit the flexibility of the linear mixed effects models in handling complex designs and correlation structures, can include continuous covariates as well as dummy factors in both the fixed or random design matrices, and include the nested curves models as special cases. Two estimation procedures are proposed. The first estimation procedure exploits the connection between linear mixed effects models and smoothing splines and can be fitted using existing software. The second procedure is a sequential estimation procedure using Kalman filtering. This algorithm avoids inversion of large dimensional matrices and therefore can be applied to large data sets. A generalized maximum likelihood (GML) ratio test is proposed for inference and model selection. An application to comparison of cortisol profiles is used as an illustration.     

Semiparametric models for missing covariate and response data in regression models

We consider a class of semiparametric models for the covariate distribution and missing data mechanism for missing covariate and/or response data for general classes of regression models including generalized linear models and generalized linear mixed models. Ignorable and nonignorable missing covariate and/or response data are considered. The proposed semiparametric model can be viewed as a sensitivity analysis for model misspecification of the missing covariate distribution and/or missing data mechanism. The semiparametric model consists of a generalized additive model (GAM) for the covariate distribution and/or missing data mechanism. Penalized regression splines are used to express the GAMs as a generalized linear mixed effects model, in which the variance of the corresponding random effects provides an intuitive index for choosing between the semiparametric and parametric model. Maximum likelihood estimates are then obtained via the EM algorithm. Simulations are given to demonstrate the methodology, and a real data set from a melanoma cancer clinical trial is analyzed using the proposed methods.     

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.     

Heterogeneous capture-recapture models with covariates: a partial likelihood approach for closed populations

In practice, when analyzing data from a capture-recapture experiment it is tempting to apply modern advanced statistical methods to the observed capture histories. However, unless the analysis takes into account that the data have only been collected from individuals who have been captured at least once, the results may be biased. Without the development of new software packages, methods such as generalized additive models, generalized linear mixed models, and simulation-extrapolation cannot be readily implemented. In contrast, the partial likelihood approach allows the analysis of a capture-recapture experiment to be conducted using commonly available software. Here we examine the efficiency of this approach and apply it to several data sets.     

Robust alternatives to the F-Test in mixed linear models based on MM-estimates

Mixed linear models are commonly used to analyze data in many settings. These models are generally fitted by means of (restricted) maximum likelihood techniques relying heavily on normality. The sensitivity of the resulting estimators and related tests to this underlying assumption has been identified as a weakness that can even lead to wrong interpretations. Very recently a highly robust estimator based on a scale estimate, that is, an S-estimator, has been proposed for general mixed linear models. It has the advantage of being easy to compute and allows the computation of a robust score test. However, this proposal cannot be used to define a likelihood ratio type test that is certainly the most direct route to robustify an F-test. As the latter is usually a key tool of hypothesis testing in mixed linear models, we propose two new robust estimators that allow the desired extension. They also lead to resistant Wald-type tests useful for testing contrasts and covariate effects. We study their properties theoretically and by means of simulations. The analysis of a real data set illustrates the advantage of the new approach in the presence of outlying observations.     

Structural inference in transition measurement error models for longitudinal data

We propose a new class of models, transition measurement error models, to study the effects of covariates and the past responses on the current response in longitudinal studies when one of the covariates is measured with error. We show that the response variable conditional on the error-prone covariate follows a complex transition mixed effects model. The naive model obtained by ignoring the measurement error correctly specifies the transition part of the model, but misspecifies the covariate effect structure and ignores the random effects. We next study the asymptotic bias in naive estimator obtained by ignoring the measurement error for both continuous and discrete outcomes. We show that the naive estimator of the regression coefficient of the error-prone covariate is attenuated, while the naive estimators of the regression coefficients of the past responses are generally inflated. We then develop a structural modeling approach for parameter estimation using the maximum likelihood estimation method. In view of the multidimensional integration required by full maximum likelihood estimation, an EM algorithm is developed to calculate maximum likelihood estimators, in which Monte Carlo simulations are used to evaluate the conditional expectations in the E-step. We evaluate the performance of the proposed method through a simulation study and apply it to a longitudinal social support study for elderly women with heart disease. An additional simulation study shows that the Bayesian information criterion (BIC) performs well in choosing the correct transition orders of the models.     

Testing random effects in linear mixed‐effects models with serially correlated errors

In linear mixed‐effects models, random effects are used to capture the heterogeneity and variability between individuals due to unmeasured covariates or unknown biological differences. Testing for the need of random effects is a nonstandard problem because it requires testing on the boundary of parameter space where the asymptotic chi‐squared distribution of the classical tests such as likelihood ratio and score tests is incorrect. In the literature several tests have been proposed to overcome this difficulty, however all of these tests rely on the restrictive assumption of i.i.d. measurement errors. The presence of correlated errors, which often happens in practice, makes testing random effects much more difficult. In this paper, we propose a permutation test for random effects in the presence of serially correlated errors. The proposed test not only avoids issues with the boundary of parameter space, but also can be used for testing multiple random effects and any subset of them. Our permutation procedure includes the permutation procedure in Drikvandi, Verbeke, Khodadadi, and Partovi Nia (2013) as a special case when errors are i.i.d., though the test statistics are different. We use simulations and a real data analysis to evaluate the performance of the proposed permutation test. We have found that random slopes for linear and quadratic time effects may not be significant when measurement errors are serially correlated.     

Analysis of a Generalized Linear Mixed Model: A Case Study and Simulation Results

A class of generalized linear mixed models can be obtained by introducing random effects in the linear predictor of a generalized linear model, e.g. a split plot model for binary data or count data. Maximum likelihood estimation, for normally distributed random effects, involves high-dimensional numerical integration, with severe limitations on the number and structure of the additional random effects. An alternative estimation procedure based on an extension of the iterative re-weighted least squares procedure for generalized linear models will be illustrated on a practical data set involving carcass classification of cattle. The data is analysed as overdispersed binomial proportions with fixed and random effects and associated components of variance on the logit scale. Estimates are obtained with standard software for normal data mixed models. Numerical restrictions pertain to the size of matrices to be inverted. This can be dealt with by absorption techniques familiar from e.g. mixed models in animal breeding. The final model fitted to the classification data includes four components of variance and a multiplicative overdispersion factor. Basically the estimation procedure is a combination of iterated least squares procedures and no full distributional assumptions are needed. A simulation study based on the classification data is presented. This includes a study of procedures for constructing confidence intervals and significance tests for fixed effects and components of variance. The simulation results increase confidence in the usefulness of the estimation procedure.     

Tests of Special Structures on the Dispersion Matrix Associated with a Two-Way Mixed Effects Model

Exact and approximate methods are available in the literature to compare the fixed effect levels in an unbalanced two-way mixed model under the conventional distributional assumptions for random effects. However, as suggested by SHEFFÉ (1959) the conventional assumptions may not be justified in practice. Recently, KHATRI and PATEL (1992) have studied a model with an unstructured dispersion matrix associated with the random effects of which the conventional model is a special model. In this note we give likelihood ratio tests for testing some special structures on the dispersion matrix.     

Semiparametric frailty models for clustered failure time data

We consider frailty models with additive semiparametric covariate effects for clustered failure time data. We propose a doubly penalized partial likelihood (DPPL) procedure to estimate the nonparametric functions using smoothing splines. We show that the DPPL estimators could be obtained from fitting an augmented working frailty model with parametric covariate effects, whereas the nonparametric functions being estimated as linear combinations of fixed and random effects, and the smoothing parameters being estimated as extra variance components. This approach allows us to conveniently estimate all model components within a unified frailty model framework. We evaluate the finite sample performance of the proposed method via a simulation study, and apply the method to analyze data from a study of sexually transmitted infections (STI).     

Testing environmental and genetic effects in the presence of spatial autocorrelation

Spatial autocorrelation is a well‐recognized concern for observational data in general, and more specifically for spatial data in ecology. Generalized linear mixed models (GLMMs) with spatially autocorrelated random effects are a potential general framework for handling these spatial correlations. However, as the result of statistical and practical issues, such GLMMs have been fitted through the undocumented use of procedures based on penalized quasi‐likelihood approximations (PQL), and under restrictive models of spatial correlation. Alternatively, they are often neglected in favor of simpler but more questionable approaches. In this work we aim to provide practical and validated means of inference under spatial GLMMs, that overcome these limitations. For this purpose, a new software is developed to fit spatial GLMMs. We use it to assess the performance of likelihood ratio tests for fixed effects under spatial autocorrelation, based on Laplace or PQL approximations of the likelihood. Expectedly, the Laplace approximation performs generally slightly better, although a variant of PQL was better in the binary case. We show that a previous implementation of PQL methods in the R language, glmmPQL, is not appropriate for such applications. Finally, we illustrate the efficiency of a bootstrap procedure for correcting the small sample bias of the tests, which applies also to non‐spatial models.     

Modeling continuous auxiliary covariate data in generalized linear mixed models using the kernel smoother

Auxiliary covariate data are often collected in biomedical studies when the primary exposure variable is only assessed on a subset of the study subjects. In this study, we investigate a semiparametric‐estimated likelihood estimation for the generalized linear mixed models (GLMM) in the presence of a continuous auxiliary variable. We use a kernel smoother to handle continuous auxiliary data. The method can be used to deal with missing or mismeasured covariate data problems in a variety of applications when an auxiliary variable is available and cluster sizes are not too small. Simulation study results show that the proposed method performs better than that which ignores the random effects in GLMM and that which only uses data in the validation data set. We illustrate the proposed method with a real data set from a recent environmental epidemiology study on the maternal serum 1,1‐dichloro‐2,2‐bis(p‐chlorophenyl) ethylene level in relationship to preterm births.     

Extending Tests of Random Effects to Assess for Measurement Invariance in Factor Models

Factor analysis models are widely used in health research to summarize hard-to-measure predictor or outcome variable constructs. For example, in the ELEMENT study, factor models are used to summarize lead exposure biomarkers which are thought to indirectly measure prenatal exposure to lead. Classic latent factor models are fitted assuming that factor loadings are constant across all covariate levels (e.g., maternal age in ELEMENT); that is, measurement invariance (MI) is assumed. When the MI is not met, measurement bias is introduced. Traditionally, MI is examined by defining subgroups of the data based on covariates, fitting multi-group factor analysis, and testing differences in factor loadings across covariate groups. In this paper, we develop novel tests of measurement invariance by modeling the factor loadings as varying coefficients, i.e., letting the factor loading vary across continuous covariate values instead of groups. These varying coefficients are estimated using penalized splines, where spline coefficients are penalized by treating them as random coefficients. The test of MI is then carried out by conducting a likelihood ratio test for the null hypothesis that the variance of the random spline coefficients equals zero. We use a Monte Carlo EM algorithm for estimation, and obtain the likelihood using Monte Carlo integration. Using simulations, we compare the Type I error and power of our testing approach and the multi-group testing method. We apply the proposed methods to summarize data on prenatal biomarkers of lead exposure from the ELEMENT study and find violations of MI due to maternal age.     

Random regression analyses using B-spline functions to model growth of Nellore cattle

The objective of this study was to estimate (co)variance components using random regression on B-spline functions to weight records obtained from birth to adulthood. A total of 82 064 weight records of 8145 females obtained from the data bank of the Nellore Breeding Program (PMGRN/Nellore Brazil) which started in 1987, were used. The models included direct additive and maternal genetic effects and animal and maternal permanent environmental effects as random. Contemporary group and dam age at calving (linear and quadratic effect) were included as fixed effects, and orthogonal Legendre polynomials of age (cubic regression) were considered as random covariate. The random effects were modeled using B-spline functions considering linear, quadratic and cubic polynomials for each individual segment. Residual variances were grouped in five age classes. Direct additive genetic and animal permanent environmental effects were modeled using up to seven knots (six segments). A single segment with two knots at the end points of the curve was used for the estimation of maternal genetic and maternal permanent environmental effects. A total of 15 models were studied, with the number of parameters ranging from 17 to 81. The models that used B-splines were compared with multi-trait analyses with nine weight traits and to a random regression model that used orthogonal Legendre polynomials. A model fitting quadratic B-splines, with four knots or three segments for direct additive genetic effect and animal permanent environmental effect and two knots for maternal additive genetic effect and maternal permanent environmental effect, was the most appropriate and parsimonious model to describe the covariance structure of the data. Selection for higher weight, such as at young ages, should be performed taking into account an increase in mature cow weight. Particularly, this is important in most of Nellore beef cattle production systems, where the cow herd is maintained on range conditions. There is limited modification of the growth curve of Nellore cattle with respect to the aim of selecting them for rapid growth at young ages while maintaining constant adult weight.     

Biases and Power for Groups Comparison on Subjective Health Measurements

Subjective health measurements are increasingly used in clinical research, particularly for patient groups comparisons. Two main types of analytical strategies can be used for such data: so-called classical test theory (CTT), relying on observed scores and models coming from Item Response Theory (IRT) relying on a response model relating the items responses to a latent parameter, often called latent trait. Whether IRT or CTT would be the most appropriate method to compare two independent groups of patients on a patient reported outcomes measurement remains unknown and was investigated using simulations. For CTT-based analyses, groups comparison was performed using t-test on the scores. For IRT-based analyses, several methods were compared, according to whether the Rasch model was considered with random effects or with fixed effects, and the group effect was included as a covariate or not. Individual latent traits values were estimated using either a deterministic method or by stochastic approaches. Latent traits were then compared with a t-test. Finally, a two-steps method was performed to compare the latent trait distributions, and a Wald test was performed to test the group effect in the Rasch model including group covariates. The only unbiased IRT-based method was the group covariate Wald’s test, performed on the random effects Rasch model. This model displayed the highest observed power, which was similar to the power using the score t-test. These results need to be extended to the case frequently encountered in practice where data are missing and possibly informative.     

Goodness-of-fit tests in proportional hazards models with random effects

This paper deals with testing the functional form of the covariate effects in a Cox proportional hazards model with random effects. We assume that the responses are clustered and incomplete due to right censoring. The estimation of the model under the null (parametric covariate effect) and the alternative (nonparametric effect) is performed using the full marginal likelihood. Under the alternative, the nonparametric covariate effects are estimated using orthogonal expansions. The test statistic is the likelihood ratio statistic, and its distribution is approximated using a bootstrap method. The performance of the proposed testing procedure is studied through simulations. The method is also applied on two real data sets one from biomedical research and one from veterinary medicine.     

Generalized linear mixed models with varying coefficients for longitudinal data

The routinely assumed parametric functional form in the linear predictor of a generalized linear mixed model for longitudinal data may be too restrictive to represent true underlying covariate effects. We relax this assumption by representing these covariate effects by smooth but otherwise arbitrary functions of time, with random effects used to model the correlation induced by among-subject and within-subject variation. Due to the usually intractable integration involved in evaluating the quasi-likelihood function, the double penalized quasi-likelihood (DPQL) approach of Lin and Zhang (1999, Journal of the Royal Statistical Society, Series B61, 381-400) is used to estimate the varying coefficients and the variance components simultaneously by representing a nonparametric function by a linear combination of fixed effects and random effects. A scaled chi-squared test based on the mixed model representation of the proposed model is developed to test whether an underlying varying coefficient is a polynomial of certain degree. We evaluate the performance of the procedures through simulation studies and illustrate their application with Indonesian children infectious disease data.