Chen Chyong-Mei, Chuang Ya-Wen, Shen Pao-Sheng
Department of Statistics and Informatics Science, Providence University, Taichung, 43301, Taiwan, Republic of China; Department of Financial and Computational Mathematics, Providence University, Taichung, 43301, Taiwan, Republic of China.
Biom J. 2015 Mar;57(2):215-33. doi: 10.1002/bimj.201400001. Epub 2014 Dec 18.
Recurrent event data arise in longitudinal follow-up studies, where each subject may experience the same type of events repeatedly. The work in this article is motivated by the data from a study of repeated peritonitis for patients on peritoneal dialysis. Due to the aspects of medicine and cost, the peritonitis cases were classified into two types: Gram-positive and non-Gram-positive peritonitis. Further, since the death and hemodialysis therapy preclude the occurrence of recurrent events, we face multivariate recurrent event data with a dependent terminal event. We propose a flexible marginal model, which has three characteristics: first, we assume marginal proportional hazard and proportional rates models for terminal event time and recurrent event processes, respectively; second, the inter-recurrences dependence and the correlation between the multivariate recurrent event processes and terminal event time are modeled through three multiplicative frailties corresponding to the specified marginal models; third, the rate model with frailties for recurrent events is specified only on the time before the terminal event. We propose a two-stage estimation procedure for estimating unknown parameters. We also establish the consistency of the two-stage estimator. Simulation studies show that the proposed approach is appropriate for practical use. The methodology is applied to the peritonitis cohort data that motivated this study.
复发事件数据出现在纵向随访研究中，其中每个受试者可能会反复经历相同类型的事件。本文的工作是由一项针对腹膜透析患者反复发生腹膜炎的研究数据所推动的。由于医学和成本方面的原因，腹膜炎病例被分为两种类型：革兰氏阳性和非革兰氏阳性腹膜炎。此外，由于死亡和血液透析治疗会排除复发事件的发生，我们面临具有相依终末事件的多变量复发事件数据。我们提出了一个灵活的边际模型，它具有三个特点：第一，我们分别对终末事件时间和复发事件过程假设边际比例风险模型和比例率模型；第二，复发事件之间的依赖性以及多变量复发事件过程与终末事件时间之间的相关性通过对应于指定边际模型的三个乘性脆弱性来建模；第三，具有脆弱性的复发事件率模型仅在终末事件之前的时间上指定。我们提出了一种用于估计未知参数的两阶段估计程序。我们还建立了两阶段估计量的一致性。模拟研究表明，所提出的方法适用于实际应用。该方法应用于推动本研究的腹膜炎队列数据。
