Wang Jue, Luo Sheng
Department of Biostatistics, The University of Texas Health Science Center at Houston, Houston, TX, USA.
Stat Methods Med Res. 2017 Aug;26(4):1684-1699. doi: 10.1177/0962280215586010. Epub 2015 Jun 2.
Many longitudinal studies (e.g. observational studies and randomized clinical trials) have collected multiple rating scales at each visit in the form of patient-reported outcomes (PROs) in the close unit interval [0 ,1]. We propose a joint modeling framework to address the issues from the following data features: (1) multiple correlated PROs; (2) the presence of the boundary values of zeros and ones; (3) extreme outliers and heavy tails; (4) the PRO-dependent terminal events such as death and dropout. Our modeling framework consists of a multivariate augmented mixed-effects sub-model based on Beta rectangular distributions for the multiple longitudinal outcomes and a Cox model for the terminal events. The simulation studies suggest that in the presence of outliers, heavy tails, and dependent terminal event, our proposed models provide more accurate parameter estimates than the joint model based on Beta distributions. The proposed models are applied to the motivating Long-term Study-1 (LS-1 study, n = 1741) of Parkinson's disease patients.
许多纵向研究(如观察性研究和随机临床试验)在每次访视时都以患者报告结局(PROs)的形式收集了多个评分量表,这些量表取值范围在紧密的单位区间[0,1]内。我们提出了一个联合建模框架,以解决以下数据特征带来的问题:(1)多个相关的PROs;(2)零值和一值边界值的存在;(3)极端异常值和重尾分布;(4)与PRO相关的终末事件,如死亡和失访。我们的建模框架由一个基于贝塔矩形分布的多变量增强混合效应子模型组成,用于多个纵向结局,以及一个用于终末事件的Cox模型。模拟研究表明,在存在异常值、重尾分布和相关终末事件的情况下,我们提出的模型比基于贝塔分布的联合模型能提供更准确的参数估计。所提出的模型应用于具有启发性的帕金森病患者长期研究-1(LS-1研究,n = 1741)。