Joint modeling of generalized scale-change models for recurrent event and failure time data.

Recurrent event and failure time data arise frequently in many clinical and observational studies. In this article, we propose a joint modeling of generalized scale-change models for the recurrent event process and the failure time, and allow the two processes to be correlated through a shared frailty. The proposed joint model is flexible in that it requires neither the Poisson assumption for the recurrent event process nor a parametric assumption on the frailty distribution. Estimating equation approaches are developed for parameter estimation, and the asymptotic properties of the resulting estimators are established. Simulation studies are conducted to evaluate the finite sample performances of the proposed method. An application to a medical cost study of chronic heart failure patients is provided.