Bayesian methods for joint modelling of survival and longitudinal data: applications and computing




Sabelnykova, Veronica

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Multi-state models are useful for modelling progression of a disease, where states represent the health status of a subject under study. In practice, patients may be observed when necessity strikes thus implying that the disease and observation processes are not independent. Often, clinical visits are postponed or advanced by the clinician or patient themselves based on the health status of the patient. In such situations, there is a potential for the frequency and timing of the examinations to be dependent on the latent transition times, and the observation process may be informative. We consider the case where the exact times of transitions between health states of the patient are not observed and so the disease process is interval censored. We model the disease and observation processes jointly to ensure valid inference. The transition intensities are modelled assuming proportional hazards and we link the two processes via random effects. Using a Bayesian framework we apply our joint model to the analysis of a large study examining cancer trajectories of palliative care patients.



Multi-state models, Palliative Performance Scale (PPS), Joint model, Informative observation times, Bayesian framework