Joint frailty modeling of time-to-event data to elicit the evolution pathway of events: a generalized linear mixed model approach
File version
Version of Record (VoR)
Author(s)
Tawiah, Richard
Mclachlan, Geoffrey J
Gopalan, Vinod
Griffith University Author(s)
Primary Supervisor
Other Supervisors
Editor(s)
Date
Size
File type(s)
Location
Abstract
Multimorbidity constitutes a serious challenge on the healthcare systems in the world, due to its association with poorer health-related outcomes, more complex clinical management, increases in health service utilization and costs, but a decrease in productivity. However, to date, most evidence on multimorbidity is derived from cross-sectional studies that have limited capacity to understand the pathway of multimorbid conditions. In this article, we present an innovative perspective on analyzing longitudinal data within a statistical framework of survival analysis of time-to-event recurrent data. The proposed methodology is based on a joint frailty modeling approach with multivariate random effects to account for the heterogeneous risk of failure and the presence of informative censoring due to a terminal event. We develop a generalized linear mixed model method for the efficient estimation of parameters. We demonstrate the capacity of our approach using a real cancer registry data set on the multimorbidity of melanoma patients and document the relative performance of the proposed joint frailty model to the natural competitor of a standard frailty model via extensive simulation studies. Our new approach is timely to advance evidence-based knowledge to address increasingly complex needs related to multimorbidity and develop interventions that are most effective and viable to better help a large number of individuals with multiple conditions.
Journal Title
Biostatistics
Conference Title
Book Title
Edition
Volume
Issue
Thesis Type
Degree Program
School
Publisher link
Patent number
Funder(s)
Grant identifier(s)
Rights Statement
Rights Statement
© The Author 2021. Published by Oxford University Press. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
Item Access Status
Note
This publication has been entered as an advanced online version in Griffith Research Online.
Access the data
Related item(s)
Subject
Biostatistics
Genetics
Statistics
Cancer registry data
Generalized linear mixed models
Informative censoring
Mean residual life
Multimorbidity
Persistent link to this record
Citation
Ng, SK; Tawiah, R; Mclachlan, GJ; Gopalan, V, Joint frailty modeling of time-to-event data to elicit the evolution pathway of events: a generalized linear mixed model approach., Biostatistics, 2021