A Bayesian joint bent-cable model for longitudinal measurements and survival time with heterogeneous random-effects distributions

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ABSTRACT Biomarkers are measured repeatedly in clinical studies until a pre-defined endpoint, such as death from certain causes, is reached. Such repeated measurements may present a dynamic process for understanding when to expect the study’s endpoint. Joint modelling is often employed to handle such a model. Typically, shared random effects are assumed to be common to both the longitudinal component and the study’s endpoint. These shared random effects usually assume homogeneous and follow a normal distribution. However, identifying homogeneous subgroups is important when the underlying population is heterogeneous. This issue has received little attention in the literature, particularly for multi-phase longitudinal responses. In this paper, we propose a joint modelling approach for longitudinal and survival models using a bent-cable mixed model for longitudinal measurements and a Weibull distribution for the survival component. We also incorporate a finite mixture of normal distribution assumptions to account for the unobserved heterogeneity in the shared random effects model. A Bayesian MCMC is developed for parameter estimation and inferences. The proposed method is evaluated using simulation studies and the Tehran Lipid and Glucose Study dataset.