Nonparametric estimation of transition probabilities in a non-Markov illness–death model

Abstract

In this paper we consider nonparametric estimation of transition probabilities for multi-state models. Specifically, we focus on the illness-death or disability model. The main novelty of the proposed estimators is that they do not rely on the Markov assumption, typically assumed to hold in a multi-state model. We investigate the asymptotic properties of the introduced estimators, such as their consistency and their convergence to a normal law. Simulations demonstrate that the new estimators may outperform Aalen-Johansen estimators (the classical nonparametric tool for estimating the transition probabilities) in non-Markov situation. An illustration through real data analysis is included.