Additive Gamma Frailty Model Research Articles

Investigating hospital heterogeneity with a competing risks frailty model.

Survival analysis is used in the medical field to identify the effect of predictive variables on time to a specific event. Generally, not all variation of survival time can be explained by observed covariates. The effect of unobserved variables on the risk of a patient is called frailty. In multicenter studies, the unobserved center effect can induce frailty on its patients, which can lead to selection bias over time when ignored. For this reason, it is common practice in multicenter studies to include a random frailty term modeling center effect. In a more complex event structure, more than one type of event is possible. Independent frailty variables representing center effect can be incorporated in the model for each competing event. However, in the medical context, events representing disease progression are likely related and correlation is missed when assuming frailties to be independent. In this work, an additive gamma frailty model to account for correlation between frailties in a competing risks model is proposed, to model frailties at center level. Correlation indicates a common center effect on both events and measures how closely the risks are related. Estimation of the model using the expectation‐maximization algorithm is illustrated. The model is applied to a data set from a multicenter clinical trial on breast cancer from the European Organisation for Research and Treatment of Cancer (EORTC trial 10854). Hospitals are compared by employing empirical Bayes estimates methodology together with corresponding confidence intervals.

Robust Age at Onset Linkage Analysis in Nuclear Families

Objective: Standard methods for linkage analysis ignore the phenotype of the parents when they are not genotyped. However, this information can be useful for gene mapping. In this paper we propose methods for age at onset genetic linkage analysis in sibling pairs, taking into account parental age at onset. Methods:Two new score statistics are derived, one from an additive gamma frailty model and one from a log-normal frailty model. The score statistics are classical non-parametric linkage (NPL) statistics weighted by a function of the age at onset of the four family members. The weight depends on information from registries (age-specific incidences) and family studies (sib-sib and father-mother correlation). Results:In order to investigate how age at onset of sibs and their parents affect the information for linkage analysis the weight functions were studied for rare and common disease models, realistic models for breast cancer and human lifespan. We studied the performance of the weighted NPL methods by simulations. As illustration, the score statistics were applied to the GAW12 data. The results show that it is useful to include parental age at onset information in genetic linkage analysis.

A Class of Bayesian Shared Gamma Frailty Models with Multivariate Failure Time Data

For multivariate failure time data, we propose a new class of shared gamma frailty models by imposing the Box-Cox transformation on the hazard function, and the product of the baseline hazard and the frailty. This novel class of models allows for a very broad range of shapes and relationships between the hazard and baseline hazard functions. It includes the well-known Cox gamma frailty model and a new additive gamma frailty model as two special cases. Due to the nonnegative hazard constraint, this shared gamma frailty model is computationally challenging in the Bayesian paradigm. The joint priors are constructed through a conditional-marginal specification, in which the conditional distribution is univariate, and it absorbs the nonlinear parameter constraints. The marginal part of the prior specification is free of constraints. The prior distributions allow us to easily compute the full conditionals needed for Gibbs sampling, while incorporating the constraints. This class of shared gamma frailty models is illustrated with a real dataset.

Bayesian latent variable models for mixed discrete outcomes

In studies of complex health conditions, mixtures of discrete outcomes (event time, count, binary, ordered categorical) are commonly collected. For example, studies of skin tumorigenesis record latency time prior to the first tumor, increases in the number of tumors at each week, and the occurrence of internal tumors at the time of death. Motivated by this application, we propose a general underlying Poisson variable framework for mixed discrete outcomes, accommodating dependency through an additive gamma frailty model for the Poisson means. The model has log-linear, complementary log-log, and proportional hazards forms for count, binary and discrete event time outcomes, respectively. Simple closed form expressions can be derived for the marginal expectations, variances, and correlations. Following a Bayesian approach to inference, conditionally-conjugate prior distributions are chosen that facilitate posterior computation via an MCMC algorithm. The methods are illustrated using data from a Tg.AC mouse bioassay study.

Ascertainment-adjusted maximum likelihood estimation for the additive genetic gamma frailty model.

The additive genetic gamma frailty model has been proposed for genetic linkage analysis for complex diseases to account for variable age of onset and possible covariates effects. To avoid ascertainment biases in parameter estimates, retrospective likelihood ratio tests are often used, which may result in loss of efficiency due to conditioning. This paper considers when the sibships are ascertained by having at least two affected sibs with the disease before a given age and provides two approaches for estimating the parameters in the additive gamma frailty model. One approach is based on the likelihood function conditioning on the ascertainment event, the other is based on maximizing a full ascertainment-adjusted likelihood. Explicit forms for these likelihood functions are derived. Simulation studies indicate that when the baseline hazard function can be correctly pre-specified, both approaches give accurate estimates of the model parameters. However, when the baseline hazard function has to be estimated simultaneously, only the ascertainment-adjusted likelihood method gives an unbiased estimate of the parameters. These results imply that the ascertainment-adjusted likelihood ratio test in the context of the additive genetic gamma frailty may be used for genetic linkage analysis.