arXiv subjects

Cécile Proust-Lima

Publications and source records attributed to Cécile Proust-Lima.

25 records · Page 2Linked to original sources

arXiv2019

A joint model for multiple dynamic processes and clinical endpoints: application to Alzheimer's disease

As other neurodegenerative diseases, Alzheimer's disease, the most frequent dementia in the elderly, is characterized by multiple progressive impairments in the brain structure and in clinical functions such as cognitive functioning and functional disability. Until recently, these components were mostly studied independently since no joint model for multivariate longitudinal data and time to event was available in the statistical community. Yet, these components are fundamentally inter-related in the degradation process towards dementia and should be analyzed together. We thus propose a joint model to simultaneously describe the dynamics of multiple correlated components. Each component, defined as a latent process, is measured by one or several continuous markers (not necessarily Gaussian). Rather than considering the associated time to diagnosis as in standard joint models, we assume diagnosis corresponds to the passing above a covariate-specific threshold (to be estimated) of a pathological process which is modelled as a combination of the component-specific latent processes. This definition captures the clinical complexity of diagnoses such as dementia diagnosis but also benefits from simplifications for the computation of Maximum Likelihood Estimates. We show that the model and estimation procedure can also handle competing clinical endpoints. The estimation procedure, implemented in a R package, is validated by simulations and the method is illustrated on a large French population-based cohort of cerebral aging in which we focused on the dynamics of three clinical manifestations and the associated risk of dementia and death before dementia.

stat.ME↗

arXiv2018

Individual dynamic predictions using landmarking and joint modelling: validation of estimators and robustness assessment

After the diagnosis of a disease, one major objective is to predict cumulative probabilities of events such as clinical relapse or death from the individual information collected up to a prediction time, including usually biomarker repeated measurements. Several competing estimators have been proposed to calculate these individual dynamic predictions, mainly from two approaches: joint modelling and landmarking. These approaches differ by the information used, the model assumptions and the complexity of the computational procedures. It is essential to properly validate the estimators derived from joint models and landmark models, quantify their variability and compare them in order to provide key elements for the development and use of individual dynamic predictions in clinical follow-up of patients. Motivated by the prediction of two competing causes of progression of prostate cancer from the history of prostate-specific antigen, we conducted an in-depth simulation study to validate and compare the dynamic predictions derived from these two methods. Specifically, we formally defined the quantity to estimate and its estimators, proposed techniques to assess the uncertainty around predictions and validated them. We also compared the individual dynamic predictions derived from joint models and landmark models in terms of prediction error, discriminatory power, efficiency and robustness to model assumptions. We show that these prediction tools should be handled with care, in particular by properly specifying models and estimators.

stat.AP↗

arXiv2016

Estimation of extended mixed models using latent classes and latent processes: the R package lcmm

The R package lcmm provides a series of functions to estimate statistical models based on linear mixed model theory. It includes the estimation of mixed models and latent class mixed models for Gaussian longitudinal outcomes (hlme), curvilinear and ordinal univariate longitudinal outcomes (lcmm) and curvilinear multivariate outcomes (multlcmm), as well as joint latent class mixed models (Jointlcmm) for a (Gaussian or curvilinear) longitudinal outcome and a time-to-event that can be possibly left-truncated right-censored and defined in a competing setting. Maximum likelihood esimators are obtained using a modified Marquardt algorithm with strict convergence criteria based on the parameters and likelihood stability, and on the negativity of the second derivatives. The package also provides various post-fit functions including goodness-of-fit analyses, classification, plots, predicted trajectories, individual dynamic prediction of the event and predictive accuracy assessment. This paper constitutes a companion paper to the package by introducing each family of models, the estimation technique, some implementation details and giving examples through a dataset on cognitive aging.

stat.CO↗

arXiv2015

Joint modelling of repeated multivariate cognitive measures and competing risks of dementia and death: a latent process and latent class approach

Joint models initially dedicated to a single longitudinal marker and a single time-to-event need to be extended to account for the rich longitudinal data of cohort studies. Multiple causes of clinical progression are indeed usually observed, and multiple longitudinal markers are collected when the true latent trait of interest is hard to capture (e.g. quality of life, functional dependency, cognitive level). These multivariate and longitudinal data also usually have nonstandard distributions (discrete, asymmetric, bounded,...). We propose a joint model based on a latent process and latent classes to analyze simultaneously such multiple longitudinal markers of different natures, and multiple causes of progression. A latent process model describes the latent trait of interest and links it to the observed longitudinal outcomes using flexible measurement models adapted to different types of data, and a latent class structure links the longitudinal and the cause-specific survival models. The joint model is estimated in the maximum likelihood framework. A score test is developed to evaluate the assumption of conditional independence of the longitudinal markers and each cause of progression given the latent classes. In addition, individual dynamic cumulative incidences of each cause of progression based on the repeated marker data are derived. The methodology is validated in a simulation study and applied on real data about cognitive aging coming from a large population-based study. The aim is to predict the risk of dementia by accounting for the competing death according to the profiles of semantic memory measured by two asymmetric psychometric tests.

stat.AP↗

arXiv2015

Joint modelling of longitudinal and multi-state processes: application to clinical progressions in prostate cancer

Joint modelling of longitudinal and survival data is increasingly used in clinical trials on cancer. In prostate cancer for example, these models permit to account for the link between longitudinal measures of prostate-specific antigen (PSA) and the time of clinical recurrence when studying the risk of relapse. In practice, multiple types of relapse may occur successively. Distinguishing these transitions between health states would allow to evaluate, for example, how PSA trajectory and classical covariates impact the risk of dying after a distant recurrence post-radiotherapy, or to predict the risk of one specific type of clinical recurrence post-radiotherapy, from the PSA history. In this context, we present a joint model for a longitudinal process and a multi-state process which is divided into two sub-models: a linear mixed sub-model for longitudinal data, and a multi-state sub-model with proportional hazards for transition times, both linked by shared random effects. Parameters of this joint multi-state model are estimated within the maximum likelihood framework using an EM algorithm coupled to a quasi-Newton algorithm in case of slow convergence. It is implemented under R, by combining and extending the mstate and JM packages. The estimation program is validated by simulations and applied on pooled data from two cohorts of men with localized prostate cancer and treated by radiotherapy. Thanks to the classical covariates available at baseline and the PSA measurements collected repeatedly during the follow-up, we are able to assess the biomarker's trajectory, define the risks of transitions between health states, and quantify the impact of the PSA dynamics on each transition intensity.

stat.AP↗

arXiv2015

Joint latent class model for longitudinal data and interval-censored semi-competing events: Application to dementia

Joint models are used in ageing studies to investigate the association between longitudinal markers and a time-to-event, and have been extended to multiple markers and/or competing risks. The competing risk of death must be considered in the elderly because death and dementia have common risk factors. Moreover, in cohort studies, time-to-dementia is interval-censored because dementia is only assessed intermittently. So subjects can become demented and die between two follow-up visits without being diagnosed. To study pre-dementia cognitive decline, we propose a joint latent class model combining a (possibly multivariate) mixed model and an illness-death model handling both interval censoring (by accounting for a possible unobserved transition to dementia) and semi-competing risks. Parameters are estimated by maximum likelihood handling interval censoring. The correlation between the marker and the times-to-events is captured by latent classes, homogeneous groups with specific risks of death and dementia and profiles of cognitive decline. We propose markovian and semi-markovian versions. Both approaches are compared to a joint latent class model for standard competing risks through a simulation study, and then applied in a prospective cohort study of cerebral and functional ageing to distinguish different profiles of cognitive decline associated with risks of dementia and death. The comparison highlights that among demented subjects, mortality depends more on age than duration of dementia. This model distinguishes the so-called terminal pre-death decline (among non-demented subjects) from the pre-dementia decline.

stat.ME↗

arXiv2012

A universal approximate cross-validation criterion and its asymptotic distribution

A general framework is that the estimators of a distribution are obtained by minimizing a function (the estimating function) and they are assessed through another function (the assessment function). The estimating and assessment functions generally estimate risks. A classical case is that both functions estimate an information risk (specifically cross entropy); in that case Akaike information criterion (AIC) is relevant. In more general cases, the assessment risk can be estimated by leave-one-out crossvalidation. Since leave-one-out crossvalidation is computationally very demanding, an approximation formula can be very useful. A universal approximate crossvalidation criterion (UACV) for the leave-one-out crossvalidation is given. This criterion can be adapted to different types of estimators, including penalized likelihood and maximum a posteriori estimators, and of assessment risk functions, including information risk functions and continuous rank probability score (CRPS). This formula reduces to Takeuchi information criterion (TIC) when cross entropy is the risk for both estimation and assessment. The asymptotic distribution of UACV and of a difference of UACV is given. UACV can be used for comparing estimators of the distributions of ordered categorical data derived from threshold models and models based on continuous approximations. A simulation study and an analysis of real psychometric data are presented.

math.ST↗