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Isabella Kardys

Publications and source records attributed to Isabella Kardys.

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Goodness-of-Fit Checks for Joint Models

Joint models for longitudinal and time-to-event data are widely used in many disciplines. Nonetheless, existing model comparison criteria do not indicate whether a model adequately fits the data or which components may be misspecified. We introduce a Bayesian posterior predictive checks framework for assessing a joint model's fit to the longitudinal and survival processes and their association. The framework supports multiple settings, including existing subjects, new subjects with only covariates, dynamic prediction at intermediate follow-up times, and cross-validated assessment. For the longitudinal component, goodness-of-fit is assessed through the mean, variance, and correlation structure, while the survival component is evaluated using empirical cumulative distributions and probability integral transforms. The association between processes is examined using time-dependent concordance statistics. We apply these checks to the Bio-SHiFT heart failure study, and a simulation study demonstrates that they can identify model misspecification that standard information criteria fail to detect. The proposed methodology is implemented in the freely available R package JMbayes2.

stat.ME

Joint Models with Multiple Longitudinal Outcomes and a Time-to-Event Outcome: a Corrected Two-Stage Approach

Joint models for longitudinal and survival data have gained a lot of attention in recent years, with the development of myriad extensions to the basic model, including those which allow for multivariate longitudinal data, competing risks and recurrent events. Several software packages are now also available for their implementation. Although mathematically straightforward, the inclusion of multiple longitudinal outcomes in the joint model remains computationally difficult due to the large number of random effects required, which hampers the practical application of this extension. We present a novel approach that enables the fitting of such models with more realistic computational times. The idea behind the approach is to split the estimation of the joint model in two steps; estimating a multivariate mixed model for the longitudinal outcomes, and then using the output from this model to fit the survival submodel. So called two-stage approaches have previously been proposed, and shown to be biased. Our approach differs from the standard version, in that we additionally propose the application of a correction factor, adjusting the estimates obtained such that they more closely resemble those we would expect to find with the multivariate joint model. This correction is based on importance sampling ideas. Simulation studies show that this corrected-two-stage approach works satisfactorily, eliminating the bias while maintaining substantial improvement in computational time, even in more difficult settings.

stat.ME