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Svenja Elkenkamp

Publications and source records attributed to Svenja Elkenkamp.

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hyreg2: An R package to Estimate Latent Classes on a Mixture of Continuous and Dichotomous Data

The R package hyreg2 introduces a frequentist framework for estimating latent class models for mixed outcome types using a joint likelihood approach. The method combines continuous and dichotomous data under the assumption that both outcome types arise from a common underlying data-generating process. In the implemented model, continuous responses are assumed to follow a normal distribution, while dichotomous responses are modeled using a binomial distribution. Such models are used in various scientific disciplines to estimate a common set of parameters across different types of data (e.g. clinical trials, econometrics and health economics). Latent class estimation is performed using the expectation-maximization algorithm as implemented in the widely used R package flexmix. The hyreg2 package offers a user-friendly implementation of this joint likelihood framework, allowing users to estimate models without explicitly programming the likelihood function. Heteroskedasticity as well as censored data can be taken into account. In addition to model estimation, the package provides dedicated summary and visualization functions to facilitate the interpretation of results. The article presents the methodological framework underlying the package and illustrates its functionality through an example based on the estimation of an EQ-5D-5L value set.

stat.ME

Markov-modulated marked Poisson processes for modelling disease dynamics based on medical claims data

We explore Markov-modulated marked Poisson processes (MMMPPs) as a natural framework for modelling patients' disease dynamics over time based on medical claims data. In claims data, observations do not only occur at random points in time but are also informative, i.e. driven by unobserved disease levels, as poor health conditions usually lead to more frequent interactions with the healthcare system. Therefore, we model the observation process as a Markov-modulated Poisson process, where the rate of healthcare interactions is governed by a continuous-time Markov chain. Its states serve as proxies for the patients' latent disease levels and further determine the distribution of additional data collected at each observation time, the so-called marks. Overall, MMMPPs jointly model observations and their informative time points by comprising two state-dependent processes: the observation process (corresponding to the event times) and the mark process (corresponding to event-specific information), which both depend on the underlying states. The approach is illustrated using claims data from patients diagnosed with chronic obstructive pulmonary disease (COPD) by modelling their drug use and the interval lengths between consecutive physician consultations. The results indicate that MMMPPs are able to detect distinct patterns of healthcare utilisation related to disease processes and reveal inter-individual differences in the state-switching dynamics.

stat.AP