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Spatial Multistate Transitional Models for Longitudinal Event Data
Author(s) -
Nathoo F. S.,
Dean C. B.
Publication year - 2008
Publication title -
biometrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.298
H-Index - 130
eISSN - 1541-0420
pISSN - 0006-341X
DOI - 10.1111/j.1541-0420.2007.00785.x
Subject(s) - context (archaeology) , multivariate statistics , weibull distribution , point process , markov chain , statistics , random effects model , parametric statistics , proportional hazards model , time point , piecewise , computer science , mathematics , econometrics , medicine , geography , mathematical analysis , meta analysis , archaeology , philosophy , aesthetics
Summary Follow‐up medical studies often collect longitudinal data on patients. Multistate transitional models are useful for analysis in such studies where at any point in time, individuals may be said to occupy one of a discrete set of states and interest centers on the transition process between states. For example, states may refer to the number of recurrences of an event, or the stage of a disease. We develop a hierarchical modeling framework for the analysis of such longitudinal data when the processes corresponding to different subjects may be correlated spatially over a region. Continuous‐time Markov chains incorporating spatially correlated random effects are introduced. Here, joint modeling of both spatial dependence as well as dependence between different transition rates is required and a multivariate spatial approach is employed. A proportional intensities frailty model is developed where baseline intensity functions are modeled using parametric Weibull forms, piecewise‐exponential formulations, and flexible representations based on cubic B‐splines. The methodology is developed within the context of a study examining invasive cardiac procedures in Quebec. We consider patients admitted for acute coronary syndrome throughout the 139 local health units of the province and examine readmission and mortality rates over a 4‐year period.