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gems: An R Package for Simulating from Disease Progression Models

Author

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  • Blaser, Nello
  • Vizcaya, Luisa Salazar
  • Estill, Janne
  • Zahnd, Cindy
  • Kalesan, Bindu
  • Egger, Matthias
  • Gsponer, Thomas
  • Keiser, Olivia

Abstract

Mathematical models of disease progression predict disease outcomes and are useful epidemiological tools for planners and evaluators of health interventions. The R package gems is a tool that simulates disease progression in patients and predicts the effect of different interventions on patient outcome. Disease progression is represented by a series of events (e.g., diagnosis, treatment and death), displayed in a directed acyclic graph. The vertices correspond to disease states and the directed edges represent events. The package gems allows simulations based on a generalized multistate model that can be described by a directed acyclic graph with continuous transition-specific hazard functions. The user can specify an arbitrary hazard function and its parameters. The model includes parameter uncertainty, does not need to be a Markov model, and may take the history of previous events into account. Applications are not limited to the medical field and extend to other areas where multistate simulation is of interest. We provide a technical explanation of the multistate models used by gems, explain the functions of gems and their arguments, and show a sample application.

Suggested Citation

  • Blaser, Nello & Vizcaya, Luisa Salazar & Estill, Janne & Zahnd, Cindy & Kalesan, Bindu & Egger, Matthias & Gsponer, Thomas & Keiser, Olivia, 2015. "gems: An R Package for Simulating from Disease Progression Models," Journal of Statistical Software, Foundation for Open Access Statistics, vol. 64(i10).
    • Handle: RePEc:jss:jstsof:v:064:i10
    DOI: http://hdl.handle.net/10.18637/jss.v064.i10
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    References listed on IDEAS

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    1. Jackson, Christopher, 2011. "Multi-State Models for Panel Data: The msm Package for R," Journal of Statistical Software, Foundation for Open Access Statistics, vol. 38(i08).
    2. de Wreede, Liesbeth C. & Fiocco, Marta & Putter, Hein, 2011. "mstate: An R Package for the Analysis of Competing Risks and Multi-State Models," Journal of Statistical Software, Foundation for Open Access Statistics, vol. 38(i07).
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