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Joint Modeling of Repeated Measures and Competing Failure Events in a Study of Chronic Kidney Disease


  • Wei Yang

    () (University of Pennsylvania School of Medicine)

  • Dawei Xie

    (University of Pennsylvania School of Medicine)

  • Qiang Pan

    (University of Pennsylvania School of Medicine)

  • Harold I. Feldman

    (University of Pennsylvania School of Medicine)

  • Wensheng Guo

    (University of Pennsylvania School of Medicine)


We are motivated by the chronic renal insufficiency cohort (CRIC) study to identify risk factors for renal progression in patients with chronic kidney diseases. The CRIC study collects two types of renal outcomes: glomerular filtration rate (GFR) estimated annually and end-stage renal disease (ESRD). A related outcome of interest is death which is a competing event for ESRD. A joint modeling approach is proposed to model a longitudinal outcome and two competing survival outcomes. We assume multivariate normality on the joint distribution of the longitudinal and survival outcomes. Specifically, a mixed effects model is fit on the longitudinal outcome and a linear model is fit on each survival outcome. The three models are linked together by having the random terms of the mixed effects model as covariates in the survival models. EM algorithm is used to estimate the model parameters, and the nonparametric bootstrap is used for variance estimation. A simulation study is designed to compare the proposed method with an approach that models the outcomes sequentially in two steps. We fit the proposed model to the CRIC data and show that the protein-to-creatinine ratio is strongly predictive of both estimated GFR and ESRD but not death.

Suggested Citation

  • Wei Yang & Dawei Xie & Qiang Pan & Harold I. Feldman & Wensheng Guo, 2017. "Joint Modeling of Repeated Measures and Competing Failure Events in a Study of Chronic Kidney Disease," Statistics in Biosciences, Springer;International Chinese Statistical Association, vol. 9(2), pages 504-524, December.
  • Handle: RePEc:spr:stabio:v:9:y:2017:i:2:d:10.1007_s12561-016-9186-4
    DOI: 10.1007/s12561-016-9186-4

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    References listed on IDEAS

    1. Jeremy M. G. Taylor & Yongseok Park & Donna P. Ankerst & Cecile Proust-Lima & Scott Williams & Larry Kestin & Kyoungwha Bae & Tom Pickles & Howard Sandler, 2013. "Real-Time Individual Predictions of Prostate Cancer Recurrence Using Joint Models," Biometrics, The International Biometric Society, vol. 69(1), pages 206-213, March.
    2. Fushing Hsieh & Yi-Kuan Tseng & Jane-Ling Wang, 2006. "Joint Modeling of Survival and Longitudinal Data: Likelihood Approach Revisited," Biometrics, The International Biometric Society, vol. 62(4), pages 1037-1043, December.
    3. Liang Li & Bo Hu & Tom Greene, 2009. "A Semiparametric Joint Model for Longitudinal and Survival Data with Application to Hemodialysis Study," Biometrics, The International Biometric Society, vol. 65(3), pages 737-745, September.
    4. Yi-Kuan Tseng & Fushing Hsieh & Jane-Ling Wang, 2005. "Joint modelling of accelerated failure time and longitudinal data," Biometrika, Biometrika Trust, vol. 92(3), pages 587-603, September.
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