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Semiparametric frailty models for zero-inflated event count data in the presence of informative dropout.

ABSTRACT: Recurrent events data are commonly encountered in medical studies. In many applications, only the number of events during the follow-up period rather than the recurrent event times is available. Two important challenges arise in such studies: (a) a substantial portion of subjects may not experience the event, and (b) we may not observe the event count for the entire study period due to informative dropout. To address the first challenge, we assume that underlying population consists of two subpopulations: a subpopulation nonsusceptible to the event of interest and a subpopulation susceptible to the event of interest. In the susceptible subpopulation, the event count is assumed to follow a Poisson distribution given the follow-up time and the subject-specific characteristics. We then introduce a frailty to account for informative dropout. The proposed semiparametric frailty models consist of three submodels: (a) a logistic regression model for the probability such that a subject belongs to the nonsusceptible subpopulation; (b) a nonhomogeneous Poisson process model with an unspecified baseline rate function; and (c) a Cox model for the informative dropout time. We develop likelihood-based estimation and inference procedures. The maximum likelihood estimators are shown to be consistent. Additionally, the proposed estimators of the finite-dimensional parameters are asymptotically normal and the covariance matrix attains the semiparametric efficiency bound. Simulation studies demonstrate that the proposed methodologies perform well in practical situations. We apply the proposed methods to a clinical trial on patients with myelodysplastic syndromes.

SUBMITTER: Diao G

PROVIDER: S-EPMC7573886 | biostudies-literature | 2019 Dec

REPOSITORIES: biostudies-literature

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Semiparametric frailty models for zero-inflated event count data in the presence of informative dropout.

Diao Guoqing G Zeng Donglin D Hu Kuolung K Ibrahim Joseph G JG

Biometrics 20190902 4

Recurrent events data are commonly encountered in medical studies. In many applications, only the number of events during the follow-up period rather than the recurrent event times is available. Two important challenges arise in such studies: (a) a substantial portion of subjects may not experience the event, and (b) we may not observe the event count for the entire study period due to informative dropout. To address the first challenge, we assume that underlying population consists of two subpo ...[more]

PMID: 31106400

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Project description:Microorganisms play critical roles in human health and disease. They live in diverse communities in which they interact synergistically or antagonistically. Thus for estimating microbial associations with clinical covariates, such as treatment effects, joint (multivariate) statistical models are preferred. Multivariate models allow one to estimate and exploit complex interdependencies among multiple taxa, yielding more powerful tests of exposure or treatment effects than application of taxon-specific univariate analyses. Analysis of microbial count data also requires special attention because data commonly exhibit zero inflation, i.e., more zeros than expected from a standard count distribution. To meet these needs, we developed a Bayesian variable selection model for multivariate count data with excess zeros that incorporates information on the covariance structure of the outcomes (counts for multiple taxa), while estimating associations with the mean levels of these outcomes. Though there has been much work on zero-inflated models for longitudinal data, little attention has been given to high-dimensional multivariate zero-inflated data modeled via a general correlation structure. Through simulation, we compared performance of the proposed method to that of existing univariate approaches, for both the binary ("excess zero") and count parts of the model. When outcomes were correlated the proposed variable selection method maintained type I error while boosting the ability to identify true associations in the binary component of the model. For the count part of the model, in some scenarios the univariate method had higher power than the multivariate approach. This higher power was at a cost of a highly inflated false discovery rate not observed with the proposed multivariate method. We applied the approach to oral microbiome data from the Pediatric HIV/AIDS Cohort Oral Health Study and identified five (of 44) species associated with HIV infection.

Project description:IntroductionCount outcomes in tobacco research are often analyzed with the Poisson distribution. However, they often exhibit features such as overdispersion (variance larger than expected) and zero inflation (extra zeros) that violate model assumptions. Furthermore, longitudinal studies have repeated measures that generate correlated counts. Failure to account for overdispersion, zero inflation, and correlation can yield incorrect statistical inferences. Thus, it is important to familiarize researchers with proper models for such data.Aims and methodsPoisson and Negative Binomial models with correlated random effects with and without zero inflation are presented. The illustrative data comes from a study comparing a mindfulness training app (Craving to Quit [C2Q], n = 60) with a control app (experience sampling-only app, n = 66) on smoking frequency at 1, 3, and 6 months. Predictors include app, time, the app-by-time interaction, and baseline smoking. Each model is evaluated in terms of accounting for zero inflation, overdispersion, and correlation in the data. Emphasis is placed on evaluating model fit, subject-specific interpretation of effects, and choosing an appropriate model.ResultsThe hurdle Poisson model provided the best fit to the data. Smoking abstinence rates were 33%, 32%, and 28% at 1, 3, and 6 months, respectively, with variance larger than expected by a factor >7 at each follow-up. Individuals on C2Q were less likely to achieve abstinence across time but likely to smoke fewer cigarettes if smoking.ConclusionsThe models presented are specifically suited for analyzing correlated count outcomes and account for zero inflation and overdispersion. We provide guidance to researchers on the use of these models to better inform nicotine and tobacco research.ImplicationsIn tobacco research, count outcomes are often measured repeatedly on the same subject and thus correlated. Such outcomes often have many zeros and exhibit large variances relative to the mean. Analyzing such data require models specifically suited for correlated counts. The presented models and guidelines could improve the rigor of the analysis of correlated count data and thus increase the impact of studies in nicotine and tobacco research using such outcomes.

Dataset Information

Semiparametric frailty models for zero-inflated event count data in the presence of informative dropout.

Publications

Semiparametric frailty models for zero-inflated event count data in the presence of informative dropout.

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