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A Bayesian multivariate mixture model for skewed longitudinal data with intermittent missing observations: An application to infant motor development.

ABSTRACT: In studies of infant growth, an important research goal is to identify latent clusters of infants with delayed motor development-a risk factor for adverse outcomes later in life. However, there are numerous statistical challenges in modeling motor development: the data are typically skewed, exhibit intermittent missingness, and are correlated across repeated measurements over time. Using data from the Nurture study, a cohort of approximately 600 mother-infant pairs, we develop a flexible Bayesian mixture model for the analysis of infant motor development. First, we model developmental trajectories using matrix skew-normal distributions with cluster-specific parameters to accommodate dependence and skewness in the data. Second, we model the cluster-membership probabilities using a Pólya-Gamma data-augmentation scheme, which improves predictions of the cluster-membership allocations. Lastly, we impute missing responses from conditional multivariate skew-normal distributions. Bayesian inference is achieved through straightforward Gibbs sampling. Through simulation studies, we show that the proposed model yields improved inferences over models that ignore skewness or adopt conventional imputation methods. We applied the model to the Nurture data and identified two distinct developmental clusters, as well as detrimental effects of food insecurity on motor development. These findings can aid investigators in targeting interventions during this critical early-life developmental window.

SUBMITTER: Allen C

PROVIDER: S-EPMC8297425 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundIn clinical trials and epidemiological research, mixed-effects models are commonly used to examine population-level and subject-specific trajectories of biomarkers over time. Despite their increasing popularity and application, the specification of these models necessitates a great deal of care when analysing longitudinal data with non-linear patterns and asymmetry. Parametric (linear) mixed-effect models may not capture these complexities flexibly and adequately. Additionally, assuming a Gaussian distribution for random effects and/or model errors may be overly restrictive, as it lacks robustness against deviations from symmetry.MethodsThis paper presents a semiparametric mixed-effects model with flexible distributions for complex longitudinal data in the Bayesian paradigm. The non-linear time effect on the longitudinal response was modelled using a spline approach. The multivariate skew-t distribution, which is a more flexible distribution, is utilized to relax the normality assumptions associated with both random-effects and model errors.ResultsTo assess the effectiveness of the proposed methods in various model settings, simulation studies were conducted. We then applied these models on chronic kidney disease (CKD) data and assessed the relationship between covariates and estimated glomerular filtration rate (eGFR). First, we compared the proposed semiparametric partially linear mixed-effect (SPPLM) model with the fully parametric one (FPLM), and the results indicated that the SPPLM model outperformed the FPLM model. We then further compared four different SPPLM models, each assuming different distributions for the random effects and model errors. The model with a skew-t distribution exhibited a superior fit to the CKD data compared to the Gaussian model. The findings from the application revealed that hypertension, diabetes, and follow-up time had a substantial association with kidney function, specifically leading to a decrease in GFR estimates.ConclusionsThe application and simulation studies have demonstrated that our work has made a significant contribution towards a more robust and adaptable methodology for modeling intricate longitudinal data. We achieved this by proposing a semiparametric Bayesian modeling approach with a spline smoothing function and a skew-t distribution.

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A Bayesian multivariate mixture model for skewed longitudinal data with intermittent missing observations: An application to infant motor development.

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