Original Article

Joint frailty model of recurrent and terminal events in the presence of cure fraction using a Bayesian approach

Bayesian cure joint frailty model

Abstract

Introduction: Recurrent event data are common in many longitudinal studies. Often, a terminating event such as death can be correlated with the recurrent event process. A shared frailty model applied to account for the association between recurrent and terminal events. In some situations, a fraction of subjects experience neither recurrent events nor death; these subjects are cured.

Methods: In this paper, we discussed the Bayesian approach of a joint frailty model for recurrent and terminal events in the presence of cure fraction. We compared estimates of parameters in the Frequentist and Bayesian approaches via simulation studies in various sample sizes; we applied the joint frailty model in the presence of cure fraction with Frequentist and Bayesian approaches for breast cancer.

Results: In small sample size Bayesian approach compared to Frequentist approach had a smaller standard error and mean square error, and the coverage probabilities close to nominal level of 95%. Also, in Bayesian approach, the sampling means of the estimated standard errors were close to the empirical standard error.

Conclusion: The simulation results suggested that when sample size was small, the use of Bayesian joint frailty model in the presence of cure fraction led to more efficiency in parameter estimation and statistical inference

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Table 1. Simulation Results for a generated joint frailty model with Frequentist and Bayesian approaches

Sample size Parameter Frequentist Bayesian
(Informative priors) Bayesian
(Non-informative priors)
Est SEE SEM1 MSE1 CP1 mean SD SEM2 MSE2 CP2 mean SD SEM2 MSE2 CP2
N=20

2.60 5.35 178.33 30.12 0.91 0.34 0.48 0.63 0.66 0.75 1.17 1.59 2.70 2.56 0.95

-1.28 5.85 226.70 34.90 0.94 -0.39 0.48 0.64 0.24 0.95 -0.83 1.55 2.23 2.54 0.94

1.17 4.68 14.71 22.10 0.97 0.25 0.53 0.60 0.48 0.86 0.81 1.41 1.45 2.00 0.93

1.47 1.10 0.33 1.25 0.98 1.34 0.44 0.43 0.21 0.94 1.48 0.67 0.51 0.50 0.93

1.98 4.84 0.29 23.90 0.99 1.51 0.53 0.39 0.35 0.91 1.66 0.74 0.49 0.72 0.92

1.60 10.20 25.03 1.05 0.99 0.44 0.59 0.81 0.35 0.96 0.54 0.93 1.41 0.87 0.93

-0.28 2.41 9.54 5.88 0.93 -0.51 0.61 0.67 0.37 0.93 -0.54 0.95 0.91 0.91 0.95

1.40 3.35 17.36 11.30 0.91 0.89 0.78 0.95 0.63 0.95 1.11 1.37 1.50 1.90 0.94
N=30

1.87 3.03 16.60 9.95 0.90 0.46
0.48 0.57 0.52 0.82 1.12 1.09 1.59 1.21 0.93

-0.64 3.05 5.01 9.33 0.94 -0.44 0.49 0.57 0.24 0.94 -0.72 1.03 1.24 1.11 0.95

0.59 5.56 4.43 30.90 0.99 0.30 0.49 0.54 0.40 0.87 0.66 1.02 1.07 1.05 0.95

1.36 0.51 0.24 0.27 0.94 1.28 0.33 0.34 0.11 0.94 1.37 0.42 0.44 0.19 0.94

1.67 4.00 0.23 16.20 0.99 1.40 0.39 0.32 0.11 0.92 1.49 0.47 0.50 0.28 0.91

1.12 8.02 12.87 64.7 0.99 0.42 0.50 0.66 0.26 0.95 0.53 0.73 1.42 0.54 0.95

-0.41 1.28 2.28 1.65 0.97 -0.54 0.54 0.55 0.29 0.94 -0.50 0.62 0.66 0.38 0.95

1.22 1.80 4.42 3.29 0.95 0.96 0.69 0.77 0.48 0.96 1.03 0.91 0.91 0.83 0.96
N=50

1.39 1.80 3.79 3.42 0.97 0.59 0.45 0.50 0.36 0.86 1.04 0.75 0.77 0.56 0.94

-0.61 1.25 2.017 1.53 0.99 -0.48 0.48 0.48 0.23 0.95 -0.62 0.75 0.64 0.58 0.94

0.77 0.80 0.68 0.65 0.96 0.38 0.42 0.47 0.28 0.87 0.69 0.66 0.66 0.44 0.95


1.29 0.33 0.18 0.11 0.94 1.25 0.26 0.26 0.07 0.95 1.29 0.28 0.28 0.08 0.95

1.36 0.35 0.17 0.12 0.93 1.32 0.27 0.25 0.08 0.94 1.36 0.30 0.27 0.10 0.94

0.58 1.04 4.82 1.09 0.98 0.43 0.44 0.53 0.20 0.97 0.46 0.50 0.60 0.26 0.96

-0.45 0.55 0.49 0.30 0.95 -0.51 0.44 0.53 0.20 0.94 -0.50 0.49 0.47 0.24 0.94

1.07 0.88 1.81 0.79 0.97 0.95 0.55 0.61 0.30 0.97 0.98 0.65 0.64 0.42 0.94
N=100

1.08 0.51 0.50 0.27 0.95 0.73 0.34 0.39 0.18 0.88 1.01 0.46 0.49 0.21 0.95

-0.52 0.41 0.40 0.17 0.94 -0.52 0.35 0.36 0.13 0.95 -0.59 0.41 0.40 0.18 0.93

0.74 0.51 0.45 0.26 0.96 0.47 0.36 0.37 0.18 0.91 0.67 0.44 0.45 0.21 0.95

1.25 0.19 0.13 0.03 0.95 1.22 0.18 0.18 0.03 0.95 1.24 0.19 0.19 0.03 0.95

1.29 0.19 0.13 0.04 0.93 1.27 0.18 0.18 0.03 0.95 1.28 0.20 0.18 0.04 0.94

0.49 0.33 1.56 0.11 0.94 0.43 0.30 0.37 0.09 0.97 0.44 0.32 0.40 0.10 0.96

-0.48 0.32 0.32 0.10 0.94 -0.50 0.32 0.31 0.10 0.95 -0.47 0.33 0.32 0.11 0.94

1.01 0.45 0.44 0.20 0.95 0.97 0.42 0.43 0.18 0.94 0.94 0.45 0.44 0.20 0.93
N=200

1.03 0.32 0.34 0.10 0.94 0.83 0.28 0.30 0.11 0.92 0.97 0.34 0.33 0.11 0.94

-0.51 0.29 0.27 0.08 0.95 -0.53 0.28 0.26 0.08 0.94 -0.57 0.32 0.27 0.11 0.94

0.71 0.33 0.31 0.10 0.94 0.54 0.28 0.28 0.10 0.90 0.66 0.33 0.31 0.11 0.94

1.25 0.12 0.09 0.01 0.96 1.22 0.12 0.12 0.01 0.95 1.23 0.13 0.13 0.01 0.95

1.27 0.12 0.09 0.01 0.94 1.24 0.12 0.12 0.01 0.95 1.24 0.13 0.12 0.01 0.94

0.50 0.23 0.48 0.05 0.96 0.43 0.21 0.25 0.04 0.95 0.43 0.22 0.26 0.05 0.94

-0.49 0.22 0.25 0.05 0.94 -0.50 0.24 0.22 0.06 0.94 -0.49 0.25 0.22 0.06 0.94

1.00 0.29 0.30 0.08 0.94 0.96 0.32 0.30 0.10 0.94 0.93 0.33 0.30 0.11 0.93
CP1, coverage probability of 95% confidence intervals; CP2, coverage probability of 95% equal-tail credible intervals; Est, estimates of parameters; MSE1, mean square error; MSE2, Bayesian mean square error; SD, posterior standard deviation; SEE, empirical standard error; SEM1, mean of standard error; SEM2, sample mean of the square root of posterior variances
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IssueVol 8 No 3 (2022) QRcode
SectionOriginal Article(s)
DOI https://doi.org/10.18502/jbe.v8i3.12306
Keywords
Bayesian approach Breast cancer Cure fraction Joint frailty model Recurrent event.

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1.
Baghestani AR, Arab Borzu zahra, Talebi Ghane E, Khadem maboudi AA, Saeedi A, Akhavan A. Joint frailty model of recurrent and terminal events in the presence of cure fraction using a Bayesian approach. JBE. 2023;8(3):304-313.