Bayesian joint ordinal and survival modeling for breast cancer risk assessment.

Abstract:

:We propose a joint model to analyze the structure and intensity of the association between longitudinal measurements of an ordinal marker and time to a relevant event. The longitudinal process is defined in terms of a proportional-odds cumulative logit model. Time-to-event is modeled through a left-truncated proportional-hazards model, which incorporates information of the longitudinal marker as well as baseline covariates. Both longitudinal and survival processes are connected by means of a common vector of random effects. General inferences are discussed under the Bayesian approach and include the posterior distribution of the probabilities associated to each longitudinal category and the assessment of the impact of the baseline covariates and the longitudinal marker on the hazard function. The flexibility provided by the joint model makes possible to dynamically estimate individual event-free probabilities and predict future longitudinal marker values. The model is applied to the assessment of breast cancer risk in women attending a population-based screening program. The longitudinal ordinal marker is mammographic breast density measured with the Breast Imaging Reporting and Data System (BI-RADS) scale in biennial screening exams. © 2016 The Authors. Statistics in Medicine Published by John Wiley & Sons Ltd.

journal_name

Stat Med

journal_title

Statistics in medicine

authors

Armero C,Forné C,Rué M,Forte A,Perpiñán H,Gómez G,Baré M

doi

10.1002/sim.7065

subject

Has Abstract

pub_date

2016-12-10 00:00:00

pages

5267-5282

issue

28

eissn

0277-6715

issn

1097-0258

journal_volume

35

pub_type

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