A Dynamic Risk Model for Multitype Recurrent Events

Document Type

Journal Article

Publication Date

12-20-2022

Journal

American journal of epidemiology

DOI

10.1093/aje/kwac213

Keywords

absolute risk; multi-type recurrent events; robust standard errors; survival analysis; terminating events

Abstract

Recurrent events can occur more than once in the same individual; such events may be of different types, known as multi-type recurrent events. They are very common in longitudinal studies. Often there is a terminating event, after which no further events can occur. The risk of any event including terminating events such as death or cure is typically affected by prior events. We propose a flexible joint multi-type recurrent events model that explicitly provides estimates of the change in risk for each event due to subject characteristics including number and type of prior events, the absolute risk for every event type, terminating and nonterminating, and predicts event-free survival probability over a desired time period. The model is fully parametric and therefore a standard likelihood function and robust standard errors can be constructed. We illustrate the model with applications to the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (1994-2002) and provide discussion of the results and model features.

Department

Biostatistics and Bioinformatics

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