Longitudinal profiles of bounded outcome scores as predictors for disease activity in rheumatoid arthritis patients: a joint modeling approach

A variety of statistical approaches have been suggested in the literature for the analysis of bounded outcome scores (BOS). In this paper, we suggest a statistical approach when BOSs are repeatedly measured over time and used as predictors in a regression model. Instead of directly using the BOS as a predictor, we propose to extend the approaches suggested in [16 E. Lesaffre, D. Rizopoulos, and R. Tsonaka, The logistics-transform for bounded outcome scores, Biostatistics 8 (2007), pp. 72–85. doi: 10.1093/biostatistics/kxj034[Crossref], [PubMed], [Web of Science ®] , [Google Scholar],21 M. Molas and E. Lesaffre, A comparison of the three random effects approaches to analyse repeated bounded outcome scores with an application in a stroke revalidation study, Stat. Med. 27 (2008), pp. 6612–6633. doi: 10.1002/sim.3432[Crossref], [PubMed], [Web of Science ®] , [Google Scholar],28 R. Tsonaka, D. Rizopoulos, and E. Lesaffre, Power and sample size calculations for discrete bounded outcome scores, Stat. Med. 25 (2006), pp. 4241–4252. doi: 10.1002/sim.2679[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]] to a joint modeling setting. Our approach is illustrated on longitudinal profiles of multiple patients’ reported outcomes to predict the current clinical status of rheumatoid arthritis patients by a disease activities score of 28 joints (DAS28). Both a maximum likelihood as well as a Bayesian approach is developed.