Bayesian Semiparametric Cure Rate Model with an Unknown Threshold

Abstract.  We propose a Bayesian semiparametric model for survival data with a cure fraction. We explicitly consider a finite cure time in the model, which allows us to separate the cured and the uncured populations. We take a mixture prior of a Markov gamma process and a point mass at zero to model the baseline hazard rate function of the entire population. We focus on estimating the cure threshold after which subjects are considered cured. We can incorporate covariates through a structure similar to the proportional hazards model and allow the cure threshold also to depend on the covariates. For illustration, we undertake simulation studies and a full Bayesian analysis of a bone marrow transplant data set.     

On the Bayesian estimation and influence diagnostics for the Weibull-Negative-Binomial regression model with cure rate under latent failure causes

The purpose of this paper is to develop a Bayesian approach for the Weibull-Negative-Binomial regression model with cure rate under latent failure causes and presence of randomized activation mechanisms. We assume the number of competing causes of the event of interest follows a Negative Binomial (NB) distribution while the latent lifetimes are assumed to follow a Weibull distribution. Markov chain Monte Carlos (MCMC) methods are used to develop the Bayesian procedure. Model selection to compare the fitted models is discussed. Moreover, we develop case deletion influence diagnostics for the joint posterior distribution based on the ψ-divergence, which has several divergence measures as particular cases. The developed procedures are illustrated with a real data set.     

Discrete and continuous bivariate lifetime models in presence of cure rate: a comparative study under Bayesian approach

The modeling and analysis of lifetime data in which the main endpoints are the times when an event of interest occurs is of great interest in medical studies. In these studies, it is common that two or more lifetimes associated with the same unit such as the times to deterioration levels or the times to reaction to a treatment in pairs of organs like lungs, kidneys, eyes or ears. In medical applications, it is also possible that a cure rate is present and needed to be modeled with lifetime data with long-term survivors. This paper presented a comparative study under a Bayesian approach among some existing continuous and discrete bivariate distributions such as the bivariate exponential distributions and the bivariate geometric distributions in presence of cure rate, censored data and covariates. In presence of lifetimes related to cured patients, it is assumed standard mixture cure rate models in the data analysis. The posterior summaries of interest are obtained using Markov Chain Monte Carlo methods. To illustrate the proposed methodology two real medical data sets are considered.     

A general long-term aging model with different underlying activation mechanisms: Modeling,Bayesian estimation,and case influence diagnostics

In this paper we propose a general cure rate aging model. Our approach enables different underlying activation mechanisms which lead to the event of interest. The number of competing causes of the event of interest is assumed to follow a logarithmic distribution. The model is parameterized in terms of the cured fraction which is then linked to covariates. We explore the use of Markov chain Monte Carlo methods to develop a Bayesian analysis for the proposed model. Moreover, some discussions on the model selection to compare the fitted models are given, as well as case deletion influence diagnostics are developed for the joint posterior distribution based on the ψ-divergence, which has several divergence measures as particular cases, such as the Kullback–Leibler (K-L), J-distance, L₁ norm, and χ²-square divergence measures. Simulation studies are performed and experimental results are illustrated based on a real malignant melanoma data.     

The Geometric Birnbaum-Saunders regression model with cure rate

In this paper, we propose a cure rate survival model by assuming the number of competing causes of the event of interest follows the Geometric distribution and the time to event follow a Birnbaum Saunders distribution. We consider a frequentist analysis for parameter estimation of a Geometric Birnbaum Saunders model with cure rate. Finally, to analyze a data set from the medical area.     

A Bayesian approach to mixture cure models with spatial frailties for population‐based cancer relative survival data

As the treatments of cancer progress, a certain number of cancers are curable if diagnosed early. In population‐based cancer survival studies, cure is said to occur when mortality rate of the cancer patients returns to the same level as that expected for the general cancer‐free population. The estimates of cure fraction are of interest to both cancer patients and health policy makers. Mixture cure models have been widely used because the model is easy to interpret by separating the patients into two distinct groups. Usually parametric models are assumed for the latent distribution for the uncured patients. The estimation of cure fraction from the mixture cure model may be sensitive to misspecification of latent distribution. We propose a Bayesian approach to mixture cure model for population‐based cancer survival data, which can be extended to county‐level cancer survival data. Instead of modeling the latent distribution by a fixed parametric distribution, we use a finite mixture of the union of the lognormal, loglogistic, and Weibull distributions. The parameters are estimated using the Markov chain Monte Carlo method. Simulation study shows that the Bayesian method using a finite mixture latent distribution provides robust inference of parameter estimates. The proposed Bayesian method is applied to relative survival data for colon cancer patients from the Surveillance, Epidemiology, and End Results (SEER) Program to estimate the cure fractions. The Canadian Journal of Statistics 40: 40–54; 2012 © 2012 Statistical Society of Canada     

Influence diagnostics for the Weibull-Negative-Binomial regression model with cure rate under latent failure causes

In this paper, we propose a flexible cure rate survival model by assuming that the number of competing causes of the event of interest follows the Negative Binomial distribution and the time to event follows a Weibull distribution. Indeed, we introduce the Weibull-Negative-Binomial (WNB) distribution, which can be used in order to model survival data when the hazard rate function is increasing, decreasing and some non-monotonous shaped. Another advantage of the proposed model is that it has some distributions commonly used in lifetime analysis as particular cases. Moreover, the proposed model includes as special cases some of the well-know cure rate models discussed in the literature. We consider a frequentist analysis for parameter estimation of a WNB model with cure rate. Then, we derive the appropriate matrices for assessing local influence on the parameter estimates under different perturbation schemes and present some ways to perform global influence analysis. Finally, the methodology is illustrated on a medical data.     

Latent cure rate model under repair system and threshold effect

In this paper, we formulate a simple latent cure rate model with repair mechanism for a cell exposed to radiation. This latent approach is a flexible alternative to the models proposed by Klebanov et al. [A stochastic model of radiation carcinogenesis: latent time distributions and their properties. Math Biosci. 1993;18:51–75], Kim et al. [A new threshold regression model for survival data with a cure fraction. Lifetime Data Anal. 2011;17:101–122], and is along the lines of the destructive cure rate model formulated recently by Rodrigues et al. [Destructive weighted Poisson cure rate model. Lifetime Data Anal. 2011b;17:333–346]. A new version of the modified Gompertz model and the promotion cure rate model that takes into account the first passage time of reaching the critical point are discussed, and the estimation of tumor size at detection is then addressed from the Bayesian viewpoint. In addition, a simulation study and an application to real data set illustrate the usefulness of the proposed cure rate model.     

Defective models induced by gamma frailty term for survival data with cured fraction

In this paper, we propose a defective model induced by a frailty term for modeling the proportion of cured. Unlike most of the cure rate models, defective models have advantage of modeling the cure rate without adding any extra parameter in model. The introduction of an unobserved heterogeneity among individuals has bring advantages for the estimated model. The influence of unobserved covariates is incorporated using a proportional hazard model. The frailty term assumed to follow a gamma distribution is introduced on the hazard rate to control the unobservable heterogeneity of the patients. We assume that the baseline distribution follows a Gompertz and inverse Gaussian defective distributions. Thus we propose and discuss two defective distributions: the defective gamma-Gompertz and gamma-inverse Gaussian regression models. Simulation studies are performed to verify the asymptotic properties of the maximum likelihood estimator. Lastly, in order to illustrate the proposed model, we present three applications in real data sets, in which one of them we are using for the first time, related to a study about breast cancer in the A.C.Camargo Cancer Center, São Paulo, Brazil.     

A model with long-term survivors: negative binomial Birnbaum-Saunders

Abstract

We propose a cure rate survival model by assuming that the number of competing causes of the event of interest follows the negative binomial distribution and the time to the event of interest has the Birnbaum-Saunders distribution. Further, the new model includes as special cases some well-known cure rate models published recently. We consider a frequentist analysis for parameter estimation of the negative binomial Birnbaum-Saunders model with cure rate. Then, we derive the appropriate matrices for assessing local influence on the parameter estimates under different perturbation schemes. We illustrate the usefulness of the proposed model in the analysis of a real data set from the medical area.     

Change point-cure models with application to estimating the change-point effect of age of diagnosis among prostate cancer patients

Previous research on prostate cancer survival trends in the United States National Cancer Institute's Surveillance Epidemiology and End Results database has indicated a potential change-point in the age of diagnosis of prostate cancer around age 50. Identifying a change-point value in prostate cancer survival and cure could have important policy and health care management implications. Statistical analysis of this data has to address two complicating features: (1) change-point models are not smooth functions and so present computational and theoretical difficulties; and (2) models for prostate cancer survival need to account for the fact that many men diagnosed with prostate cancer can be effectively cured of their disease with early treatment. We develop a cure survival model that allows for change-point effects in covariates to investigate a potential change-point in the age of diagnosis of prostate cancer. Our results do not indicate that age under 50 is associated with increased hazard of death from prostate cancer.     

The Poisson Generalized Linear Failure Rate Model

We formulate a new cure rate survival model by assuming that the number of competing causes of the event of interest has the Poisson distribution, and the time to this event has the generalized linear failure rate distribution. A new distribution to analyze lifetime data is defined from the proposed cure rate model, and its quantile function as well as a general expansion for the moments is derived. We estimate the parameters of the model with cure rate in the presence of covariates for censored observations using maximum likelihood and derive the observed information matrix. We obtain the appropriate matrices for assessing local influence on the parameter estimates under different perturbation schemes and present some ways to perform global influence analysis. The usefulness of the proposed cure rate survival model is illustrated in an application to real data.     

A flexible cure rate model based on the polylogarithm distribution

Models for dealing with survival data in the presence of a cured fraction of individuals have attracted the attention of many researchers and practitioners in recent years. In this paper, we propose a cure rate model under the competing risks scenario. For the number of causes that can lead to the event of interest, we assume the polylogarithm distribution. The model is flexible in the sense it encompasses some well-known models, which can be tested using large sample test statistics applied to nested models. Maximum-likelihood estimation based on the EM algorithm and hypothesis testing are investigated. Results of simulation studies designed to gauge the performance of the estimation method and of two test statistics are reported. The methodology is applied in the analysis of a data set.     

A New lifetime model for multivariate survival data with a surviving fraction

In this paper we propose a new lifetime model for multivariate survival data with a surviving fraction. We develop this model assuming that there are m types of unobservable competing risks, where each risk is related to a time of the occurrence of an event of interest. We explore the use of Markov chain Monte Carlo methods to develop a Bayesian analysis for the proposed model. We also perform a simulation study in order to analyse the frequentist coverage probabilities of credible interval derived from posteriors. Our modelling is illustrated through a real data set.     

Estimating the cure fraction in population-based cancer studies by using finite mixture models

Summary.  The cure fraction (the proportion of patients who are cured of disease) is of interest to both patients and clinicians and is a useful measure to monitor trends in survival of curable disease. The paper extends the non-mixture and mixture cure fraction models to estimate the proportion cured of disease in population-based cancer studies by incorporating a finite mixture of two Weibull distributions to provide more flexibility in the shape of the estimated relative survival or excess mortality functions. The methods are illustrated by using public use data from England and Wales on survival following diagnosis of cancer of the colon where interest lies in differences between age and deprivation groups. We show that the finite mixture approach leads to improved model fit and estimates of the cure fraction that are closer to the empirical estimates. This is particularly so in the oldest age group where the cure fraction is notably lower. The cure fraction is broadly similar in each deprivation group, but the median survival of the 'uncured' is lower in the more deprived groups. The finite mixture approach overcomes some of the limitations of the more simplistic cure models and has the potential to model the complex excess hazard functions that are seen in real data.     

The Poisson–exponential distribution: a Bayesian approach

In this paper, we proposed a new two-parameter lifetime distribution with increasing failure rate. The new distribution arises on a latent complementary risk scenario. The properties of the proposed distribution are discussed, including a formal proof of its density function and an explicit algebraic formulae for its quantiles and survival and hazard functions. Also, we have discussed inference aspects of the model proposed via Bayesian inference by using Markov chain Monte Carlo simulation. A simulation study investigates the frequentist properties of the proposed estimators obtained under the assumptions of non-informative priors. Further, some discussions on models selection criteria are given. The developed methodology is illustrated on a real data set.     

Scale mixtures log-Birnbaum–Saunders regression models with censored data: a Bayesian approach

The main objective of this paper is to develop a full Bayesian analysis for the Birnbaum–Saunders (BS) regression model based on scale mixtures of the normal (SMN) distribution with right-censored survival data. The BS distributions based on SMN models are a very general approach for analysing lifetime data, which has as special cases the Student-t-BS, slash-BS and the contaminated normal-BS distributions, being a flexible alternative to the use of the corresponding BS distribution or any other well-known compatible model, such as the log-normal distribution. A Gibbs sample algorithm with Metropolis–Hastings algorithm is used to obtain the Bayesian estimates of the parameters. Moreover, some discussions on the model selection to compare the fitted models are given and case-deletion influence diagnostics are developed for the joint posterior distribution based on the Kullback–Leibler divergence. The newly developed procedures are illustrated on a real data set previously analysed under BS regression models.     

A Semi-parametric Bayesian Analysis of Survival Data Based on Lévy-driven Processes

In the presence of covariate information, the proportional hazards model is one of the most popular models. In this paper, in a Bayesian nonparametric framework, we use a Markov (Lévy-driven) process to model the baseline hazard rate. Previous Bayesian nonparametric models have been based on neutral to the right processes, which have a number of drawbacks, such as discreteness of the cumulative hazard function. We allow the covariates to be time dependent functions and develop a full posterior analysis via substitution sampling. A detailed illustration is presented.     

Objective Bayesian analysis based on upper record values from two-parameter Rayleigh distribution with partial information

In the life test, predicting higher failure times than the largest failure time of the observed is an important issue. Although the Rayleigh distribution is a suitable model for analyzing the lifetime of components that age rapidly over time because its failure rate function is an increasing linear function of time, the inference for a two-parameter Rayleigh distribution based on upper record values has not been addressed from the Bayesian perspective. This paper provides Bayesian analysis methods by proposing a noninformative prior distribution to analyze survival data, using a two-parameter Rayleigh distribution based on record values. In addition, we provide a pivotal quantity and an algorithm based on the pivotal quantity to predict the behavior of future survival records. We show that the proposed method is superior to the frequentist counterpart in terms of the mean-squared error and bias through Monte carlo simulations. For illustrative purposes, survival data on lung cancer patients are analyzed, and it is proved that the proposed model can be a good alternative when prior information is not given.     

Comparison of Mixed-Effects Models for Skew-Normal Responses with an Application to AIDS Data: A Bayesian Approach

The potency of antiretroviral agents in AIDS clinical trials can be assessed on the basis of a viral response such as viral decay rate or change in viral load (number of HIV RNA copies in plasma). Linear, nonlinear, and nonparametric mixed-effects models have been proposed to estimate such parameters in viral dynamic models. However, there are two critical questions that stand out: whether these models achieve consistent estimates for viral decay rates, and which model is more appropriate for use in practice. Moreover, one often assumes that a model random error is normally distributed, but this assumption may be unrealistic, obscuring important features of within- and among-subject variations. In this article, we develop a skew-normal (SN) Bayesian linear mixed-effects (SN-BLME) model, an SN Bayesian nonlinear mixed-effects (SN-BNLME) model, and an SN Bayesian semiparametric nonlinear mixed-effects (SN-BSNLME) model that relax the normality assumption by considering model random error to have an SN distribution. We compare the performance of these SN models, and also compare their performance with the corresponding normal models. An AIDS dataset is used to test the proposed models and methods. It was found that there is a significant incongruity in the estimated viral decay rates. The results indicate that SN-BSNLME model is preferred to the other models, implying that an arbitrary data truncation is not necessary. The findings also suggest that it is important to assume a model with an SN distribution in order to achieve reasonable results when the data exhibit skewness.