Correlated Multistate Models for Multiple Processes: An Application to Renal Disease Progression in SystemicLupus Erythematosus
针对狼疮肾炎患者肾小球滤过率和尿蛋白含量的双向变化，提出一种多状态模型框架，通过引入患者特定随机效应来刻画过程间及患者内的相关性，并用国际协作临床数据评估模型。
Summary Bidirectional changes over time in the estimated glomerular filtration rate and in urine protein content are of interest for the treatment and management of patients with lupus nephritis. Although these processes may be modelled by separate multistate models, the processes are likely to be correlated within patients. Motivated by the lupus nephritis application, we develop a new multistate modelling framework where subject-specific random effects are introduced to account for the correlations both between the processes and within patients over time. Models are fitted by using bespoke code in standard statistical software. A variety of forms for the random effects are introduced and evaluated by using the data from the Systemic Lupus International Collaborating Clinics.