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Marginal Structural Illness-Death Models for Semi-competing Risks Data

Author

Listed:
  • Yiran Zhang

    (School of Public Health and Human Longevity Science)

  • Andrew Ying

    (Google Inc.)

  • Steve Edland

    (School of Public Health and Human Longevity Science)

  • Lon White

    (Pacific Health Research and Education Institute)

  • Ronghui Xu

    (School of Public Health and Human Longevity Science
    University of California, San Diego)

Abstract

The three-state illness-death model has been established as a general approach for regression analysis of semi-competing risks data. For observational data the marginal structural models (MSM) are a useful tool, under the potential outcomes framework to define and estimate parameters with causal interpretations. In this paper we introduce a class of marginal structural illness-death models for the analysis of observational semi-competing risks data. We consider two specific such models, the Markov illness-death MSM and the frailty-based Markov illness-death MSM. For interpretation purposes, risk contrasts under the MSMs are defined. Inference under the illness-death MSM can be carried out using estimating equations with inverse probability weighting, while inference under the frailty-based illness-death MSM requires a weighted EM algorithm. We study the inference procedures under both MSMs using extensive simulations, and apply them to the analysis of mid-life alcohol exposure on late life cognitive impairment as well as mortality using the Honolulu-Asia Aging Study data set. The R codes developed in this work have been implemented in the R package semicmprskcoxmsm that is publicly available on CRAN.

Suggested Citation

  • Yiran Zhang & Andrew Ying & Steve Edland & Lon White & Ronghui Xu, 2024. "Marginal Structural Illness-Death Models for Semi-competing Risks Data," Statistics in Biosciences, Springer;International Chinese Statistical Association, vol. 16(3), pages 668-692, December.
    • Handle: RePEc:spr:stabio:v:16:y:2024:i:3:d:10.1007_s12561-023-09413-6
    DOI: 10.1007/s12561-023-09413-6
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    References listed on IDEAS

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