Marginal analysis of multiple outcomes with informative cluster size

Pseudo-value regression of clustered multistate current status data with informative cluster sizes

Multistate current status data presents a more severe form of censoring due to the single observation of study participants transitioning through a sequence of well-defined disease states at random inspection times. Moreover, these data may be clustered within specified groups, and informativeness of the cluster sizes may arise due to the existing latent relationship between the transition outcomes and the cluster sizes. Failure to adjust for this informativeness may lead to a biased inference. Motivated by a clinical study of periodontal disease, we propose an extension of the pseudo-value approach to estimate covariate effects on the state occupation probabilities for these clustered multistate current status data with informative cluster or intra-cluster group sizes. In our approach, the proposed pseudo-value technique initially computes marginal estimators of the state occupation probabilities utilizing nonparametric regression. Next, the estimating equations based on the corresponding pseudo-values are reweighted by functions of the cluster sizes to adjust for informativeness. We perform a variety of simulation studies to study the properties of our pseudo-value regression based on the nonparametric marginal estimators under different scenarios of informativeness. For illustration, the method is applied to the motivating periodontal disease dataset, which encapsulates the complex data-generation mechanism.

A model selection criterion for clustered survival analysis with informative cluster size

We propose a model selection criterion for correlated survival data when the cluster size is informative to the outcome. This approach, called Resampling Cluster Survival Information Criterion (RCSIC), uses the Cox proportional hazards model that is weighted with the inverse of the cluster size. The RCSIC based on the within-cluster resampling idea takes into account the possible variability of the within-cluster subsampling and the possible informativeness of cluster sizes. The RCSIC allows for easy execution for the within-cluster resampling idea without a large number of resamples of the data. In contrast with the traditional model selection method in survival analysis, the RCSIC has an additional penalization for the within-cluster subsampling variability. Our simulations show the satisfactory results where the RCSIC provides a more robust power for variable selection in terms of clustered survival analysis, regardless of whether informative cluster size exists or not. Applying the RCSIC method to a periodontal disease studies, we identify the tooth loss in patients associated with the risk factors, Age, Filled Tooth, Molar, Crown, Decayed Tooth, and Smoking Status, respectively.