Bayesian semiparametric modeling for HIV longitudinal data with censoring and skewness

A Bayesian approach for mixed effects state-space models under skewness and heavy tails

Human immunodeficiency virus (HIV) dynamics have been the focus of epidemiological and biostatistical research during the past decades to understand the progression of acquired immunodeficiency syndrome (AIDS) in the population. Although there are several approaches for modeling HIV dynamics, one of the most popular is based on Gaussian mixed-effects models because of its simplicity from the implementation and interpretation viewpoints. However, in some situations, Gaussian mixed-effects models cannot (a) capture serial correlation existing in longitudinal data, (b) deal with missing observations properly, and (c) accommodate skewness and heavy tails frequently presented in patients' profiles. For those cases, mixed-effects state-space models (MESSM) become a powerful tool for modeling correlated observations, including HIV dynamics, because of their flexibility in modeling the unobserved states and the observations in a simple way. Consequently, our proposal considers an MESSM where the observations' error distribution is a skew-t. This new approach is more flexible and can accommodate data sets exhibiting skewness and heavy tails. Under the Bayesian paradigm, an efficient Markov chain Monte Carlo algorithm is implemented. To evaluate the properties of the proposed models, we carried out some exciting simulation studies, including missing data in the generated data sets. Finally, we illustrate our approach with an application in the AIDS Clinical Trial Group Study 315 (ACTG-315) clinical trial data set.

Extending multivariate Student's- t $$ t $$ semiparametric mixed models for longitudinal data with censored responses and heavy tails

This article extends the semiparametric mixed model for longitudinal censored data with Gaussian errors by considering the Student's t $$ t $$ -distribution. This model allows us to consider a flexible, functional dependence of an outcome variable over the covariates using nonparametric regression. Moreover, the proposed model takes into account the correlation between observations by using random effects. Penalized likelihood equations are applied to derive the maximum likelihood estimates that appear to be robust against outlying observations with respect to the Mahalanobis distance. We estimate nonparametric functions using smoothing splines under an EM-type algorithm framework. Finally, the proposed approach's performance is evaluated through extensive simulation studies and an application to two datasets from acquired immunodeficiency syndrome clinical trials.

A robust method for the assessment of average bioequivalence in the presence of outliers and skewness

PURPOSE

In this paper, we propose a robust Bayesian method for the assessment of average bioequivalence based on data from conventional crossover studies. We evaluate and motivate empirically the need for robust methods in bioequivalence studies by comparing the results of robust and conventional statistical methods in a large data pool of bioequivalence studies.

METHODS

Robustness of the statistical methodology is achieved by replacing the normal distributions for residuals in the linear mixed model with skew-t distributions. In this way, the statistical model can accommodate skew and heavy-tailed data, particularly outliers, yielding robust statistical inference without the need for excluding outliers from the analysis. We performed a simulation study to investigate and compare the performance of the robust and conventional models.

RESULTS

Our study shows that in some trials, the distribution of residuals is skew and heavy-tailed. In the presence of outliers, the 90% confidence intervals for the ratio of geometric means tend to be narrower for the robust methods than for the conventional method. Our simulation study shows that the robust method has suitable frequentist properties and yields more precise confidence intervals and higher statistical power than the conventional maximum likelihood method when outliers are present in the data.

CONCLUSIONS

As a sensitivity analysis, we recommend the fit of robust models for handling outliers that are occasionally encountered in crossover design bioequivalence data.

Robust inference for skewed data in health sciences

Health data are often not symmetric to be adequately modeled through the usual normal distributions; most of them exhibit skewed patterns. They can indeed be modeled better through the larger family of skew-normal distributions covering both skewed and symmetric cases. Since outliers are not uncommon in complex real-life experimental datasets, a robust methodology automatically taking care of the noises in the data would be of great practical value to produce stable and more precise research insights leading to better policy formulation. In this paper, we develop a class of robust estimators and testing procedures for the family of skew-normal distributions using the minimum density power divergence approach with application to health data. In particular, a robust procedure for testing of symmetry is discussed in the presence of outliers. Two efficient computational algorithms are discussed. Besides deriving the asymptotic and robustness theory for the proposed methods, their advantages and utilities are illustrated through simulations and a couple of real-life applications for health data of athletes from Australian Institute of Sports and AIDS clinical trial data.