Merits of modelling multivariate survival data using random effects proportional odds model

Abstract

Recently, there has been a great deal of interest in the analysis of multivariate survival data. In most epidemiological studies, survival times of the same cluster are related because of some unobserved risk factors such as the environmental or genetic factors. Therefore, modelling of dependence between events of correlated individuals is required to ensure a correct inference on the effects of treatments or covariates on the survival times. In the past decades, extension of proportional hazards model has been widely considered for modelling multivariate survival data by incorporating a random effect which acts multiplicatively on the hazard function. In this article, we consider the proportional odds model, which is an alternative to the proportional hazards model at which the hazard ratio between individuals converges to unity eventually. This is a reasonable property particularly when the treatment effect fades out gradually and the homogeneity of the population increases over time. The objective of this paper is to assess the influence of the random effect on the within-subject correlation and the population heterogeneity. We are particularly interested in the properties of the proportional odds model with univariate random effect and correlated random effect. The correlations between survival times are derived explicitly for both choices of mixing distributions and are shown to be independent of the covariates. The time path of the odds function among the survivors are also examined to study the effect of the choice of mixing distribution. Modelling multivariate survival data using a univariate mixing distribution may be inadequate as the random effect not only characterises the dependence of the survival times, but also the conditional heterogeneity among the survivors. A robust estimate for the correlation of the logarithm of the survival times within a cluster is obtained disregarding the choice of the mixing distributions. The sensitivity of the estimate of the regression parameter under a misspecification of the mixing distribution is studied through simulation. © 2004 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.