Abstract:Longitudinal clinical studies often collect repeated measurements of biomarkers or health-related quality of life together with a time-to-event outcome. These processes are intrinsically linked: longitudinal trajectories may predict event risk, while event occurrence, or its anticipation, can induce informative censoring of the longitudinal process. Joint models provide a principled framework for handling this dependence, but most existing formulations rely on proportional hazards assumptions that may be restrictive and offer limited interpretability on the time scale. We propose a class of semiparametric accelerated failure time joint models that directly model covariate effects on event timing while flexibly capturing longitudinal-event associations. The survival component is specified through an accelerated failure time model with the baseline component represented by a flexible basis expansion, allowing a broad class of smooth baseline specifications. We illustrate the framework using Bernstein polynomial baseline representations and introduce rescaling strategies to improve numerical stability and parameter identifiability under time-warping. Estimation is conducted within a Bayesian framework, enabling joint inference for longitudinal, survival, and association parameters. Simulation studies reflecting realistic longitudinal trajectories, censoring mechanisms, and dependence structures are used to evaluate finite-sample performance. The proposed models show improved recovery of longitudinal treatment effects compared with a standalone linear mixed model when event risk depends on the underlying longitudinal process. Overall, the framework extends existing joint modelling methodology by offering a flexible and interpretable alternative to proportional hazards-based approaches.
From: Ding Ma [view email]
[v1]
Mon, 15 Jun 2026 00:42:23 UTC (190 KB)
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