Abstract #302126

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JSM 2003 Abstract #302126
Activity Number: 96
Type: Contributed
Date/Time: Monday, August 4, 2003 : 8:30 AM to 10:20 AM
Sponsor: Biometrics Section
Abstract - #302126
Title: Modeling a Multi-State Disease Process with Phase-Type Distributions
Author(s): Chen-Hsin Chen*+
Companies: Academia Sinica
Address: , Taipei 11529, , , Taiwan
Keywords: cancer screening ; censored data ; disease progression ; Markov model
Abstract:

It is often useful to depict the evolution of a disease process in terms of multiple medically detectable disease states. The phase-type distribution has recently been advocated for greater application in survival analysis with only two states (Aalen 1995, Asmussen 1996). The distribution is coupled with a time-homogeneous Markov process using a finite number of phases in which one is absorbing, and the others are transient. The sojourn time up to absorption, that follows a phase-type distribution, is the only observation time, but the transition times over the phases embedded between two states are unobservable. By extending Olsson's (1996) work to a multi-state model, we estimate a biologically based sophisticated Markov process with phase-type distributions. A five-state model is applied to estimate the natural history of cervical cancer based on the screening data. Some statistical issues of interval censorship and nonsusceptibility arising from a periodical screening program for early detection of a multi-state progressive disease are also considered.

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