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Related Experiment Video

Updated: Mar 7, 2026

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A two-phase model for chronic disease processes under intermittent inspection.

Ying Wu1, Richard J Cook2

  • 1Institute of Statistics, Nankai University, 94 Weijin Road, Tianjin, 300071, China.

Statistics in Medicine
|February 27, 2017
PubMed
Summary

A new two-phase model tracks chronic disease progression, distinguishing indolent and active phases. This aids in understanding disease duration and identifying associated genetic factors like human leukocyte antigens.

Keywords:
expectation-maximization algorithminterval-censoringrecurrent eventstwo-phase processtwo-stage estimation

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Area of Science:

  • Biostatistics
  • Epidemiology
  • Immunogenetics

Background:

  • Chronic diseases often exhibit distinct indolent and active phases.
  • Understanding disease progression dynamics is crucial for effective management and treatment.
  • Current models may not adequately capture the complexities of two-phase disease progression.

Purpose of the Study:

  • To develop and validate a novel statistical model for chronic diseases with indolent and active phases.
  • To enable separate modeling of the indolent phase duration and the active phase intensity.
  • To apply the model to real-world data, such as psoriatic arthritis progression.

Main Methods:

  • Development of a semi-Markov-based two-phase model.
  • Incorporation of interval-censored transition times for cohort studies.
  • Specification of weakly parametric models with piecewise constant hazard and rate functions.
  • Utilizing an expectation-maximization algorithm for model fitting.
  • Conducting simulation studies to assess model performance.

Main Results:

  • The proposed model effectively fits data with interval-censored transition times.
  • Simulation studies demonstrate good performance for maximum likelihood and two-stage estimation.
  • Application to psoriatic arthritis data identified novel human leukocyte antigens (HLAs) linked to indolent phase duration.

Conclusions:

  • The developed two-phase model provides a robust framework for analyzing chronic diseases with distinct progression phases.
  • The model facilitates the identification of factors influencing disease duration and progression.
  • The findings highlight the potential of HLA in modulating the indolent phase of psoriatic arthritis.