Nonparametric estimators of survival function under the mixed case interval-censored model with left truncation

It is well known that the nonparametric maximum likelihood estimator (NPMLE) can severely underestimate the survival probabilities at early times for left-truncated and interval-censored (LT-IC) data. For arbitrarily truncated and censored data, Pan and Chappel (JAMA Stat Probab Lett 38:49-57, 1998a, Biometrics 54:1053-1060, 1998b) proposed a nonparametric estimator of the survival function, called the iterative Nelson estimator (INE). Their simulation study showed that the INE performed well in overcoming the under-estimation of the survival function from the NPMLE for LT-IC data. In this article, we revisit the problem of inconsistency of the NPMLE. We point out that the inconsistency is caused by the likelihood function of the left-censored observations, where the left-truncated variables are used as the left endpoints of censoring intervals. This can lead to severe underestimation of the survival function if the NPMLE is obtained using Turnbull's (JAMA 38:290-295, 1976) EM algorithm. To overcome this problem, we propose a modified maximum likelihood estimator (MMLE) based on a modified likelihood function, where the left endpoints of censoring intervals for left-censored observations are the maximum of left-truncated variables and the estimated left endpoint of the support of the left-censored times. Simulation studies show that the MMLE performs well for finite sample and outperforms both the INE and NPMLE.