– Unusual schedule
SASlab (6.4.29) Faculty of Sciences of the Universidade de Lisboa
Long-term Dagum-power variance function frailty regression model: Application in health studies
Survival models with cure fractions, known as long-term survival models, are widely used in epidemiology to account for both immune and susceptible patients regarding a failure event. In such studies, it is also necessary to estimate unobservable heterogeneity caused by unmeasured prognostic factors. Moreover, the hazard function may exhibit a non-monotonic shape, specifically, an unimodal hazard function. In this article, we propose a long-term survival model based on a defective version of the Dagum distribution, incorporating a power variance function frailty term to account for unobservable heterogeneity. This model accommodates survival data with cure fractions and non-monotonic hazard functions. The distribution is reparameterized in terms of the cure fraction, with covariates linked via a logit link, allowing for direct interpretation of covariate effects on the cure fractionan uncommon feature in defective approaches. We present maximum likelihood estimation for model parameters, assess performance through Monte Carlo simulations, and illustrate the models applicability using two health-related datasets: severe COVID-19 in pregnant and postpartum women and patients with malignant skin neoplasms.