A Longitudinal Study of the Bladder Cancer Applying a State-Space Model with Non-Exponential Staying Time in States

Delia Montoro-Cazorla, Rafael Pérez-Ocón and Alicia Pereira das Neves-Yedig
Additional contact information
Delia Montoro-Cazorla: Department of Statistics and Operational Research, University of Jaén, 23071 Jaén, Spain
Rafael Pérez-Ocón: Department of Statistics and Operational Research, University of Granada, 18071 Granada, Spain
Alicia Pereira das Neves-Yedig: Department of Statistics and Operational Research, University of Granada, 18071 Granada, Spain

Mathematics, 2021, vol. 9, issue 4, 1-19

Abstract: A longitudinal study for 847 bladder cancer patients for a period of fifteen years is presented. After the first surgery, the patients undergo successive ones (recurrences). A state-model is selected for analyzing the evolution of the cancer, based on the distribution of the times between recurrences. These times do not follow exponential distributions, and are approximated by phase-type distributions. Under these conditions, a multidimensional Markov process governs the evolution of the disease. The survival probability and mean times in the different states (levels) of the disease are calculated empirically and also by applying the Markov model, the comparison of the results indicate that the model is well-fitted to the data to an acceptable significance level of 0.05. Two sub-cohorts are well-differenced: those reaching progression (the bladder is removed) and those that do not. These two cases are separately studied and performance measures calculated, and the comparison reveals details about the characteristics of the patients in these groups.

Keywords: bladder cancer; matrix-analytic methods; phase-type distributions; state-space model; survival (search for similar items in EconPapers)
JEL-codes: C (search for similar items in EconPapers)
Date: 2021
References: View references in EconPapers View complete reference list from CitEc
Citations:

Downloads: (external link)
https://www.mdpi.com/2227-7390/9/4/363/pdf (application/pdf)
https://www.mdpi.com/2227-7390/9/4/363/ (text/html)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:gam:jmathe:v:9:y:2021:i:4:p:363-:d:497534

Access Statistics for this article

Mathematics is currently edited by Ms. Emma He

More articles in Mathematics from MDPI
Bibliographic data for series maintained by MDPI Indexing Manager ().