Mixture Joint Models for Event Time and Longitudinal Data With Multiple Features

It often happens in longitudinal studies that repeated measurements of markers are observed with various data features of a heterogeneous population comprising of several subclasses, left-censoring due to a limit of detection (LOD) and covariates measured with error. Moreover, repeatedly measured markers in time may be associated with a time-to-event of interest. Inferential procedures may become very complicated when one analyzes data with these features together. This article explores a finite mixture of hierarchical joint models of event times and longitudinal measures with an attempt to alleviate departures from homogeneous characteristics, tailor observations below LOD as missing values, mediate accuracy from measurement error in covariate and overcome shortages of confidence in specifying a parametric time-to-event model with a nonparametric distribution. The Bayesian joint modeling is employed to not only estimate all parameters in mixture of joint models, but also evaluate probabilities of class membership. A real data example is analyzed to demonstrate the methodology by jointly modeling the viral dynamics and the time to decrease in CD4/CD8 ratio in the presence of CD4 cell counts with measurement error and the analytic results are reported by comparing potential models for various scenarios. Supplementary materials for this article are available online.