Time-Varying Coefficient Models for Recurrent Events

I have developed time-varying coefficient models for recurrent event data to evaluate the temporal profiles for recurrence rate and covariate effects. There are three major parts in this dissertation. The first two parts propose a mixed Poisson process model with gamma frailties for single type recurrent events. The third part proposes a Bayesian joint model based on multivariate log-normal frailties for multi-type recurrent events. In the first part, I propose an approach based on penalized B-splines to obtain smooth estimation for both time-varying coefficients and the log baseline intensity. An EM algorithm is developed for parameter estimation. One issue with this approach is that the estimating procedure is conditional on smoothing parameters, which have to be selected by cross-validation or optimizing certain performance criterion. The procedure can be computationally demanding with a large number of time-varying coefficients. To achieve objective estimation of smoothing parameters, I propose a mixed-model representation approach for penalized splines. Spline coefficients are treated as random effects and smoothing parameters are to be estimated as variance components. An EM algorithm embedded with penalized quasi-likelihood approximation is developed to estimate the model parameters. The third part proposes a Bayesian joint model with time-varying coefficients for multi-type recurrent events. Bayesian penalized splines are used to estimate time-varying coefficients and the log baseline intensity. One challenge in Bayesian penalized splines is that the smoothness of a spline fit is considerably sensitive to the subjective choice of hyperparameters. I establish a procedure to objectively determine the hyperparameters through a robust prior specification. A Markov chain Monte Carlo procedure based on Metropolis-adjusted Langevin algorithms is developed to sample from the high-dimensional distribution of spline coefficients. The procedure includes a joint sampling scheme to achieve better convergence and mixing properties. Simulation studies in the second and third part have confirmed satisfactory model performance in estimating time-varying coefficients under different curvature and event rate conditions. The models in the second and third part were applied to data from a commercial truck driver naturalistic driving study. The application results reveal that drivers with 7-hours-or-less sleep prior to a shift have a significantly higher intensity after 8 hours of on-duty driving and that their intensity remains higher after taking a break. In addition, the results also show drivers' self-selection on sleep time, total driving hours in a shift, and breaks. These applications provide crucial insight into the impact of sleep time on driving performance for commercial truck drivers and highlights the on-road safety implications of insufficient sleep and breaks while driving. This dissertation provides flexible and robust tools to evaluate the temporal profile of intensity for recurrent events.