Patient-reported outcomes and survival analysis of chronic obstructive pulmonary disease patients: a two-stage joint modelling approach

Joint modelling has gained attention in longitudinal studies incorporating biomarkers and survival data. In the context of chronic diseases, patient evolution is often tracked through multiple assessments, with patient-reported outcomes playing a crucial role. The Beta-Binomial distribution is suggested as a suitable model for these longitudinal variables. However, its integration into joint modelling remains unexplored. This study introduces an estimation procedure for analyzing longitudinal patient-reported outcomes and survival data together. We compare different estimation approaches through simulation experiments, including the proposed model. Furthermore, the methodologies are applied to real data from a follow-up study on chronic obstructive pulmonary disease patients.