0000000000270519
AUTHOR
David C. Atkins
Quantifying treatment effects when flexibly modeling individual change in a nonlinear mixed effects model
A core task in analyzing randomized clinical trials based on longitudinal data is to find the best way to describe the change over time for each treatment arm. We review the implementation and estimation of a flexible piecewise Hierarchical Linear Model (HLM) to model change over time. The flexible piecewise HLM consists of two phases with differing rates of change. The breakpoints between these two phases, as well as the rates of change per phase are allowed to vary between treatment groups as well as individuals. While this approach may provide better model fit, how to quantify treatment diff erences over the longitudinal period is not clear. In this paper, we develop a procedure for summ…
Segmented mixed models with random changepoints: a maximum likelihood approach with application to treatment for depression study
We present a simple and effective iterative procedure to estimate segmented mixed models in a likelihood based framework. Random effects and covariates are allowed for each model parameter, including the changepoint. The method is practical and avoids the computational burdens related to estimation of nonlinear mixed effects models. A conventional linear mixed model with proper covariates that account for the changepoints is the key to our estimating algorithm. We illustrate the method via simulations and using data from a randomized clinical trial focused on change in depressive symptoms over time which characteristically show two separate phases of change.