Dynamic predictions with time-dependent covariates in survival analysis using joint modeling and landmarking

Abstract

A key question in clinical practice is accurate prediction of patient prognosis. To this end, nowadays, physicians have at their disposal a variety of tests and biomarkers to aid them in optimizing medical care. These tests are often performed on a regular basis in order to closely follow the progression of the disease. In this setting, it is of interest to optimally utilize the recorded information and provide medically relevant summary measures, such as survival probabilities, which will aid in decision making. In this work, we present and compare two statistical techniques that provide dynamically updated estimates of survival probabilities, namely landmark analysis and joint models for longitudinal and time-to-event data. Special attention is given to the functional form linking the longitudinal and event time processes, and to measures of discrimination and calibration in the context of dynamic prediction.