Bayesian inference for smoking cessation with a latent cure state

Biometrics. 2009 Sep;65(3):970-8. doi: 10.1111/j.1541-0420.2008.01167.x. Epub 2009 Jan 23.

Abstract

We present a Bayesian approach to modeling dynamic smoking addiction behavior processes when cure is not directly observed due to censoring. Subject-specific probabilities model the stochastic transitions among three behavioral states: smoking, transient quitting, and permanent quitting (absorbent state). A multivariate normal distribution for random effects is used to account for the potential correlation among the subject-specific transition probabilities. Inference is conducted using a Bayesian framework via Markov chain Monte Carlo simulation. This framework provides various measures of subject-specific predictions, which are useful for policy-making, intervention development, and evaluation. Simulations are used to validate our Bayesian methodology and assess its frequentist properties. Our methods are motivated by, and applied to, the Alpha-Tocopherol, Beta-Carotene Lung Cancer Prevention study, a large (29,133 individuals) longitudinal cohort study of smokers from Finland.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Algorithms
  • Bayes Theorem*
  • Biometry / methods*
  • Clinical Trials as Topic / methods
  • Computer Simulation
  • Humans
  • Models, Biological
  • Models, Statistical
  • Outcome Assessment, Health Care / methods*
  • Patient Selection*
  • Reaction Time
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Smoking / epidemiology*
  • Smoking Cessation / statistics & numerical data*
  • Smoking Prevention*