Dynamic prediction of an event using multiple longitudinal markers: a model averaging approach

Dynamic event prediction, using joint modeling of survival time and longitudinal variables, is extremely useful in personalized medicine. However, the estimation of joint models including many longitudinal markers is still a computational challenge because of the high number of random effects and parameters to be estimated. In this paper, we propose a model averaging strategy to combine predictions from several joint models for the event, including one longitudinal marker only or pairwise longitudinal markers. The prediction is computed as the weighted mean of the predictions from the one-marker or two-marker models, with the time-dependent weights estimated by minimizing the time-dependent Brier score. This method enables us to combine a large number of predictions issued from joint models to achieve a reliable and accurate individual prediction. Advantages and limits of the proposed methods are highlighted in a simulation study by comparison with the predictions from well-specified and misspecified all-marker joint models as well as the one-marker and two-marker joint models. Using the PBC2 data set, the method is used to predict the risk of death in patients with primary biliary cirrhosis. The method is also used to analyze a French cohort study called the 3C data. In our study, seventeen longitudinal markers are considered to predict the risk of death.