{"ID":2858838,"CreatedAt":"2026-06-01T04:54:23.091178241Z","UpdatedAt":"2026-06-01T04:54:23.091178241Z","DeletedAt":null,"paper_url":"https://arxiv.org/abs/2510.07128","arxiv_id":"2510.07128","title":"A General Framework for Joint Multi-State Models","abstract":"Conventional joint modeling approaches generally characterize the relationship between longitudinal biomarkers and discrete event occurrences within terminal, recurring or competing risk settings, thereby offering a limited representation of complex, multi-state trajectories. We propose a general multi-state joint modeling framework that unifies longitudinal biomarker dynamics with multi-state time-to-event processes defined on arbitrary directed graphs. The proposed framework also accomodates nonlinear longitudinal submodels and scalable inference via stochastic gradient descent. This formulation encompasses both Markovian and semi-Markovian transition structures, allowing recurrent cycles and terminal absorptions to be naturally represented. The longitudinal and event processes are linked through shared latent structures within nonlinear mixed-effects models, extending classical joint modeling formulations. We derive the complete likelihood, model selection criteria, and develop scalable inference procedures based on stochastic gradient descent to enable high-dimensional and large-scale applications. In addition, we formulate a dynamic prediction framework that provides individualized state-transition probabilities and personalized risk assessments along complex event trajectories. Through simulation and application to the PAQUID cohort, we demonstrate accurate parameter recovery and individualized prediction.","short_abstract":"Conventional joint modeling approaches generally characterize the relationship between longitudinal biomarkers and discrete event occurrences within terminal, recurring or competing risk settings, thereby offering a limited representation of complex, multi-state trajectories. We propose a general multi-state joint mode...","url_abs":"https://arxiv.org/abs/2510.07128","url_pdf":"https://arxiv.org/pdf/2510.07128v5","authors":"[\"Félix Laplante\",\"Christophe Ambroise\"]","published":"2025-10-08T15:24:51Z","proceeding":"stat.ME","tasks":"[\"stat.ME\",\"stat.ML\"]","methods":"[]","has_code":false}