Analysis of repeated events

Abstract

Events that may occur repeatedly for individual subjects are of interest in many medical studies. We review methods of analysis for repeated events, emphasizing that the approach taken in a given study should allow clinical questions to be addressed as directly as possible. Methods based on full models for event processes as well as on simpler ‘marginal’ assumptions are considered. The treatment of dependent terminating events related to the recurrent events is also discussed. We apply various methods of analysis to studies involving pulmonary exacerbations in persons with cystic fibrosis, and the occurrence of bone metastases and skeletal events in cancer patients, respectively. Most of the methodology considered can be implemented with existing software.