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. Author manuscript; available in PMC: 2025 Apr 29.
Published in final edited form as: Bernoulli (Andover). 2023 Aug 22;29(4):2828–2853. doi: 10.3150/22-bej1565

Semiparametric regression of panel count data with informative terminal event

XIANGBIN HU 1,a, LI LIU 2,c, YING ZHANG 3,d, XINGQIU ZHAO 1,b
PMCID: PMC12040413  NIHMSID: NIHMS2018374  PMID: 40303898

Abstract

We study a semiparametric model for robust analysis of panel count data with an informative terminal event. To explore the explicit effect of the terminal event on recurrent events of interest, we propose a conditional mean model for a reversed counting process anchoring at the terminal event. Treating the distribution function of the terminal event as a nuisance functional parameter, we develop a predicted least squares-based two-stage estimation procedure with the spline-based sieve estimation technique, and derive the convergence rate of the proposed estimator. Furthermore, overcoming the difficulties caused by the convergence rate slower than 1n, we establish the asymptotic normality for the estimator of the finite-dimensional parameter and a functional of the estimator of the infinite-dimensional parameter. The proposed method is evaluated through extensive simulation studies and illustrated with an application to the Longitudinal Healthy Longevity Survey study on elder people in China.

Keywords: Asymptotic normality, counting process, empirical process, panel count data, predicted least squares, terminal event, two-stage estimation

1. Introduction

In many longitudinal follow-up studies, the observations of recurrent events usually occur at some random discrete time points, and only the event counts between the adjacent observation times are possibly recorded. Such data are referred to as panel count data (Kalbfleisch and Lawless, 1985). We take the number of serious diseases in a dataset of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) (Zeng et al., 2017) as an example. In this study, the population-based survey on individuals who were at least 65 years old started in 1998 followed by six other waves in 2000, 2002, 2005, 2008, 2011, and 2014. During this longitudinal survey, the individuals were reached out for the information of severe illness since the last survey. For each individual, the survey dates were different, and the occurrences of severe illness between two adjacent survey dates were recorded resulting in panel count data on the counting process of occurrences of severe illness.

There were many studies for analysis of panel count data. Using the isotonic regression, Sun and Kalbfleisch (1995) first investigated the nonparametric estimation for the mean function of the counting process with panel count data. Wellner and Zhang (2000) and Lu, Zhang and Huang (2007) proposed the nonparametric maximum pseudo-likelihood and maximum likelihood estimation procedures for the mean function. Considering the covariate effect, Zhang (2002) and Wellner and Zhang (2007) studied the semiparametric maximum pseudo-likelihood and maximum likelihood estimations with the unknown baseline function estimated by the step function. Introducing the monotone spline approximation, Lu, Zhang and Huang (2009) improved the convergence rate of the estimators proposed by Zhang (2002) and Wellner and Zhang (2007). Zhang (2006), Balakrishnan and Zhao (2009), Zhao and Sun (2011), and Zhao and Zhang (2017) considered the two-sample or multi-sample hypothesis test for the mean function of the counting process with panel count data. For the problem of variable selection with panel count data, Tong et al. (2009) and Zhang, Sun and Wang (2013) studied the regularized estimation with the non-concave penalty and the seamless-L0 (SELO) penalty, respectively. Recently, the statistical estimation and analysis approaches with panel count data were summarized in Sun and Zhao (2013) and Chiou et al. (2019).

In the above studies of panel count data, researchers modeled the counting process in a forward manner with the event count being 0 at the starting time of the study. However, this approach is not practically convenient when one is particularly interested in exploring the recurrent events near an informative terminal event, such as the severe disease profiles near death as exemplified in CLHLS study. In the early studies, the frailty model (Sun, Tong and He, 2007; Sun et al., 2012; Zhao, Li and Sun, 2013a; 2013b; Zhou et al., 2017) was the most commonly used method to describe the effect of an informative terminal event. This model introduced a latent frailty variable to characterize the correlation between the counting process and the terminal event and supposed that they were conditionally independent given the latent variable. In the CLHLS study, elder people tended to encounter more serious diseases before death, and a high incidence of severe illness can, in turn, lead them to death. However, in the frailty model, the frailty, the latent random variable while useful to acknowledge the association between the recurrent event process and the terminal event, lacks an explicit interpretation of the relationship between them. Recently, to evaluate the rate of recurrent events prior to the terminal events, Chan and Wang (2010) considered the time-backward processes, which started at the terminal event time and counted in a time-going-backward way. Then their model can be used to directly illustrate the effect of the terminal event through an unspecified nonparametric function. Recognizing the special data structure, the backward model for longitudinal data with the starting time anchoring at the informative terminal event seems more relevant in such applications. Treating the terminal event time as a fixed effect covariate and following the backward model in Chan and Wang (2010), Li et al. (2017) studied the semiparametric model for longitudinal data with an informative terminal event, and Shen et al. (2021) further investigated the model with an additional effect of the number of observations. Kong et al. (2018) established the asymptotic properties of the backward semiparametric model for longitudinal data with an informative terminal event. Li et al. (2018) also treated the terminal event time in the longitudinal data as a covariate, and they proposed a more general two-dimensional nonparametric function to represent the effect of the terminal event. To the best of our knowledge, there was no study for the backward semiparametric model with panel count data. For the backward nonparametric model, Liu et al. (2022) extended the method of Kong et al. (2018) to model panel count data with an informative terminal event backwards. They proposed a two-stage spline-based sieve nonparametric maximum likelihood estimation procedure for the inference of underlying recurrent events with panel count data associated with an informative right-censored terminal event.

This paper studies a semiparametric regression model for panel count data with an informative terminal event, where the stochastic mechanism for the underlying counting process arising from recurrent events is completely unspecified. We use the monotone I-spline function to approximate the unknown mean function of the process, and propose a least squares-based two-stage estimation by treating the distribution of the terminal event as a nuisance functional parameter. In stage 1, we estimate the conditional distribution of the terminal event given covariates under a conventional semiparametric model such as the Cox model (Cox, 1972; Breslow, 1972). In stage 2, we construct a loss function based on predicted least squares for estimation of the reversed counting process model. Furthermore, we establish the asymptotic properties of the proposed two-stage estimator.

The rest of this paper is organized as follows. In Section 2, we introduce the semiparametric model and the loss function for model estimation. We establish the consistency, the convergence rate, and the asymptotic normality of the proposed estimator in Section 3. Simulation and application results are reported in Sections 4 and 5, respectively. Some concluding remarks are made in Section 6. All technical proofs are given in the Appendix.

2. Model setting and estimation procedure

Denote the number of recurrent events of interest occurred up to time t by the counting process {N(t):0tτ}, where τ is a fixed time point. Set K to be the total number of observations and T=(T1,,TK) to be the observation times of N(t). Then the observed panel counts on the counting process are represented by N=(N(T1),,N(TK)). Let U and C denote the terminal event time and the censoring time, respectively. We can only observe Y=UC and Δ=1{UC}. Let Z be a covariate vector associated with recurrent events and the terminal event. Let X=(Y,Δ,K,T,N,Z). Then for a panel count data study with n subjects, the observed data consist of X={Xi,i=1,,n}, where Xi=(Yi,Δi,Ki,Ti,Ni,Zi) with Ti=(Ti,1,,Ti,Ki) and Ni={Ni(Ti,1),,Ni(Ti,Ki)} for i=1,,n.

Setting the number of recurrent events from time t to the terminal event U to be N~(t;U), we suppose that given the covariate and the terminal event time, the conditional expectation of N~(t;U) is

E(N~(t;U)U=u,Z=z)=eβTzΛ(ut),0tuτ, (1)

where Λ is a non-negative and non-decreasing function with Λ(0)=0. Noting that N(t2)N(t1)=N~(t1;U)N~(t2;U) for all 0t1t2uτ, then

E((N(t2)N(t1))U=u,Z=z)=eβTz(Λ(ut1)Λ(ut2)). (2)

Suppose that the conditional distribution function of U given Z satisfies the Cox model

F(uZ=z)=P(UuZ=z)=1eH(u)eγTz, (3)

where H(u) is the baseline cumulative hazard function of U. Then the unknown parameters and functions to be estimated under models (1) and (3) are (β, Λ; H, γ). Although the covariates associated with the terminal event may not be the same as the covariates associated with the counting process, we would like to include all the potential covariates Z for exploring their effects on both the counting process and terminal events and for the sake of easy notation. That is, we denote the union of covariates associated with the counting process and the terminal event by Z. In models (1) and (3), the coefficients for unrelated covariates are 0. We need the following basic assumptions before the analysis: (i) given Z, C and U are independent; (ii) given Z, C is noninformative to Λ; and (iii) given (Y, Δ, Z), (K, T) is noninformative to Λ. In the following, we let 𝒫 and Pn denote the probability measure and the empirical measure, respectively.

Set ΔNj=N(Tj)N(Tj1) and ΔΛj(u)=Λ(uTj1)Λ(uTj) for j=1,,K with T0=0. To use the least squares approach, we consider

Pn[j=1K{ΔNjeβTZΔΛj(U)}2]=1ni=1nj=1Ki{ΔNi,jeβTZiΔΛi,j(Ui)}2.

However, some Ui are unknown due to censoring. We turn to consider the predicted least squares as a loss function. Define

m(β,Λ,F;X)E[j=1K{ΔNjeβTZΔΛj(U)}2Y,Δ,K,T,N,Z]=j=1K[Δ{ΔNjeβTZΔΛj(Y)}2+1Δ1F(YZ)Y{ΔNjeβTZΔΛj(u)}2dF(uZ)]. (4)

By (4), we propose the empirical predicted least squares-based loss function as

n(β,Λ,F;X)=Pnm(β,Λ,F;X)=1ni=1nj=1KiΔi{ΔNi,jeβTZiΔΛi,j(Yi)}2+1ni=1nj=1Ki1Δi1F(YiZi)Yi{ΔNi,jeβTZiΔΛi,j(u)}2dF(uZi), (5)

where ΔNi,j=Ni(Ti,j)Ni(Ti,j1) and ΔΛi,j(Yi)=Λ(YiTi,j1)Λ(YiTi,j).

Replacing F(uZi) by 1exp{H(u)exp(γTZi)}, a reasonable estimator is the minimizer of the loss function (5). Nevertheless, since the loss function consists of the unknown distribution function F, it is difficult to obtain the minimizer directly. Then we consider the two-stage estimation procedure by treating F as the nuisance functional parameter. In stage 1, we estimate γ and H by the partial likelihood estimator γ^n and the Breslow estimator H^n (Breslow, 1972), respectively. Then we obtain the estimator of the conditional distribution function of the terminal event F^(uz)=1exp{H^n(u)exp(γ^nTz)}. In stage 2, replacing F by F^n in (5), (β^n, Λ^n) is obtained by minimizing the loss function n(β,Λ,F^n;X).

To estimate Λ, we use the monotone I-spline function approximation. To this end, we divide [0, τ] into mn+1 subintervals by 0=t1==td<td+1<<tmn+d<tmn+d+1==<tmn+2d=τ with knots {ti:i=1,,mn+2d}, where d represents the order of I-spline functions. Let the I-spline basis functions be {Il(s),l=1,,qn}, where qn=mn+d. Then we define the functional space for Λ:

Φn={l=1qnαlIl(s):αl0,l=1,,qn}.

Define I(s)=(I1(s),,Iqn(s))T and α=(α1,,αqn)T, and replace Λ(s) by I(s)Tα. Then we can minimize the loss function by the constrained BFGS algorithm (Lange, 2001). Setting the minimizer of the loss function to be (β^n,α^n), the spline estimator of Λ(s) is Λ^n(s)=I(s)Tα^n.

3. Asymptotic properties

In this section, we establish the asymptotic properties of (β^n,Λ^n). First, we define the following function classes

r={g:g(r1)(s)g(r1)(t)c0stfor all0s,tτ},Φ={Λr:Λis a nondecreasing continuous function on[0,τ]withΛ(0)=0},={F:F(z)is a distribution function on[0,)forz𝒵},

where g(r) is the r derivative of g for r1 and 𝒵Rp. For a bounded and convex set Rp, denote the interior of by . Set FZ to be the distribution function of Z with a bounded support 𝒵, and (β0,Λ0,F0)×Φ× to be the true value of (β, Λ, F). Let and p be the collection of Borel sets in R and Rp, respectively. Then for B1, B2[0,τ]{B[0,τ]:B} and Cp, we define

μ1(B1×B2×C)=Ck=1P(K=kU=u,Z=z)×j=1kP((uTj)B1,(uTj1)B2K=k,U=u,Z=z)dF0(uz)dFZ(z),μ2(B1×B2)=μ1(B1×B2×Rp).

Setting ΔΛ(s1,s2)=Λ(s2)Λ(s1), for any functions Λ1, Λ2Φ, we define the metric

d12(Λ1,Λ2)=ΔΛ1(s1,s2)ΔΛ2(s1,s2)L2(μ2)2=E[j=1K(ΔΛ1,j(U)ΔΛ2,j(U))2]=E[j=1K{Δ(ΔΛ1,j(Y)ΔΛ2,j(Y))2+1Δ1F0(YZ)Y(ΔΛ1,j(u)ΔΛ2,j(u))2dF0(uZ)}].

For any functions F1, F2, we define the metric

d2(F1,F2)=supu,zF1(uz)F2(uz).

For any (β1, Λ1) and (β2, Λ2) in the space ×Φ, we define the metric

d3((β1,Λ1),(β2,Λ2))={β1β222+d12(Λ1,Λ2)}12.

To establish the asymptotic properties of the proposed estimator, we need the following regularity conditions.

(C1) 0<Λ0(τ)<.

(C2) The true values of γ and H satisfy γ0 and H0(τ)<, respectively. Furthermore, the derivative of H0(u) has a uniform positive lower bound for all u[M1,τ], where M1<τ is a constant representing the minimum value of the support of U.

(C3) E[{N(TK)}2]<.

(C4) The probability of censoring ϱ=P(Y<U) satisfies that 0<ϱ<1.

(C5) The measure μ2×FZ is absolutely continuous with respect to μ1.

(C6) P(aTZc)>0 for all a0Rp and for all cR.

(C7) There is a constant M2>0 such that P(KM2)=1.

(C8) The number of subinterval in [0, τ] satisfies mn=O(nν) for 0<ν<12. Furthermore,

maxd+1imn+d+1titi1=O(nν)andmaxd+1imn+d+1titi1mind+1imn+d+1titi1M3,

uniformly for n with a constant M3>0.

(C9) P(TjTj1M4) for all j=1,,K)=1 and P(YM4)=1 with a constant M4>0.

Remark 1. Conditions (C1) and (C3) are mild for the statistical analysis of panel count data. Conditions (C2) and (C4) are common in survival data analysis. According to Wellner and Zhang (2007), Conditions (C5) and (C6) are necessary for the identifiability of the semiparametric model. Condition (C7) indicates that the number of observations is bounded, which is standard in many applications for panel count data. Condition (C8) is a regularity condition for the spline approximation by Lu, Zhang and Huang (2007, 2009). By Wellner and Zhang (2007), Condition (C9) is regular in applications of panel count data, meaning that the adjacent observation times are separable.

Theorem 3.1 (Consistency). Suppose Conditions (C1)–(C9) hold. Then we have the following:

  1. (β0, Λ0) is the unique minimum of 𝒫m(β,Λ,F0;X).

  2. d3((β^n,Λ^n),(β0,Λ0))0 almost surely.

We need the following additional conditions to derive the convergence rate and establish asymptotic normality.

(C10) infz𝒵P(UτZ=z)>0 and P(Cτ)>0.

(C11) μ2 is absolutely continuous with respect to Lebesgue measure with a derivative μ.2, and μ.2 has a uniform positive lower bound.

(C12) There is a constant 0<M5< such that 1M5<Λ0(s)<M5 for all s[τ,τ], where 0<ττ such that Λ0(τ)>0.

(C13) There is a sufficiently large constant c such that E[exp(cN(τ))Z] is uniformly bounded for Z𝒞.

(C14) There is a constant η(0,1) such that for all aRp, we have aTVar(ZS1,S2)aηaTE(ZZTS1,S2)a a.e. for (S1, S2, Z) having the distribution μ1.

Remark 2. By Kong et al. (2018), Condition (C10) is necessary for the uniform weak convergence rate of F^n on a finite interval. According to Wellner and Zhang (2007) and Lu, Zhang and Huang (2009), Conditions (C11)–(C14) are common in analysis of panel count data.

Theorem 3.2 (Convergence Rate). Suppose that Conditions (C1)–(C14) hold. Then, taking ν=1(1+2r), we have d3((β^n,Λ^n),(β0,Λ0))=Op(nr(1+2r)).

Remark 3. Although the overall convergence rate of (β^n, Λ^n) is slower than 1n, the convergence rate of β^n is still 1n, and we can also find a functional of Λ^n having the convergence rate 1n.

Theorem 3.3 (Asymptotic Normality). Suppose that Conditions (C1)–(C14) hold, and Λ0r with r2. Then we have the following:

  • (i)

    For all h1 and h2r, we have

nR1(h1,h2)(β^nβ0)+nR2(h1,h2)(Λ^nΛ0)N(0,σ0[h1,h2]2),

where R1(h1,h2)(β^nβ0), R2(h1,h2)(Λ^nΛ0), and σ0[h1,h2]2 are defined in the Appendix.

  • (ii)

    Furthermore, we have

n(β^nβ0)N(0,(A)1B((A)1)T),

where A and B are defined in the Appendix.

The result of the theorem can be used for making statistical inference of covariate effects on the recurrent event process.

4. Simulation studies

In this section, we conducted some simulation studies to evaluate the finite-sample performance of the proposed method. We generated the covariate vector Zi=(Zi1,Zi2)T by Zi1Unif(0,1) and Zi2Bernoulli(0.5). Given the covariate vector Zi, the terminal event Ui, satisfied model (3) with γ0=(γ1,γ2)T=(1,2)T and H0(u)=u26 for u[6,). The censoring time Ci was generated from the Cox model with covariates Zi along with the coefficients (κ,2κ)T and the baseline cumulative hazard function c6 for c[6,), where κ was −1.611 and −0.594 to yield 20% and 40% censoring rate, respectively. Then we had Yi=UiCi and Δi=1{UiCi} with τ=10. For the observation time process, we generated a sequence of independent times ΔTijUnif(0.1,3) for j=1,2,, and Ki was the maximum number of k such that Tik=j=1kΔTijYi. Then we obtained the observation time points {Ti1,,TiKi}. Under model (1), we considered the following two different cases of Λ0

Case1:Λ0(s)=sand Case2:Λ0(s)=10ss+1

to generate the counting process Ni={Ni(Ti1),,Ni(TiKi)} from the Poisson process with β0=(β1,β2)T=(1,1.5)T. That is Ni(Ti1) was generated from the Poisson distribution with mean {Λ0(Ui)Λ0(UiTi1)}exp(β0ZiT) was generated from the Poisson distribution with mean {Λ0(UiTi(j1))Λ0(UiTij)}exp(β0ZiT) for j=2,,Ki. For the knots of the I-spline basis functions, we set td+1,,td+mn to be the 1(mn+1),,mn(mn+1) percentiles of {YiTij}:j=1,,Ki;i=1,,n with d=4 and mn=[n13]. Since it was difficult to empirically estimate the asymptotic variance given in Theorem 3.3, the standard error of the proposed estimate of regression parameter β0 was estimated based on 100 bootstrap samples. The initial value of the BFGS iteration was taken as α=1qn and β=0, where 1qn was the qn-dimensional vector with elements 1. The simulation results were summarized based on 500 replications with sample size n=100 and 200.

For comparison purposes, we also applied the forward proportional mean model with panel count data (Wellner and Zhang, 2007; Lu, Zhang and Huang, 2009). We implemented the maximum pseudolikelihood spline (MPLS) and the maximum likelihood spline (MLS) by “panelReg” with methods “MPLs” and “MLs” in the R package “spef”.

We show the estimation results of Λ under our reversed mean model for Case 1 in Figure 1. The plots for Case 2 are similar, and we show them in Figure 2. In those figures, the dash lines display the averages of the estimated functions, the solid lines are the true value Λ0 for comparison, and the dotted-dash lines are the 2.5% and 97.5% pointwise percentiles of the estimated functions, which reveal the uncertainty of the estimated functions. We can see that the averages of the estimated functions are close to Λ0, meaning that Λ^n is consistent. The simulation results for the regression parameter β based on MPLS, MLS, and our proposed model are summarized in Table 1. Note that in Case 1, we set Λ0(s)=s, for which the proposed model and the forward proportional mean model with panel count data (Wellner and Zhang, 2007; Lu, Zhang and Huang, 2009) are essentially the same. Hence, Table 1 shows that MPLS and MLS were valid for Case 1 as expected and had slightly better estimation efficiency than the proposed method due to the fact that no estimation for the conditional distribution function was needed. It is also interesting to note that for Case 1, the censoring rate does not seem to impact the estimation results of the counting process much. We believe it is due to the fact that our model is equivalent to the forward proportional mean model with no effect of the terminal event being considered, for which the censoring rate for the terminal event is not even relevant. However, for Case 2, the forward proportional mean model was misspecified, which resulted in biased inferences for MPLS and MLS. In addition, Table 1 also shows that the biases of our estimates are small and the sample standard deviations (SSD) are close to the estimated standard errors (ESE). Both of them decrease as the sample size increases, and they also decrease as the censoring rate decreases in Case 2. The empirical coverage probabilities (CP) of the 95% Wald confidence intervals are close to 0.95. The simulation studies provide the numerical evidence to support the asymptotic properties depicted in Section 3. It appears that the inference based on the asymptotic theory for our proposed method is valid in finite sample with moderate sample size, say n>100.

Figure 1.

Figure 1.

Simulation results for Λ in Case 1. The solid lines are the true functions, the dash lines are the mean of the estimates, and the dotted-dash lines are the 2.5% and 97.5% pointwise percentiles.

Figure 2.

Figure 2.

Simulation results for Λ in Case 2. The solid lines are the true functions, the dash lines are the mean of the estimates, and the dotted-dash lines are the 2.5% and 97.5% pointwise percentiles.

Table 1.

Simulation results for the estimation of parameter β.

Censoring rate = 20% Censoring rate = 40%
Proposed MPLS MLS Proposed MPLS MLS
Case 1, n=100
Bias (0.001,0.001) (−0.001,−0.003) (0.001,0.001) (−0.001,0.001) (−0.001,−0.001) (−0.002,0.002)
SSD (0.079,0.051) (0.078,0.052) (0.067,0.045) (0.084,0.057) (0.079,0.058) (0.071,0.051)
ESE (0.075,0.054) (0.073,0.055) (0.065,0.049) (0.076,0.055) (0.074,0.055) (0.066,0.049)
CP (0.934,0.946) (0.916,0.940) (0.938,0.956) (0.910,0.932) (0.922,0.914) (0.922,0.906)
Case 1, n=200
Bias (0.006,0.001) (0.006,0.001) (0.005,−0.001) (0.001,0.001) (0.001,−0.001) (0.001,−0.001)
SSD (0.052,0.038) (0.053,0.039) (0.047,0.034) (0.052,0.037) (0.050,0.041) (0.045,0.036)
ESE (0.052,0.038) (0.050,0.039) (0.045,0.035) (0.054,0.039) (0.052,0.039) (0.046,0.035)
CP (0.954,0.952) (0.928,0.948) (0.938,0.942) (0.966,0.932) (0.948,0.912) (0.962,0.932)
Case 2, n=100
Bias (0.003,0.015) (−0.148,−0.256) (−0.172,−0.305) (−0.002,0.007) (−0.155,−0.256) (−0.176,−0.300)
SSD (0.111,0.080) (0.176,0.102) (0.191,0.098) (0.140,0.089) (0.175,0.101) (0.193,0.101)
ESE (0.106,0.078) (0.180,0.099) (0.193,0.101) (0.131,0.087) (0.184,0.100) (0.197,0.102)
CP (0.922,0.922) (0.870,0.272) (0.860,0.156) (0.936,0.940) (0.852,0.286) (0.842,0.184)
Case 2, n=200
Bias (0.001,0.012) (−0.141,−0.260) (−0.166,−0.308) (0.010,0.014) (−0.135,−0.248) (−0.160,−0.292)
SSD (0.079,0.055) (0.127,0.073) (0.135,0.073) (0.092,0.066) (0.123,0.073) (0.133,0.072)
ESE (0.073,0.054) (0.124,0.069) (0.136,0.070) (0.089,0.061) (0.129,0.071) (0.138,0.070)
CP (0.932,0.932) (0.784,0.066) (0.762,0.018) (0.938,0.916) (0.818,0.080) (0.774,0.018)

5. Application

In this section, we used the proposed semiparametric approach to analyze the incidence of serious diseases for elder people in China based on the datasets of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) in the period 1998 to 2014 (Zeng et al., 2017). The CLHLS was conducted by the Center for Healthy Aging and Development Studies (CHADS) of the National School of Development at Peking University and the Chinese Center for Disease Control and Prevention (CDC), starting in 1998 with 6 follow-up waves in 2000, 2002, 2005, 2008, 2011 and 2014. Aiming to provide a better understanding of the determinants of health and longevity, the CLHLS interviewed a large number of elder people in the 22 provinces of China, who were at least 65 years old at the interviews, and collected the information about their medical history, socioeconomic status, lifestyles, family and demographic profile.

In this study, for the ith elder person, we took the number of months from the date of the first survey to the date of the jth follow-up wave of survey to be Tij for j=1,,Ki, where Ki6 representing the number of follow-up surveys. τ=197 is the longest follow-up time possibly occurred in this study. Denote the incidence of serious diseases for this subject before the jth follow-up survey to be N(Tij), the incidence of serious diseases from the jth follow-up survey to death to be N~(Tij), the terminal event time due to death to be Ui, and the censoring time due to loss-of-connection to be Ci. Then Yi=UiCi is the follow-up time, and Δi=1{UiCi} the indicator of the observation of death.

We focused on the difference of the incidence of serious diseases between elders living in urban and rural. For this analysis, we considered 5 covariates that include three demographic variables: residence status (Z1=1 for urban and Z1=0 for rural), age (Z2), and gender (Z3=1 for male and Z3=0 for female); and two clinical variables: indicator of hypertension (Z4=1 for systolic blood pressure ≥ 140 mmHg and Z4=0 for others), and peak lung flow (Z5) at the first interview. We chose the individuals who had at least one follow-up survey. Hence a total of 4831 individuals interviewed in both 1998 and 2000 were selected for analysis. After removing 1099 individuals with missing or erroneous records, and 1160 individuals who had lived in both areas during the study period, we finally included 2572 individuals in the analysis, among which 73.7% had the terminal event, death. Table 2 shows the number of elders with different categories of age, gender, blood pressure, and peak lung flow stratified by urban and rural, respectively. In this table, the p-values of 𝒳2 tests reveal that the age of elders living in urban is different from elders living in rural at significance level 0.01; and the gender, the hypertension, and the degree of peak lung flow are not different between elders living in urban and rural at significance level 0.01.

Table 2.

The number of participants with different types of covariates for different residence status.

Total Age Gender
≤79 80-89 90-99 ≥100 Male Female
Urban 1152 15 636 381 120 507 645
Rural 1420 13 689 406 312 590 830
Total 2572 28 1325 787 432 1097 1475
p-value < 0.001*** 0.224
Systolic Pressure Peak Lung Flow
≥140 ≤139 ≤99 100-199 200-299 300-399 ≥400
Urban 820 332 373 484 232 53 10
Rural 1005 415 423 467 267 71 12
Total 1825 747 796 1131 499 124 22
p-value 0.856 0.406
***

represents significance level of 0.01.

Although the unit of peak lung flow (Z5) was not specified in the dataset, it was clinically important because people with larger peak lung flow value generally have higher functional cardiorespiratory system capacity. We standardized the covariates Z2 and Z5 to put them on the same scale before the analysis. We considered the I-spline sieve estimation for Λ() with order d=4 and seven internal knots located at td+1=τ8,td+7=7τ8 for the I-spline basis functions. We chose the initial value α=1 and β=0 in the BFGS algorithm. Similar to Section 4, we used MLS for comparison and obtained the bootstrap standard error of the proposed estimates of the regression parameters based on 100 bootstrap samples.

In Figure 3, the solid line represents the estimate of Λ under our backward model. Table 3 summarizes the inferences on the covariates effects on the incidence of serious diseases under our reversed mean model and the MLS. Compared to the MLS method, for which only Z1 showed a significant positive effect at the 0.01 level, our proposed model seemed to have a better power to pick out more statistically significant covariates. Z1 is significant at the 0.05 level; Z3 and Z5 are marginally significant at the 0.1 level. Specifically, Z1 has positive effect on the incidence of serious diseases, which may reflect the fact that people living in urban have a better opportunity to access advanced healthcare services than people living in rural that allow then to have more serious diseases identified. That Z3 has negative effect on the incidence of serious diseases may be due to the longer lifetime in females. The positive effect of Z5 is reasonable because of the higher functional cardiorespiratory system capacity for people with larger peak lung flow.

Figure 3.

Figure 3.

Estimate of Λ for the CLHLS data.

Table 3.

Inference results for the CLHLS data.

Reversed Mean Model MLS
Z1 Z2 Z3 Z4 Z5 Z1 Z2 Z3 Z4 Z5
Estimates 0.246 −0.061 −0.175 −0.065 0.106 0.284 0.068 −0.073 0.106 0.040
ESE 0.100 0.063 0.101 0.122 0.056 0.077 0.044 0.076 0.083 0.039
p-value 0.014** 0.333 0.084* 0.595 0.059* 0.001*** 0.130 0.330 0.200 0.310
*

represents a significant inference at level of 0.1

**

represents a significant inference at level of 0.05

***

represents a significant inference at level of 0.01.

6. Concluding remarks

For analyzing complex panel count data with an informative terminal event, we proposed a reversed mean model to depict its explicit relationship with recurrent events. For estimating unknown parameters of the proposed model, we developed a two-stage spline-based sieve estimation procedure to reduce the computation burden. Overcoming the theoretical challenges from the estimator having the overall convergence rate slower than the standard rate, we established the joint asymptotic normality for a functional of the estimator, and further concluded that the finite-dimensional estimator still achieves the standard convergence rate and is asymptotically normal.

Note that the proposed estimation procedure is robust in the sense that the stochastic mechanism of the recurrent event process is completely unspecified. When the underlying counting process is a Poisson-type process, we can use the maximum likelihood approach to improve the estimation efficiency. Since the likelihood function in this situation is much more complicated, extra efforts are needed to study the theoretical properties, which are currently under investigation. Though Cox model (3) and Breslow-induced estimator F^n(tZ) were adopted in our implementation for stage 1 due to their popularity and good asymptotic properties, they are not the only choice. Indeed, our theories only require that the estimator of the conditional distribution function of the terminal event time can be asymptotically represented by the sum of a series of i.i.d. terms, such as the representation in Lemma 1. Then the asymptotic properties for Λ^n and β^n in Theorems 3.1-3.3 still hold.

The proposed method focuses on modeling the data with some conditions that the observation times are independent of the recurrent events and the covariates are time-independent. Though these conditions were commonly adopted in analysis for panel count data, the use of the proposed method is somehow restricted in view of real-world applications. A further direction is to consider the informative observation times and time-dependent covariates for analysis of panel count data with an informative terminal event.

Supplementary Material

Suppl

Acknowledgments

The authors would like to thank the editor, the associate editor, and the referee for their valuable comments and suggestions.

Funding

This work is supported in part by the Research Grant Council of Hong Kong (15301218, 15303319) and the CAS AMSS-PolyU Joint Laboratory of Applied Mathematics for Xingqiu Zhao, the Natural Science Foundation of China (12171374) for Li Liu, and NIH/NIGMS (2 U54 GM115458-06) for Ying Zhang.

Appendix: Proofs of main results

A.1. Proof of Theorem 3.1

Proof. (i) We show that (β0, Λ0) is the unique minimum of 𝒫m(β,Λ,F0;X). After some algebraic calculations, we have

𝒫m(β,Λ,F0;X)𝒫m(β0,Λ0,F0;X)=𝒫[j=1K{eβ0TZΔΛ0,j(U)eβTZΔΛj(U)}2]0.

It follows that 𝒫m(β,Λ,F0;X)𝒫m(β0,Λ0,F0;X), and 𝒫m(β,Λ,F0;X)=𝒫m(β0,Λ0,F0;X) if and only if ΔΛ(s1,s2)exp(βTz)=ΔΛ0(s1,s2)exp(β0Tz) a.e. with respect to μ1. This implies that (ΔΛ(s1,s2)ΔΛ0(s1,s2))exp(βTz)=ΔΛ0(s1,s2)(exp(β0Tzexp(βTz)) a.e. with respect to μ1. By Condition (C5), μ2×FZ is absolutely continuous with respect to μ1. Using Fubini’s theorem, we obtain

{a(s1,s2)(ΔΛ(s1,s2)ΔΛ0(s1,s2))}dμ2{b(z)eβTz}dFZ={a(s1,s2)ΔΛ0(s1,s2)}dμ2{b(z)(eβ0TzeβTz)}dFZ,

for all μ2 measurable function a(s1,s2) and FZ measurable function b(z). Taking a(s1,s2)=(ΔΛ(s1,s2)Δ0Λ(s1,s2))1A and b(z)=exp(βTz)1B for A[0,τ]2 and Bp, we have

A(ΔΛ(s1,s2)ΔΛ0(s1,s2))2dμ2Be2βTzdFZ=A{(ΔΛ(s1,s2)ΔΛ0(s1,s2))ΔΛ0(s1,s2)}dμ2B{(eβ0TzeβTz)eβTz}dFZ.

Similarly, a(s1,s2)=(ΔΛ0(s1,s2)1A and b(z)=(exp(β0Tz))1B yield that

A{ΔΛ0(s1,s2)(ΔΛ(s1,s2)ΔΛ0(s1,s2))}dμ2B{(eβ0TzeβTz)eβTz}dFZ=A(ΔΛ0(s1,s2))2dμ2B(eβ0TzeβTz)2dFZ.

Then for all the product sets A×B, we obtain

A×B(ΔΛ(s1,s2)ΔΛ0(s1,s2))2e2βTzdμ2×FZ=A×B(ΔΛ0(s1,s2))2(eβ0TzeβTz)2dμ2×FZ.

That is (ΔΛ(s1,s2)ΔΛ0(s1,s2))2exp(2βTz)=(ΔΛ0(s1,s2))2(exp(β0Tz)exp(βTz))2 a.e. with respect to μ2×FZ, which is equivalent to (ΔΛ(s1,s2)ΔΛ0(s1,s2)1)2=(exp((β0β)Tz1))2 a.e. with respect to μ2×FZ. Intergrading the above equality with respect to μ2, we obtain that the right hand side is a constant a.e. with respect to FZ. Then Condition (C6) implies that β=β0 and ΔΛ(s1,s2)=ΔΛ0(s1,s2) a.e. with respect to μ2.

(ii) To prove the consistency, we first show that λ^n is uniformly bounded. By Lemma A1 of Lu, Zhang and Huang (2007), under Condition (C8), there is a ΛnΦn such that ΛnΛ0=O(nνr). Consider a direction vector h1,n with h1,n22=O(na) for a constant 0<a<12 and a bounded positive monotone nondecreasing direction function h2,nΦn with Δh2,n(s1,s2)L2(μ2)2=O(nνr+n(1ν2)), where Δh2,n(s1,s2)=h2,n(s2)h2,n(s1). Then for any constant α>0, we have ΔΛn(s1,s2)ΔΛ0(s1,s2)+αΔh2,n(s1,s2)L2(μ2)2=O(nνr+n(1ν)2) and infs2s1M4(ΔΛn(s1,s2)ΔΛ0(s1,s2)+αΔh2,n(s1,s2))>0 for sufficiently large n with M4 defined in Condition (C9). By some direct calculations,

m.(α)=m(β0+αh1,n,Λn+αh2,n,F^n;X)α=2ψ(β0+αh1,n,Λn+αh2,n,F^n;X)[h1,n,h2,n],

where

ψ(β,Λ,F;X)[h1,h2]=j=1K[Δ{ΔNjeβTZΔΛj(Y)}eβTZ{ΔΛj(Y)h1TZ+Δh2,j(Y)}]+[1Δ1F(YZ)Y{ΔNjeβTZΔΛj(u)}eβTZ{ΔΛj(u)h1TZ+Δh2,j(u)}dF(uZ)]. (6)

Note that we obtain (β^n, Λ^n) by minimizing Pnm(β,Λ,F^n;X) under the constraint that (β,Λ)×Φn. Then we can verify d3((β^n,Λ^n),(β0,Λ0))=op(1) by showing that Pnm.(α)>0 and Pnm.(α)<0 for any constant α>0. Similar to Lemma 3, we have

{ψ(β,Λ,F;X)[h1,h2]:(β,Λ)×Φ,F,(h1,h2)×Φ,Λandh2are uniformly bounded}

is Donsker. Therefore, we obtain (Pn𝒫)m.(α)=Op(1n). Furthermore, Lemma 2 implies that

𝒫m.(α)2𝒫ψ(β0+αh1,n,Λn+αh2,n,F0;X)[h1,n,h2,n]d2(F^n,F0)=2𝒫[j=1K{(eβ0TZΔΛ0,j(U)e(β0+αh1,n)TZ(ΔΛn,j(U)+αΔh2,n,j(U)))}]×e(β0+αh1,n)TZ[{((ΔΛn,j(U)+αΔh2,n,j(U))h1,nTZ+Δh2,n,j(U))}]d2(F^n,F0)=2𝒫[j=1K{(b(1)b(0))e(β0+αh1,n)TZ((ΔΛn,j(U)+αΔh2,n,j(U))h1,nTZ+Δh2,n,j(U))}]d2(F^n,F0),

where b(ξ)=exp((β0+ξαh1,n)TZ)(ΔΛ0,j(U)+ξ(ΔΛn,j(U)ΔΛ0,j(U)+αΔh2,n,j(U))), and the notation c1c2 means that c1cc2 for a constant c. By the mean value theorem, there exists a 0<ξ<1 such that b(1)b(0)=b(ξ), where

b(ξ)=e(β0+ξαh1,n)TZ(ΔΛn,j(U)ΔΛ0,j(U)+αΔh2,n,j(U))+e(β0+ξαh1,n)TZαh1,nTZ(ΔΛ0,j(U)+ξ(ΔΛn,j(U)ΔΛ0,j(U)+αΔh2,n,j(U))).

Since Λ0, Λn, and h2,n are bound on [0,τ], and β0 and h1,n are bounded vectors, it follows that b(ξ)(ΔΛn,j(U)ΔΛ0,j(U)+αΔh2,n,j(U))+h1,nTZ. Thus,

𝒫m.(α)c𝒫[j=1K{((ΔΛn,j(U)ΔΛ0,j(U)+αΔh2,n,j(U))+h1,nTZ)(h1TZ+Δh2,j(U))}]d2(F^n,F0)cO(nνr+n(1ν)2+na)d2(F^n,F0),

for a constant c. Note that nνr+n(1ν2)nr(1+2r)>(1n, 0<a<12, and d2(F^n,F^0)=Op(1n). This yields that Pnm.(α)(Pn𝒫)m.(α)+cO(nνr+n(1ν)2+na)d2(F^n,F0)>0 with probability converging to one. We can similarly show that Pnm.(α)<0 except on an event with probability converging to zero. Therefore, for all ε>0, we have P(d3((β^n,Λ^n),(β0,Λ0))>ε)0 as n. It follows that for any >0, there exists a measurable set Ξ with P(Ξ)1 such that Λ^n(s) is uniformly bounded for s[0,τ] on Ξ.

We restrict us on the measurable set Ξ at the moment. By the Cauchy–Schwarz inequality, under Conditions (C1) and (C7), we have

𝒫m(β,Λ,F0;X)𝒫m(β0,Λ0,F0;X)=E[j=1K(eβTZΔΛj(U)eβ0TZΔΛ0,j(U))2]E[j=1K(ΔΛj(U)ΔΛ0,j(U))2]+E[j=1K(eβTZeβ0TZ)2]+2{E[j=1K(ΔΛj(U)ΔΛ0,j(U))2]}12{E[j=1K(eβTZeβ0TZ)2]}12E[j=1K(ΔΛj(U)ΔΛ0,j(U))2]+E[(eβTZeβ0TZ)2].

By the mean value theorem, there exists a βζ such that E[(exp(βTZ)exp(β0TZ))2]=E[exp(2βζTZ){ZT(ββ0)}2]||ββ0||22. It follows that

𝒫m(β,Λ,F0;X)𝒫m(β0,Λ0,F0;X)ββ022+d12(Λ,Λ0)=d32((β,Λ),(β0,Λ0)).

Furthermore, Note that 𝒫m(β,Λ,F0;X)𝒫m(β0,Λ0,F0;X)0 with equality if and only if β=β0 and ΔΛ(s1,s2)=ΔΛ0(s1,s2) a.e. with respect to μ2. Hence, for every δ>0, there exists an ε>0 such that {d3((β^n,Λ^n),(β0,Λ0))δ}{𝒫m(β^n,Λ^n,F0;X)𝒫m(β0,Λ0,F0;X)>ε}. Note that

0𝒫m(β^n,Λ^n,F0;X)𝒫m(β0,Λ0,F0;X)=𝒫m(β^n,Λ^n,F0;X)𝒫m(β^n,Λ^n,F^n;X)+𝒫m(β^n,Λ^n,F^n;X)Pnm(β^n,Λ^n,F^n;X)+Pnm(β^n,Λ^n,F^n;X)Pnm(β0,Λn,F^n;X)+Pnm(β0,Λn,F^n;X)𝒫m(β0,Λn,F^n;X)+𝒫m(β0,Λn,F^n;X)𝒫m(β0,Λn,F0;X)+𝒫m(β0,Λn,F0;X)𝒫m(β0,Λ0,F0;X). (7)

According to Conditions (C2) and (C7), 0𝒫m(β0,Λn,F0;X)𝒫m(β0,Λ0,F0;X)ΛnΛ02=o(1). The definition of (β^n,Λ^n) yields that Pnm(β^n,Λ^n,F^n;X)Pnm(β0,Λn,F^n;X). By Lemma 2 of the online Supplementary Material (Hu et al., 2023), we have 𝒫m(β^n,Λ^n,F^n;X)𝒫m(β^n,Λ^n,F^n;X)=op(1) and 𝒫m(β0,Λn,F^n;X)𝒫m(β0,Λn,F0;X)=op(1). By Lemma 3 of the online Supplementary Material (Hu et al., 2023), {m(β,Λ,F;X):β, ΛΦ, Λ is uniformly bounded, F, d2(F,F0)δ} is Donsker, meaning that it is Glivenko-Cantelli. Noting that d2(F^n,F0)=Op(n12), we have (Pn𝒫)m(β^n,Λ^n,F^n;X)=op(1) and (Pn𝒫)m(β0,Λn,F^n;X)=op(1). Combining them with (7), we have 0𝒫m(β^n,Λ^n,F0;X)𝒫m(β0,Λ0,F0;X)op(1). Therefore, {𝒫m(β^n,Λ^n,F0;X)>𝒫m(βn,Λn,F0;X)+ε} goes into a null set as n. Then (β^n,Λ^n)(β0,Λ0) almost uniformly, recalling that the relation holds on the measurable set Ξ with P(Ξ)1. Thus, the almost sure convergence of (β^n, Λ^n) follows by Lemma 1.9.2 of van der Vaart and Wellner (1996). □

A.2. Proof of Theorem 3.2

Proof. We use Lemma 5 of the online Supplementary Material (Hu et al., 2023) to prove the rate of convergence.

First, by some direct calculations, we have

𝒫(m(β0,Λ0,F;X)m(β,Λ,F;X))=E[j=1K(eβTZΔΛj(U)eβ0TZΔΛ0,j(U))2]+𝒫[j=1K1Δ1F0(YZ)Y(eβTZΔΛj(u)eβ0TZΔΛ0,j(u))2]dF0(uZ)[j=1K1Δ1F(YZ)Y(eβTZΔΛj(u)eβ0TZΔΛ0,j(u))2dF(uZ)].

The bound of E[j=1K{exp(βTZ)ΔΛj(U)exp(β0TZ)ΔΛ0,j(u)}2] can be assessed by the arguments similar to those for the proof of Theorem 3.2 in Wellner and Zhang (2007). For ΛΦ, βRp and (S1,S2,Z)μ1, let g(ξ)=exp(β0TZ)ΔΛξ(S1,S2), where ΔΛξ(S1,S2)=ξΔΛ(S1,S2)+(1ξ)ΔΛ0(S1,S2) and βξ=ξβ+(1ξ)β0 with ξ(0,1). Then we have exp(βTZ)ΔΛ(S1,S2)exp(β0TZ)ΔΛ0(S1,S2)=g(1)g(0). By the mean value theorem, there is a ξ(0,1) such that

g(1)g(0)=g(ξ)=eβξTZ[(ΔΛ(S1,S2)ΔΛ0(S1,S2))+ΔΛξ(S1,S2)(ββ0)TZ]=eβξTZ[{1+(ΔΛ(S1,S2)ΔΛ0(S1,S2))ΔΛ0(S1,S2)ξ}(ββ0)TZΔΛ0(S1,S2)+(ΔΛ(S1,S2)ΔΛ0(S1,S2))],

where g is the derivative of g. Setting g1=(ββ0)TZΔΛ0(S1,S2), g2=(ΔΛ(S1,S2)ΔΛ0(S1,S2)) and g3=1+ξ(ΔΛ(S1,S2)ΔΛ0(S1,S2))ΔΛ0(S1,S2), we have g(1)g(0)=exp(βξTZ)(g1g3+g2) This yields that

E[j=1K{eβTZΔΛj(U)eβ0TZΔΛ0,j(U)}2]=Eμ1[{g(1)g(0)}2]Eμ1[(g1g3+g2)2].

Similar to the proof of Theorem 3.2 in Wellner and Zhang (2007), Condition (C14) implies that Eμ12[g1g2](1η)Eμ1[(g1)2]Eμ1[(g2)2]. According to Lemma 8.8 of van der Vaart (2002), we have Eμ1[(g1g3+g2)2]Eμ1[(g1)2]+Eμ1[(g2)2]d32((β,Λ),(β0,Λ0)). Therefore,

𝒫(m(β0,Λ0,F;X)m(β,Λ,F;X))d32((β,Λ),(β0,Λ0))+𝒫[j=1K1Δ1F0(YZ)Y{eβTZΔΛj(u)eβ0TZΔΛ0,j(u)}2dF0(uZ)][j=1K1Δ1F(YZ)Y{eβTZΔΛj(u)eβ0TZΔΛ0,j(u)}2dF(uZ)].

By Conditions (C1), (C2) and (C7), Cauchy–Schwarz inequality and Lemma 2 of the online Supplementary Material (Hu et al., 2023),

𝒫[j=1K(1Δ){Y(eβTZΔΛj(u)eβ0TZΔΛ0,j(u))2dF0(uZ)1F0(YZ)}][{Y(eβTZΔΛj(u)eβ0TZΔΛ0,j(u))2dF(uZ)1F(YZ)}]{𝒫[j=1K(eβTZΔΛj(U)eβ0TZΔΛ0,j(U))2]}+𝒫{[j=1K2eβTZΔΛj(U)eβ0TZΔΛ0,j(U)eβTZΔΛj(U)eβ0TZΔΛ0,j(U)]}d2(F,F0)d3((β,Λ),(β0,Λ0))d2(F,F0)+d32((β,Λ),(β0,Λ0))d2(F,F0).

This yields that

𝒫(m(β0,Λ0,F^n;X)m(β^n,Λ^n,F^n;X))d32((β^n,Λ^n),(β0,Λ0))+d3((β^n,Λ^n),(β0,Λ0))d2(F^n,F0)+d32((β^n,Λ^n),(β0,Λ0))d2(F^n,F0).

Second, we need to find a ϕn(η) such that

Esup{(β,Λ)×Φn:d3((β,Λ),(β0,Λ0))<η}(Pn𝒫)(m(β,Λ,F^n;X)m(β0,Λ0,F^n;X))ϕn(η)n.

By Lemma 4 of the online Supplementary Material (Hu et al., 2023), for sufficiently large n, we have

logN[](ε,η(F^n),P,B)qnlog(ηε),

where (F^n)={m(β,Λ,F^n;X)m(β0,Λ0,F^n;X):β,ΛΦn,d32((β,Λ),(β0,Λ0))η2}. For (β,Λ)×Φn satisfying d3((β,Λ),(β0,Λ0))<η, similar to the proof of Lemma 4 of the online Supplementary Material (Hu et al., 2023), we have

m(β,Λ,F^n;X)m(β0,Λ0,F^n;X)j=1K[(ΔNj+1){ΔeβTZΔΛj(Y)eβ0TZΔΛ0,j(Y)}]+[{1Δ1F^n(YZ)j=1KYeβTZΔΛj(u)eβ0TZΔΛ0,j(u)dF^n(uZ)}].

Furthermore, since exp(βTZ), ΔΛj, exp(β0TZ) and ΔΛ0,j are bounded and d2(F^n,F0)=op(1), we have exp(m(β,Λ,F^n;X)m(β0,Λ0F^n;X))exp(CN(TK)). The above two inequalities yield that

𝒫[em(β,Λ,F^n;X)m(β0,Λ0,F^n;X)m(β,Λ,F^n;X)m(β0,Λ0,F^n;X)2]𝒫[j=1KΔ{eβTZΔΛj(Y)eβ0TZΔΛ0,j(Y)}2]+j=1K1Δ1F^n(YZ)Y[{eβTZΔΛj(u)eβ0TZΔΛ0,j(u)}2dF^n(uZ)]d32((β,Λ),(β0,Λ0))+d3((β,Λ),(β0,Λ0))d2(F^n,F0).

That means for sufficiently large n, m(β,Λ,F^n;X)m(β0,Λ0F^n;X)P,B2η2. By Lemma 3.4.3 of van der Vaart and Wellner (1996),

En12(Pn𝒫)n(F^n)J[](η,η(F^n),P,B){1+J[](η,n(F^n),P,B)(η2n12)},

where J[](η,η(F^n),P,B)0η{1+logN[](ε,n(F^n),P,B)}12dεqn12η. It follows that

Esup{(β,Λ)×Φn:d3((β,Λ),(β0,Λ0))<η}(Pn𝒫)(m(β,Λ,F^n;X)m(β0,Λ0,F^n;X))nqnη+qnn.

Setting ϕn(η)=qnη+qnn such that ϕn(η)η decreases about η, for a sequence rn=O(na), we have rn2ϕ(1rn)=qnrn+qnrn2n. Note that qn=O(nν), 0<ν<12. This yields that rn2ϕ(1rn)=O(na+ν2+n2a+ν12). Since a(1ν)2 ensures rn2ϕ(1rn)n, we choose rn=O(n(1ν)2).

Finally, we determine ν satisfying Pn(m(β^n,Λ^n,F^n;X)m(β0,Λ0,F^n;X))Op(1rn2). Note that for Λ0r, there is a ΛnΦn such that ΛnΛ0=O(nνr). By the definition of (β^n,Λ^n) and 0𝒫m(β0,Λn,F^n;X)𝒫m(β0,Λ0,F^n;X)ΛnΛ02, we have

Pn(m(β^n,Λ^n,F^n;X)m(β0,Λ0,F^n;X))=Pnm(β^n,Λ^n,F^n;X)Pn(β0,Λn,F^n;X)+Pnm(β0,Λn,F^n;X)𝒫m(β0,Λn,F^n;X)+𝒫m(β0,Λn,F^n;X)𝒫m(β0,Λ0,F^n;X)+𝒫m(β0,Λ0,F^n;X)Pnm(β0,Λ0,F^n;X)nνr+ε(Pn𝒫)[{m(β0,Λn,F^n;X)m(β0,Λ0,F^n;X)}nνr+ε]+Op(n2νr).

Set ~(F^n)={m(β0,Λ,F^n;X)m(β0,Λ0,F^n;X):ΛΦn,ΛΛ0O(nνr)}. According to Lemma 4 of the online Supplementary Material (Hu et al., 2023), ~(F^n) is Donsker. After some algebraic calculations, for any f~(F^n), we have P(fnνr+ε)20 as n0 for any ε>0. Using Corollary 2.3.12 of van der Vaart and Wellner (1996), we have (Pn𝒫)(m(β0,Λn,F^n;X)m(β0,Λ0,F^n;X))=op(nνr+ε12). When 0<ε12rν, we have Pn(m(β^n,Λ^n,F^n;X)m(β0,Λ0,F^n;X))Op(n2νr), meaning that ν1(1+2r) ensures Pn(m(β^n,Λ^n,F^n;X)m(β0,Λ0,F^n;X))Op(rn2). Thus, taking ν=1(1+2r), we have d3((β^n,Λ^n),(β0,Λ0))=Op(nr(1+2r)). □

A.3. Proof of Theorem 3.3

Proof. (i) Define ~={(h1,h2):h1,h2r}. For (h1,h2)~, let Qn(β,Λ,F)[h1,h2]=Pnψ(β,Λ,F;X)[h1,h2] and Q(β,Λ,F)[h1,h2]=𝒫ψ(β,Λ,F;X)[h1,h2] with ψ(β,Λ,F;X)[h1,h2] given in (6). Following Theorem 1 of Zhao and Zhang (2017), it suffices to verify the following conditions (B1)-(B5) to prove this theorem.

(B1) Q(β0,Λ0,F0)[h1,h2]=0 and Qn(β^n,Λ^n,F^n)[h1,h2]=op(n12).

(B2) n(QnQ)(β^n,Λ^n,F^)[h1,h2]n(QnQ)(β0,Λ0,F0)=[h1,h2]=op(1).

(B3) Q(β,Λ,F)[h1,h2] is Fréchet-differentiable with respect to (β, Λ) at (β0, Λ0, F0) with a continuous derivative Q.1,β0,Λ0,F0[h1,h2]; Q(β,Λ,F)[h1,h2] is Fréchet-differentiable with respect to F at (β0, Λ0, F0) with a continuous derivative Q.2,β0,Λ0,F0[h1,h2].

(B4) Q(β^n,Λ^n,F^n)[h1,h2]Q(β0,Λ0,F0)[h1,h2]Q.1,β0,Λ0,F0(β^nβ0,Λ^nΛ0)[h1,h2]Q.2,β0,Λ0,F0(F^nF0)[h1,h2]=op(n12).

(B5) nQn(β0,Λ0,F0)[h1,h2]+nQ.2,β0,Λ0,F0(F^nF0)[h1,h2] converges in distribution to a tight Gaussian progress.

For (B1), under model (1), we have Q(β0,Λ0,F0)[h1,h2]=0. By the definition of (β^n, Λ^n), for all (h1,h2)×Φn, we obtain limη0Pnm(β^n+ηh1,Λ^n+ηh2.F^n;X)η=0. This implies that Qn(β^n,Λ^n,F^n)[h1,h2]=0 for all (h1,h2)×Φn. By Lemma A1 of Lu, Zhang and Huang (2007) and the properties of spline functions, for any h2r, we can find an h2,nΦn satisfying h2,nh2=O(nr(1+2r)) and h2,nh2=O(1), where h2 is the derivative of h2. Thus, for each h2r, we need to prove Qn(β^n,Λ^n,F^n)[0,h2h2,n]=Pnψ(β^n,Λ^n,F^n)[0,h2h2,n]=op(n12) to verify Qn(β^n,Λ^n,F^n)[h1,h2]=op(n12). Note that

Qn(β^n,Λ^n,F^n)[0,h2h2,n]={Qn(β^n,Λ^n,F^n)[0,h2h2,n]Qn(β^n,Λ^n,F0)[0,h2h2,n]}+{Qn(β^n,Λ^n,F0)[0,h2h2,n]Qn(β0,Λ0,F0)[0,h2h2,n]}+Qn(β0,Λ0,F0)[0,h2h2,n]I1n+I2n+I3n.

For the first term I1n, Lemma 2 of the online Supplementary Material (Hu et al., 2023) yields that

𝒫I1n=𝒫Qn(β^n,Λ^n,F^n)[0,h2h2,n]Qn(β^n,Λ^n,F0)[0,h2h2,n]𝒫[j=1K(1Δ)Y{ΔNjeβ^nTZΔΛ^n,j(u)}(Δh2,j(u)Δh2,n,j(u))dF^n(uZ)1F^n(YZ)][Y{ΔNjeβ^nTZΔΛ^n,j(u)}(Δh2,j(u)Δh2,n,j(u))dF0(uZ)1F0(YZ)eβ^nTZ]d2(F^n,F0)(h2h2,n+h2h2,n)=op(n12).

For the second term I2n, after some algebraic calculations, we have

𝒫I2n=𝒫Qn(β^n,Λ^n,F0)[0,h2h2,n]Qn(β0,Λ0,F0)[0,h2h2,n]h2h2,n𝒫[k=1KΔ{ΔNjeβ^nTZΔΛ^nj(Y)}eβ^nTZ{ΔNjeβ0TZΔΛ0,j(Y)}eβ0TZ]+1Δ1F0(YZ)Y[{ΔNjeβ^nTZΔΛ^n,j(u)}eβ^nTZ{ΔNjeβ0TZΔΛ0,j(u)}eβ0TZdF0(uZ)]{β^nβ02+d3((2β^n,Λ^n),(2β0,Λ0))}h2h2,n=op(n12).

For the third term I3n, note that Q(β0,Λ0,F0;X)[0,h2h2,n]=0. By the independence of Xi and Xj, it follows that

𝒫I3n2=n1𝒫(1ni=1nψ2(β0,Λ0,F0;Xi)[0,h2h2,n])n1𝒫[j=1K{ΔΔNjeβ0TZΔΛ0,j(Y)eβ0TZ}]+1Δ1F0(YZ)Y[{ΔNjeβ0TZΔΛ0,j(Y)eβ0TZdF0(uZ)}]2h2h2,n2n1h2h2,n2.

Then we have Qn(β^n,Λ^n,F^n)[0,h2h2,n]=op(n12), and (B1) holds.

For (B2), after some algebraic calculations, we have

n(QnQ)(β^n,Λ^n,F^n)[h1,h2]n(QnQ)(β0,Λ0,F0)[h1,h2]=n(Pn𝒫)(ψ(β^n,Λ^n,F^n;X)[h1,h2]ψ(β0,Λ0,F0;X)[h1,h2]).

For each fixed bounded (h1,h2)~, set

Ψ-η(h1,h2)={ψ(β,Λ,F;X)[h1,h2]ψ(β0,Λ0,F0;X)[h1,h2]:β,ΛΦn,Fd3((β,Λ),(β0,Λ0))<η,d2(F,F0)<η,Λis uniformly bounded}.

Similar to Lemma 3 of the online Supplementary Material (Hu et al., 2023), it follows that Ψ-η(h1,h2) is Donsker. By Condition (C6) and Lemma 2 of the online Supplementary Material (Hu et al., 2023), after some algebraic calculations, we obtain 𝒫(ψ(β,Λ,F;X)[h1,h2]ψ(β0,Λ0,F0;X)[h1,h2])2d3((β,Λ),(β0,Λ0))2+d2(F,F0)2. Then Corollary 2.3.12 of van der Vaart and Wellner (1996) implies that

n(Pn𝒫)(ψ(β^n,Λ^n,F^n;X)[h1,h2]ψ(β0,Λ0,F0;X)[h1,h2])=op(1),

and (B2) holds.

For (B3), Q(β,Λ,F)[h1,h2] is Fréchet-differentiable with respect to (β, Λ) at (β0, Λ0, F0) because Q(β,Λ,F)[h1,h2] is a smooth functional with respect to (β, Λ, F). Similarly, Q(β,Λ,F)[h1,h2] is Fréchet-differentiable with respect to F at (β0, Λ0, F0). By some direct calculations, we obtain

Q.1,β0,Λ0,F0(β^nβ0,Λ^nΛ0)[h1,h2]=ddε{𝒫[j=1K{Δ(ΔNj(ΔΛ0,j(Y)+ε(ΔΛ^n,j(Y)ΔΛ0,j(Y)))e(β0+ε(β^nβ0))TZ}]}×(Δh2,j(Y)+(ΔΛ0,j(Y)+ε(ΔΛ^n,j(Y)ΔΛ0,j(Y)))h1TZ)e(β0+ε(β^nβ0))TZ+1Δ1F0(YZ)Y(ΔNj(ΔΛ0,j(u)+ε(ΔΛ^n,j(u)ΔΛ0,j(u)))e(β0+ε(β^nβ0))TZ){[{×(Δh2,j(u)+(ΔΛ0,j(u)+ε(ΔΛ^n,j(u)ΔΛ0,j(u)))h1TZ)e(β0+ε(β^nβ0))TZdF0(uZ)}]}ε=0R1(h1,h2)(β^nβ0)R2(h1,h2)(Λ^nΛ0),

where

R1(h1,h2)(β^nβ0)=𝒫[eβ0TZj=1K{Δ(ΔNj2eβ0TZΔΛ0,j(Y))(Δh2,j(Y)+ΔΛ0,j(Y)h1TZ)}]+1Δ1F0(YZ)Y[{(ΔNj2eβ0TZΔΛ0,j(u))(Δh2,j(u)+ΔΛ0,j(u)h1TZ)dF0(uZ)}ZT](β^nβ0) (8)

and

R2(h1,h2)(Λ^nΛ0)=𝒫[eβ0TZj=1K{Δ(ΔNjh1TZ2eβ0TZΔΛ0,j(Y)h1TZeβ0TZΔh2,j(Y))}]×(ΔΛ^n,j(Y)ΔΛ0,j(Y))+1Δ1F0(YZ)Y(ΔΛ^n,j(u)Λ0,j(u))×[{(ΔNjh1TZ2eβ0TZΔΛ0,j(u)h1TZeβ0TZΔh2,j(u))dF0(uZ)}]. (9)

Since the equation

dYg(uTj)d(F0+ε(F^nF0))(uZ)1F0(YZ)ε(F^nF0)(YZ)dεε=0=(1F0(YZ))Yg(uTj)d(F^nF0)(uZ)+(F^nF0)(YZ)Yg(uTj)dF0(uZ)(1F0(YZ))2=11F0(YZ)Y{g(uTj)Yg(sTj)1F0(YZ)dF0(sZ)}d(F^nF0)(uZ)

holds for any differentiable function g, we obtain

Q.2,β0,Λ0,F0(F^nF0)[h1,h2]=ddε{Q(β0,Λ0,F0+ε(F^nF0))[h1,h2]}ε=0=ddε{𝒫[j=1K1Δ1F0(YZ)ε(F^nF0)(YZ)Y{ΔNjeβ0TZΔΛ0,j(u)}]}×{[eβ0TZ{Δh2,j(u)+ΔΛ0,j(u)h1TZ}d(F0+ε(F^nF0))(uZ)]}ε=0=𝒫[Yφ-β0,Λ0,F0(u;X)[h1,h2]d(F^nF0)(uZ)],

where

φ-β0,Λ0,F0(u;X)[h1,h2]=1Δ1F0(YZ)j=1K{φ~j,β0,Λ0,F0(u;X)[h1,h2]Yφ~j,β0,Λ0,F0(s;X)[h1,h2]1F0(YZ)dF0(sZ)},

and φ~j,β0,Λ0,F0(u;X)[h1,h2]={ΔNjexp(β0TZ)ΔΛ0,j(u)}exp(β0TZ){Δh2,j(u)+ΔΛ0,j(u)h1TZ}. Then (B3) is verified.

For (B4), since d3((β^n,Λ^n),(β0,Λ0))=Op(nr(1+2r)) and by the Taylor expansion, we have exp(β^nTZ)=exp(β0TZ)+exp(β0TZ)ZT(β^nβ0)+op(1n). By the above equation and Lemma 2 of the online Supplementary Material (Hu et al., 2023), we obtain

Q(β^n,Λ^n,F^n)[h1,h2]Q(β0,Λ^n,F^n)[h1,h2]=𝒫[eβ0TZj=1K{Δ(ΔNj2eβ0TZΔΛ^n,j(Y))(Δh2,j(Y)+ΔΛ^n,j(Y)h1TZ)}+1Δ1F^n(YZ)]×Y[{(ΔNj2eβ0TZΔΛ^n,j(u))(Δh2,j(u)+ΔΛ^n,j(u)h1TZ)dF^n(uZ)}ZT](β^nβ0)=𝒫[eβ0TZj=1K{Δ(ΔNj2eβ0TZΔΛ^n,j(Y))(Δh2,j(Y)+ΔΛ^n,j(Y)h1TZ)+1Δ1F0(YZ)}]×Y[{(ΔNj2eβ0TZΔΛ^n,j(u))(Δh2,j(u)+ΔΛ^n,j(u)h1TZ)dF0(uZ)}ZT](β^nβ0)+op(n12)=R1(h1,h2)(β^nβ0)+op(n12). (10)

Similarly, since d1(Λ^n,Λ0)=Op(nr(1+2r)) and d1(Λ^n,Λ0)=op(1), using Lemma 2 of the online Supplementary Material (Hu et al., 2023), we have

Q(β0,Λ^n,F^n)[h1,h2]Q(β0,Λ0,F^n)[h1,h2]=𝒫[j=1K{Δ(e2β0TZ(ΔΛ0,j(Y)2ΔΛ^n,j(Y)2)h1TZ+(ΔΛ^n,j(Y)ΔΛ0,j(Y)))}]×((ΔNjeβ0TZh1TZe2β0TZΔh2,j(Y)))+1Δ1F0(YZ)Y(e2β0TZ(ΔΛ^n,j(u)2ΔΛ0,j(u)2))h1TZ+[{(ΔΛ^n,j(u)ΔΛ0,j(u))((ΔNjeβ0TZh1TZe2β0TZΔh2,j(u)))dF0(uZ)}]+op(n12)=R2(h1,h2)(Λ^nΛ0)𝒫[j=1K{Δe2β0TZ(ΔΛ^n,j(Y)ΔΛ0,j(Y))2h1TZ}]+1Δ1F0(YZ)Y[{(e2β0TZ(ΔΛ^n,j(u)ΔΛ0,j(u))2h1TZ)dF0(uZ)}]+op(n12)=R2(h1,h2)(Λ^nΛ0)+op(n12). (11)

By (10) and (11), it follows that Q(β^n,Λ^n,F^n)[h1,h2]Q(β0,Λ0,F^n)[h1,h2]=Q.1,β0,Λ0,F0(β^nβ0,Λ^nΛ0)[h1,h2]+op(1n). By Lemma 2 of the online Supplementary Material (Hu et al., 2023), we can obtain that

Q(β0,Λ0,F^n)[h1,h2]Q(β0,Λ0,F0)[h1,h2]Q.2,β0,Λ0,F0(F^nF0)[h1,h2]=𝒫[(1Δ)F^n(YZ)F0(YZ)1F0(YZ)j=1K{Yφ~j,β0,Λ0,F0(u;X)[h1,h2]dF^n(uZ)1F^n(YZ)}][{Yφ~j,β0,Λ0,F0(u;X)[h1,h2]dF0(uZ)1F0(YZ)}]F^nF0𝒫[(1Δ)j=1KYφ~j,β0,Λ0,F0(u;X)[h1,h2]dF^n(uZ)1F^n(YZ)][Yφ~j,β0,Λ0,F0(u;X)[h1,h2]dF0(uZ)1F0(YZ)]F^nF02=op(n12).

Thus, (B4) holds.

Finally, we consider (B5). Note that

nQn(β0,Λ0,F0)[h1,h2]+nQ.2,β0,Λ0,F0(F^nF0)[h1,h2]=nPnψ(β0,Λ0,F0;X)[h1,h2]+n𝒫[Yφ-β0,Λ0,F0(u;X)[h1,h2]d(F^nF0)(uZ)].

According to Lemma 1 of the online Supplementary Material (Hu et al., 2023), we have

𝒫[Yφ-β0,Λ0,F0(u;X)[h1,h2]d(F^n(uZ)F0(uZ))]=𝒫[Yφ-β0,Λ0,F0(u;X)[h1,h2]u(F^n(uZ)F0(uZ))du][φ-β0,Λ0,F0(Y;X)[h1,h2](F^n(YZ)F0(YZ))]=𝒫[1ni=1n{Yφ-β0,Λ0,F0(u;X)[h1,h2]uΩ(u,Z;Y~i,Δ~i,Z~i)du}][{φ-β0,Λ0,F0(Y;X)[h1,h2]Ω(Y,Z;Y~i,Δ~i,Z~i)}]Pnφ(β0,Λ0,F0;Y~,Δ~,Z~)[h1,h2],

where

φ(β0,Λ0,F0;Y~,Δ~,Z~)[h1,h2]=𝒫X[{Yφ-β0,Λ0,F0(u;X)[h1,h2]uΩ(u,Z;Y~,Δ~,Z~)du}][{φ-β0,Λ0,F0(Y;X)[h1,h2]Ω(Y,Z;Y~,Δ~,Z~)}].

By the central limit theorem, setting

σ0[h1,h2]2=E[{ψ(β0,Λ0,F0;X)[h1,h2]+φ(β0,Λ0,F0;Y~,Δ~,Z~)[h1,h2]}2], (12)

we have nQn(β0,Λ0,F0)[h1,h2]+nQ.2,β0,Λ0,F0(F^nF0)[h1,h2]N(0,σ0[h1,h2]2), and (B5) holds.

By Theorem 1 of Zhao and Zhang (2017), (B1)-(B5) yields that

nR1(h1,h2)(β^nβ0)+nR2(h1,h2)(Λ^nΛ0)N(0,σ0[h1,h2]2).

(ii) To prove the asymptotic normality of β^n, we need to find an (h1, h2) such that R2(h1,h2)(Λ^nΛ0)=0. After some algebraic calculations, we obtain

R2(h1,h2)(Λ^nΛ0)=𝒫[j=1K{(ΔΛ^n,j(U)ΔΛ0,j(U))E[(Δh2,j(U)+ΔΛ0,j(U)h1TZ)e2β0TZU,K,T]}].

Setting R(U,K,T)=E[exp(2β0TZ)ZU,K,T]E[exp(2β0TZ)U,K,T], the above equality implies that Δh2,j(U)=h1T(U,K,T)ΔΛ0,j(U). Then we have

ΔΛj(U)h1TZ+Δh2,j(U)=ΔΛj(U)h1T(ZR(U,K,T)). (13)

It follows that R1(h1,h2)((β^nβ0)=h1TA(β^nβ0), where

A=𝒫[j=1K{e2β0TZΔΛ0,j(U)2(ZR(U,K,T))2}].

Furthermore, by (13), we obtain

ψ(β0,Λ0,F0;X)[h1,h2]=h1Tj=1K[Δ{ΔNjeβ0TZΔΛ0,j(Y)}eβ0TZΔΛ0,j(Y)(ZR(Y,K,T))]+[1Δ1F0(YZ)Y{ΔNjeβ0TZΔΛ0,j(u)}eβTZΔΛ0,j(u)(ZR(u,K,T))dF0(uZ)]h1Tψ(β0,Λ0,F0;X),φ(β0,Λ0,F0;Y~,Δ~,Z~)[h1,h2]=h1T𝒫X=[{Yφ-β0,Λ0,F0(u;X)uΩ(u,Z;Y~,Δ~,Z~)du}][{φ-β0,Λ0,F0(Y;X)Ω(Y,Z;Y~,Δ~,Z~)}]h1Tφ(β0,Λ0,F0;Y~,Δ~,Z~),

where

φ-β0,Λ0,F0(u;X)=1Δ1F0(YZ)j=1K{φ~j,β0,Λ0,F0(u;X)Yφ~j,β0,Λ0,F0(s;X)1F0(YZ)dF0(sZ)}

and φ~j,β0,Λ0,F0(u;X)={ΔNjexp(β0TZ)ΔΛ0,j(u)}exp(β0TZ){ΔΛj(u)(ZR(u,K,T)). After some algebraic calculations, we have

σ0[h1,h2]2=E[{ψ(β0,Λ0,F0;X)[h1,h2]+φ(β0,Λ0,F0;Y~,Δ~,Z~)[h1,h2]}2]=h1TE[{ψ(β0,Λ0,F0;X)+φ(β0,Λ0,F0;Y~,Δ~,Z~)}2]h1h1TBh1.

It follows that nh1TA(β^nβ0)N(0,h1TBh1) for all h1. Then we obtain n(β^nβ0)N(0,(A)1B((A)1)T). □

Footnotes

Supplementary Material

Lemmas (DOI: 10.3150/22-BEJ1565SUPP; .pdf). The supplementary material contains some Lemmas.

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