Cluster-weighted modeling of lifetime hierarchical data for profiling COVID-19 heart failure patients

Fuente: arXiv
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Autori principali: Caldera, Luca, Cappozzo, Andrea, Masci, Chiara, Forlani, Marco, Antonelli, Barbara, Leoni, Olivia, Paganoni, Anna Maria, Ieva, Francesca
Natura: Preprint
Pubblicazione: 2025
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author Caldera, Luca
Cappozzo, Andrea
Masci, Chiara
Forlani, Marco
Antonelli, Barbara
Leoni, Olivia
Paganoni, Anna Maria
Ieva, Francesca
author_facet Caldera, Luca
Cappozzo, Andrea
Masci, Chiara
Forlani, Marco
Antonelli, Barbara
Leoni, Olivia
Paganoni, Anna Maria
Ieva, Francesca
contents This study investigates the heterogeneity in survival times among COVID-19 patients with Heart Failure (HF) hospitalized in the Lombardy region of Italy during the pandemic. To address this, we propose a novel mixture model for right-censored lifetime data that incorporates random effects and allows for local distributions of the explanatory variables. Our approach identifies latent clusters of patients while estimating component-specific covariate effects on survival, taking into account the hierarchical structure induced by the healthcare facility. Specifically, a shared frailty term, unique to each cluster, captures hospital-level variability enabling a twofold decoupling of survival heterogeneity across both clusters and hierarchies. Two EM-based algorithms, namely a Classification EM (CEM) and a Stochastic EM (SEM), are proposed for parameter estimation. The devised methodology effectively uncovers latent patient profiles, evaluates within-cluster hospital effects, and quantifies the impact of respiratory conditions on survival. Our findings provide new information on the complex interplay between the impacts of HF, COVID-19, and healthcare facilities on public health, highlighting the importance of personalized and context-sensitive clinical strategies.
format Preprint
id arxiv_https___arxiv_org_abs_2507_12230
institution arXiv
publishDate 2025
record_format arxiv
spellingShingle Cluster-weighted modeling of lifetime hierarchical data for profiling COVID-19 heart failure patients
Caldera, Luca
Cappozzo, Andrea
Masci, Chiara
Forlani, Marco
Antonelli, Barbara
Leoni, Olivia
Paganoni, Anna Maria
Ieva, Francesca
Applications
This study investigates the heterogeneity in survival times among COVID-19 patients with Heart Failure (HF) hospitalized in the Lombardy region of Italy during the pandemic. To address this, we propose a novel mixture model for right-censored lifetime data that incorporates random effects and allows for local distributions of the explanatory variables. Our approach identifies latent clusters of patients while estimating component-specific covariate effects on survival, taking into account the hierarchical structure induced by the healthcare facility. Specifically, a shared frailty term, unique to each cluster, captures hospital-level variability enabling a twofold decoupling of survival heterogeneity across both clusters and hierarchies. Two EM-based algorithms, namely a Classification EM (CEM) and a Stochastic EM (SEM), are proposed for parameter estimation. The devised methodology effectively uncovers latent patient profiles, evaluates within-cluster hospital effects, and quantifies the impact of respiratory conditions on survival. Our findings provide new information on the complex interplay between the impacts of HF, COVID-19, and healthcare facilities on public health, highlighting the importance of personalized and context-sensitive clinical strategies.
title Cluster-weighted modeling of lifetime hierarchical data for profiling COVID-19 heart failure patients
topic Applications
url https://arxiv.org/abs/2507.12230