Chapter 4
Growth Curve Models

4.1 INTRODUCTION

In Chapters 2 and 3, we discussed the repeated measurements data analysis with univariate and multivariate methods. These methods are not always useful and have several restrictions imposed on them. To use the univariate methods, we require the dispersion matrix for the repeated measurements on units to satisfy the sphericity condition. This condition can be relaxed for multivariate methods. However, the multivariate methods require equal number of repeated measurements on each unit and the same covariates at each measurement time. The relaxation of this requirement needs a more broad-based linear and nonlinear models, and we will consider some such cases in this chapter.

In a dose–response curve, the responses are plotted against different dose levels (or log dose levels) of the drug. The response curve will be steep in a small window of required dose level and is nearly flat outside that window. Because of the slope pattern, these are known as sigmoidal (or S-shaped) curves. Some commonly used curves are based on logit, probit, and Gompertz models, and we will discuss them in Section 4.2.

A simple growth curve model can be used accounting for time-invariant and time-dependent covariates. We will consider them in Section 4.4 as linear models and in Section 4.5 as nonlinear models. Numerical examples are provided in Section 4.6. We will briefly discuss the mixed model analysis in Section 4.3 and the joint action models in Section 4.7.

4.2 Sigmoidal Curves

In some settings, the response variable Y is almost flat at the lower and higher values of the independent variable x and is steep in the effective domain of x. Such curves are known as sigmoidal curves and the underlying model is nonlinear. Some applications of such curves can be found in pharmacokinetics (Krug and Liebig, 1988; Liebig, 1988), toxicology (Becka and Urfer, 1996; Becka, Bolt, and Urfer, 1993), and other disciplines. Usually, x will be the dose (or log of the dose) level and Y will be the response for a drug.

The general form of the nonlinear model can be written as

where Yi is the ith response, θ is the parameter vector of dimensionality p, xi is the ith dose or log of the ith dose (di), and ei are random errors. A suitable assumption of the errors can be made depending on the nature of the dose–response curve. While there is vast literature on finding the optimal choice of xi for a linear model (cf. Bose and Dey, 2009; Goos, 2002; Kiefer, 1958; Kunert, 1983; Pukelsheim, 1993; Shah and Sinha, 1989), limited work has been done on nonlinear models. The optimal designs for nonlinear models are given for minimal designs, where n = p; and the interested reader is referred to Antonello and Raghavarao (2000), Biedermann, Dette, and Zhu (2006), Chaudhuri and Mykland (1995), Dette, Melas, and Pepelyshev (2004), Kalish (1990), Dette, Melas, and Wong (2005), and Sitter and Torsney (1995) for details.

In Equation (4.2.1), θ will be estimated iteratively. We start with a vector of initial values, θ(0), and write

(4.2.2)images

where

and where θ(a + 1) is substituted for θ in Equation (4.2.3).

Taking V to be the dispersion matrix of the error vector e′ = (e1, e2, …, en), by weighted least squares, we get

(4.2.4)images

where

images
images

and

imagesθ(a + 1) -  θ(a)imagesimagesθ(a + 1) -  θ(a)images is less than a small predetermined bound δ.

Note that H(a) is like the design matrix X in linear models. The estimated dispersion matrix of images is

(4.2.5)images

In general, we have four-parameter sigmoidal curves, where the parameters are denoted by a, b, c, and d.

We take the following:

  1. The plot Y versus x as sigmoid.
  2. When x = c, Y = (a + d)/2.
  3. Y is a function of x through b(x – c).
  4. When b > 0 (or <0), Y → d (or a) as x → –, and Y → a (or d) as x.

Here, a and d are the extreme values of the response, b is the slope of the curve, and c is referred to as log(ED50) corresponding to a response proportion of 0.5.

The four-parameter family reduces to a three-parameter family by taking d to be known, say 0. It belongs to a two-parameter family by considering a and d to be known, say d = 0 and a = 1.

For simplicity, we denote b(xic) as ti and (Yid)/(a – d) as Pi and express the relationship between Y and x as

(4.2.6)images

The model (4.2.1) becomes

(4.2.7)images

The ith row of H(a), that is, X, can be written with four columns

(4.2.8)images

where gi = g(ti) = (∂G(ti))/∂ti and Gi = G(ti).

With this X matrix and a suitable choice of V, we can determine the optimum Pi values, and they in turn based on historic data determine the optimum dose levels.

Logistic model is widely used and is given by

(4.2.9)images

or equivalently

Probit and Gompertz models are also used in this context and are given by

and

respectively, where Φ(•) is the standard normal cumulative distribution function.

The images estimator and its dispersion matrix can be obtained from SAS for different sigmoid curves. As an illustration, let us consider the effect of exercise time on weight loss. We will take eight volunteers with similar demographic variables and body weight. Artificial data of the exercise time in min (x, variable) and weight loss in lbs (Y, variable) after 3 months are given in Table 4.2.1.

Table 4.2.1 Artificial data of exercise time (X) and weight loss (Y)

Volunteer 1 2 3 4 5 6 7 8
Exercise time (min) 20 20 30 30 45 45 60 60
Weight loss (lbs) 4 5 15 16 30 32 35 38

The following programming lines provide the necessary output to draw inferences on the parameters:

data a; input x y@@; cards;
20 4 20 5 30 15 30 16 45 30 45 32 60 35 60 38
;
data b;set a;
proc nlin method=gauss ;
parms a=50 b= .5 c=30 d=0;
model y = d + (a − d)/(1 + exp(−b * (x − c)));* this model fits the equation (4.2.10); run;
***
The NLIN Procedure
Approx
Parameter Estimate Std Error Approximate 95% Confidence Limits
(a1) (a2) (a3) (a4)
a 37.8999 1.8455 32.7760 43.0238
b 0.1158 0.0298 0.0329 0.198
c 30.6832 2.8516 22.7660 38.6004
d −5.1965 6.7907 −24.0506 13.6577
***

data a;
input x y@@;cards;
20 4 20 5 30 15 30 16 45 30 45 32 60 35 60 38
;
data b;set a;
proc nlin method=gauss ;
parms a=50 b= .5 c=30 d=0;
model y = d + (a − d)* probnorm (b* (x − c));*this model fits equation (4.2.11); run;
***
The NLIN Procedure
Approx
Parameter Estimate Std Error Approximate 95% Confidence Limits
(a5) (a6) (a7) (a8)
a 37.1825 1.4965 33.0275 41.3376
b 0.0727 0.0184 0.0216 0.1237
c 30.5795 3.3837 21.1849 39.9742
d −4.7732 7.5297 −25.6787 16.1323
***

data a;
input x y@@;cards;
20 4 20 5 30 15 30 16 45 30 45 32 60 35 60 38
;
data b;set a;
proc nlin method=gauss ;
parms a=50 b= .5 c=30 d=0;
model y = d + (a − d)/(2** exp(−b * (x − c)));*this model fits equation (4.2.12);run;
***
The NLIN Procedure
Approx
Parameter Estimate Std Error Approximate 95% Confidence Limits
(a9) (a10) (a11) (a12)
a 38.3101 2.0392 32.6483 43.9718
b 0.0987 0.0236 0.0332 0.1642
c 33.5640 1.4577 29.5168 37.6112
d 1.9127 3.2882 −7.2169 11.0422
***

Using the column (a1), the fitted logistic model given in Equation (4.2.10) is

images

The standard errors of these parameters are given in column (a2) and the confidence intervals in [(a3), (a4)].

Using the column (a5), the fitted probit model given in Equation (4.2.11) is

images

The standard errors of these parameters are given in column (a6) and the confidence intervals in [(a7), (a8)].

Using the column (a9), the fitted Gompertz model given in Equation (4.2.12) is

images

The standard errors of these parameters are given in column (a10) and the confidence intervals in [(a11), (a12)].

The estimated parameters of a, b, c, and d for the three models are summarized in Table 4.2.2. From this table, we observe that parameter estimates of a, b, and c are reasonably close for these models, whereas d is slightly higher for Gompertz model.

Table 4.2.2 Comparison of the parameter for the three models

Parameter Logistic Probit Gompertz
a 37.8999 37.1825 38.3101
b 0.1158 0.0727 0.0987
c 30.6832 30.5795 33.5640
d −5.1965 −4.7732 1.9127

The D-optimal designs are compromised of those design points that minimize the determinant of the variance–covariance matrix of the estimated parameters. Box (1971) showed that the D-optimality criterion is desirable because it tends to reduce the biases of the maximum likelihood estimates of the parameters in nonlinear models. We will now illustrate the method of determining D-optimum minimal design pi’s for a two-parametric logistic model with a = 1 and d = 0.

Here, the model is

images

and the H-matrix (or equivalently the design matrix X) is

(4.2.13)images

Let us assume binomial variation of errors and take

images

Maximizing |XV− 1X| is equivalent to maximizing |XV− 1/2|. We now have

images

Differentiating |XV− 1/2| with respect to p1 and p2 and equating to zero, we get

and

Solving for p1 and p2 from the two Equations (4.2.14) and (4.2.15), we get

images

The dose levels corresponding to these response proportions are the optimum design points. This result was obtained by Kalish and Rosenberger (1978) and also by Antonello and Raghavarao (2000). By using similar methods, we can determine optimal pi values for minimal designs.

Testing the lack of fit of minimal designs is very important for these models, and the interested reader is referred to Lupinacci and Raghavarao (2000) and Su and Raghavarao (2013).

4.3 Analysis of Mixed Models

The analysis of growth curves requires some understanding of restricted maximum likelihood (REML) and penalized least squares, and in this section, a brief summary of these methods will be provided.

Consider a mixed model

(4.3.1)images

where Y is a n × 1 random vector of responses, β is a r × 1 vector of fixed effect parameters and u is a p × 1 vector of random effect parameters, e is random error, and X and Z are design matrices of fixed and random effects. For simplicity, we assume X to be of rank r, and this can always be accomplished by reparametrizing the parameters of the vector β. We assume u to have a multivariate normal distribution Np(0, G) and e to have a multivariate normal distribution Nn(0, R); u and e are independent. Usually, G and R will be diagonal matrices. We assume G and R to be nonsingular. We have

(4.3.2)images
(4.3.3)images

The best linear unbiased estimator images of β and the best linear unbiased predictor images of u can be obtained by minimizing

with respect to β and u. This process is known as penalized least squares. The resulting normal equations by minimizing the penalized least squares (Eq. 4.3.4) are

Note that

(4.3.6)images

From the second Equation of (4.3.5), we have

and substituting this in the first Equation of (4.3.5), we get

images
images

which simplifies to

The estimated images of Equation (4.3.8) can also be obtained as weighted least squares estimator for the model

(4.3.9)images

We can also verify

(4.3.10)images

so that Equation (4.3.7) gives

(4.3.11)images

If V is known, we can solve for images from Equation (4.3.8). If V is unknown, we need to estimate it and we will do this by REML.

Let K be a n × (n–r) matrix such that

(4.3.12)images

and make the transformation

(4.3.13)images

so that

(4.3.14)images

We observe

and

Since the determinants of the left-hand side Equations of (4.3.15) and (4.3.16) are the same, we have

(4.3.17)images

Put M = I − X(XV−1 X)−1XV−1, and note

Clearly, V is a g-inverse of K(KVK)− 1K′, as

images

Let

so that

images

and

Substituting Equations (4.3.19) and (4.3.20) in Equation (4.3.18),

(4.3.21)images

The log likelihood of V, using the distribution of Y and ignoring the constant expression, is

(4.3.22)images

By differentiating images with respect to the parameters of G and R and solving the equations, we estimate V and subsequently β. In SAS, procedure PROC MIXED provides the necessary output to draw inferences on the parameters, and we will illustrate this in the following example:

Table 4.3.1 Average class GPA based on teaching method and instructor

Teacher A B C A B C A B C
Method 1 2 3 2 3 1 3 1 2
Class GPA 2.9 3.1 2.9 3.0 3.4 2.8 3.0 2.6 2.8

We assume the model

images

where Yij is the class GPA, with jth teacher and ith teaching method; βi is the fixed effect of ith method; uj is the random effect of jth teacher; uij is the random interaction effect of the ith method and jth instructor; and eij are random errors. All the random effects parameters are assumed to have zero mean. The parameters uj, uij, and eij are assumed to have variances images, images, and σ2, respectively. Further, uj and eij are assumed to be independent, as well as uij and eij. The parameters uj and uij are assumed to have σ12 covariance.

The necessary programming lines and output are given as follows:

data a;
input teacher method gpa @@;cards;
1 1 2.9 2 2 3.1 3 3 2.9 1 2 3.0 2 3 3.4 3 1 2.8 1 3 3.0 2 1 2.6 3 2 2.8
;
data c;set a;
proc mixed covtest;
class teacher ;*In this program we are not considering method as a class variable;
model gpa=method /s;
random int method /type=un sub=teacher cl; run;

***
Iteration History
Iteration Evaluations −2 Res Log Like Criterion
0 1 0.11209305
1 1 −6.90241885 0.00000000
Convergence criteria met.
The Mixed Procedure
Covariance Parameter Estimates
Standard Z
Cov Parm Subject Estimate Error Value Pr Z
(b1) (b2)
UN(1,1) teacher 0.1037 0.1117 0.93 0.1765 (b3)
UN(2,1) teacher −0.06278 0.06685 −0.94 0.3477 (b4)
UN(2,2) teacher 0.03917 0.04086 0.96 0.1689 (b5)
Residual 0.003333 0.002722 1.22 0.1103
    Fit Statistics
−2 Res Log Likelihood −6.9
AIC (smaller is better) 1.1
AICC (smaller is better) 21.1
BIC (smaller is better) −2.5
Null Model Likelihood Ratio Test
DF Chi-Square Pr > ChiSq
3 7.01 0.0714
Solution for Fixed Effects
Standard
Effect Estimate Error DF t Value Pr > |t|
Intercept 2.6111 0.1928 2 13.55 0.0054
method 0.1667 0.1167 2 1.43 0.2893
Solution for Random Effects
Std Err
Effect teacher Estimate Pred DF t Value Pr > |t| Alpha Lower Upper
(b7)
Intercept 1 0.2103 0.1968 3 1.07 0.3635 0.05 −0.4159 0.8366
method 1 −0.1024 0.1186 3 −0.86 0.4514 0.05 −0.4798 0.2750
Intercept 2 −0.3587 0.1968 3 −1.82 0.1658 0.05 −0.9850 0.2675
method 2 0.2238 0.1186 3 1.89 0.1555 0.05 −0.1536 0.6012
Intercept 3 0.1484 0.1968 3 0.75 0.5055 0.05 −0.4778 0.7746
method 3 −0.1214 0.1186 3 −1.02 0.3812 0.05 −0.4988 0.2559
The Mixed Procedure
Type 3 Tests of Fixed Effects
Num Den
Effect DF DF F Value Pr > F
method 1 2 2.04 0.2893 (b6)

From the output in column (b1), we get the estimators for images, σ12, images, and σ2 and its standard error in column (b2). The p-values at (b3), (b4), and (b5) can be used to test the significance of images, σ12, and images. The p-value at (b6) is used to test the significance of the fixed effect parameter, and in our case, it is not significant. The p-values in column (b7) can be used to test the significance of intercepts and slope for the methods with each teacher.

For more details, the interested readers are referred to Harville (1977), Searle, Casella, and McCulloch (1992), and Patterson and Thompson (1971).

4.4 Simple Linear Growth Curve Model

Let us consider n experimental units and the maximum number of repeated measures on any unit is T. However, it is not necessary to have all T observations on every unit. Let ti(≤T) be the number of repeated observations on the ith unit. Let aij denote a time score for the jth observation on the ith unit. Let X1, X2, …, XM be the M time-invariant covariates and let W1, W2, …, WL be the L time-variant covariates. We will assume a two-stage linear model. Let Yij be the response on the jth observation on the ith unit. We assume

where images is value of the images covariate images at the jth observation on the ith unit and we take it to be zero, if no data are available; eij are random errors; η0i is intercept; and η1i and images are slopes. We model the parameters as follows using the time-invariant covariates:

(4.4.2)images

(4.4.3)images

where ξ0i, ξ1i, and images are random errors and γ’s are slopes of the time-invariant covariates. We will take xim to be zero if the data on Xi are not available.

Combining Equations (4.4.1)–(4.4.4), we write the response vector Yi′ of dimension ti as

where 1 is a column vector of 1’s of suitable dimension (i.e., Jt,1), images, images, images, images, images is a tj × L matrix, images, images is a L × M matrix, images, and images. In xi, and Wi, we put 0 values when data are not collected on those variables at the indicated response time.

Let images. We combine the expression of the response vectors of Equation (4.4.5) to get an N component vector response images as

In Equation (4.4.6), X is an N × M matrix

images

images; A is an N × M matrix

images

W is an N × L matrix

images
images

B is an N × L vector matrix

images

and images.

Model (4.4.6) is a mixed effects model, where the last four terms give random effects parameter and the remaining terms are fixed effects parameter. The effect of the M time-invariant covariates X1, X2, …, XM can be tested by testing the parameters γ01, γ02, …, γ0M. The effect of the L time-variant covariates W1, W2, …, WL can be tested by testing the parameters α21, α22, …, α2L. The effects of the time scores can be tested by testing the parameters γ11, γ12, …, γ1M. The interaction between the set of parameters images and {WM} can be tested by testing the parameters images for images; m = 1, 2, …, M.

4.5 Nonlinear Growth Curve Model

Continuing the notation of Section 4.4, for simplicity, we assume one time-variant covariate, W, and one time-invariant covariate, X. Let tij be the score indicating the repetition of the observation on the unit. We can assume any nonlinear model for repeated observations on a unit and also with a time-invariant covariate.

Let us assume the logistic model for repeated observations as

We model the coefficients images for images of Equation (4.5.1) as

(4.5.3)images
(4.5.4)images

Substituting Equations (4.5.2)–(4.5.5) in Equation (4.5.1), we obtain

(4.5.6)images

Usually, the covariate wij in Equation (4.5.1) is considered with coefficient 1; however, for generality, we consider its coefficient bi1.

4.6 Numerical Example

In this section, the linear and nonlinear growth curves will be illustrated. Example 4.6.1 illustrates fitting the linear growth curve model, and Example 4.6.2 illustrates fitting the nonlinear model.

Table 4.6.1 Artificial data on change of A1C

Patient 3 m 6 m 9 m
X i1 X i2 W ij1 yij W ij1 yij W ij1 yij
1 170 60 20 +0.2 30 −0.5 30 +0.1
2 220 55 40 −0.1 35 −0.6 30 −0.1
3 180 40 50 −0.5 40 0.1 45 −0.2
4 200 50 30 −0.1 40 −0.1 40 +0.1
5 185 60 10 −0.3 30 −0.1 30 −0.1
data a;
input patient period xi1 xi2 aj wi1 y@@;cards;
1 1 170 60 3 20 .2 1 2 170 60 6 30 -.5 1 3 170 60 9 30 .12 1 220 55 3 40 -.1 2 2 220 55 6 35 -.6 2 3 220 55 9 30 -.13 1 180 40 3 50 -.5 3 2 180 40 6 40 .1 3 3 180 40 9 45 -.24 1 200 50 3 30 -.1 4 2 200 50 6 40 -.1 4 3 200 50 9 40 .15 1 185 60 3 10 -.3 5 2 185 60 6 30 -.1 5 3 185 60 9 30 -.1
;

data b;set a;
%macro est(in,patno);
data c;set a;
if patient=&patno; proc sort; by patient;

ods trace on;
proc glm outstat=z ;
model y=aj wi1 /noint ;
*no intercept is used because not enough period observations are taken;
ods output parameterestimates=all; output out=aa; run;

data all1; set all; keep estimate parameter ;
proc transpose out=allt; var estimate parameter;
data allt; set allt; patient=&patno; if _name_ = 'Estimate';
ajhat=col1+0; wi1hat=col2+0; drop col1 col2;
patient=&patno; proc sort; by patient; drop col1 col2 col3;

data all2; set all; keep stderr parameter ;
proc transpose out=allt2; var stderr parameter;
data allt2; set allt2; patient=&patno; if _name_ = 'StdErr';
seajhat=col1+0; sewi1hat=col2+0; drop col1 col2;
patient=&patno; proc sort; by patient; drop col1 col2 col3;

data all3; set all; keep probt parameter ;
proc transpose out=allt3; var probt parameter;
data allt3; set allt3; patient=&patno; if _name_ = 'Probt';
ajpvalue=col1+0; wi1pvalue=col2+0; drop col1 col2;
patient=&patno; proc sort; by patient; drop col1 col2 col3;

data z1;set z; if _source_ = 'ERROR';
patient=&patno; keep ss patient; proc sort; by patient;

data zz;merge allt c z1 allt2 allt3;by patient;

data ∈set zz;
keep ajhat seajhat wi1hat sewi1hat xi1 xi2 ss ajpvalue wi1pvalue;
if _n_ =1;
%mend est;
%est(pat1,1);%est(pat2,2);%est(pat3,3);%est(pat4,4);%est(pat5,5);

data final;set pat1 pat2 pat3 pat4 pat5;
errorMS=SS; drop ss probt;

data final2;set final;
proc print; var ajhat seajhat ajpvalue wi1hat sewi1hat wi1pvalue errorms;run;

Output (c1) :
Obs ajhat seajhat ajpvalue wi1hat sewi1hat wi1pvalue errorMS
1 0.045614 0.18103 0.8429 −0.014211 0.043324 0.7982 0.25474
2 −0.009877 0.07535 0.9170 −0.005926 0.013858 0.7428 0.16667
3 0.052335 0.06301 0.5588 −0.011691 0.009038 0.4190 0.09058
4 0.051111 0.01423 0.1729 −0.009333 0.002494 0.1663 0.00200
5 −0.026667 0.11624 0.8564 0.002000 0.029933 0.9575 0.06400

data final1; set final;
proc glm; model ajhat=xi1 xi2; run;
proc glm; model wi1hat=xi1 xi2; run;
The GLM Procedure
Dependent Variable: ajhat
Source DF Sum of Squares Mean Square F Value Pr > F
Model 2 0.00286544 0.00143272 1.01 0.4980
Error 2 0.00284314 0.00142157 (c2)
Corrected Total 4 0.00570858
***
Parameter Estimate Standard Error t Value Pr > |t|
(c3) (c4) (c5)
Intercept 0.3169810450 0.22294561 1.42 0.2910
xi1 −.0008153084 0.00096733 −0.84 0.4880
xi2 −.0026179955 0.00225382 −1.16 0.3653
The GLM Procedure
Dependent Variable: wi1hat
Source DF Sum of Squares Mean Square F Value Pr > F
Model 2 0.00004202 0.00002101 0.36 0.7343
Error 2 0.00011611 0.00005806 (c6)
Corrected Total 4 0.00015813
***
Parameter Estimate Standard Error t Value Pr > |t|
(c7) (c8) (c9)
Intercept −.0443513365 0.04505511 −0.98 0.4287
xi1 0.0001076860 0.00019549 0.55 0.6370
xi2 0.0003009658 0.00045548 0.66 0.5767

In Part (c1) of the output, the individual patients analysis are given. One can determine the significance of the parameters from that output. In (c2) and (c6), the error mean squares are provided for the parameters aj’s and wi1. The estimates, standard errors, and p-values are given for the second-stage parameters in columns (c3)–(c5) and (c7)–(c9).

Table 4.6.2 Artificial data on weight loss

Volunteer Xi Wij, tij, yij
1 1200 (20, 3, 3) (40, 6, 5) (25, 9, 3.5) (30, 12, 4)
2 1200 (20, 3, 4) (25, 6, 5) (60, 12, 9) (40, 9, 7)
3 1200 (25, 6, 5) (40, 9, 7) (60, 12, 9) (30, 3, 5)
4 1500 (20, 3, 4) (25, 6, 5) (40, 9, 7) (60, 12, 10)
5 1500 (25, 6, 5) (40, 9, 6)
6 1500 (25, 6, 4) (40, 9, 6) (60, 12, 8)

The following programming lines provide the necessary output to draw inferences:

data a;input patient x w t y @@;cards;
1 1200 20 3 3 1 1200 40 6 5 1 1200 25 9 3.5 1 1200 30 12 4
2 1200 20 3 4 2 1200 25 6 5 2 1200 60 12 9 2 1200 40 9 7
3 1200 25 6 5 3 1200 40 9 7 3 1200 60 12 9 3 1200 30 3 5
4 1500 20 3 4 4 1500 25 6 5 4 1500 40 9 7 4 1500 60 12 10
5 1500 25 6 5 5 1500 40 9 6
6 1500 25 6 4 6 1500 40 9 6 6 1500 60 12 8
;
proc sort;by patient;

Step 1: Summarize the parameters b1, b2, b3 and b4 for the 6 patients

data b;set a;
%macro est(subject,out);

data c;  set b;
if patient=&subject;
proc nlin noprint;   parms b1= .1 b2=3 b3= .5 b4=1;
model y=((b1*w)+b4)/(1+exp(−(t−b2)/b3)); output out=&out parms=b1 b2 b3 b4; run;
data &out ;set &out;
proc sort nodupkey;by patient;
%mend est;

%est(1,out1); %est (2,out2); %est (3,out3);
%est(4,out4); %est (5,out5); %est (6,out6);

data final;set out1 out2 out3 out4 out5 out6;
data final1; set final;  keep patient b1 b2 b3 b4;  proc print; run;
(d1)
Obs patient b1 b2 b3 b4
1 1 0.10000 −6.1601 0.61366 1.00000
2 2 0.07514 −8.7579 4.17192 3.20507
3 3 0.07329 −9.2748 3.44509 3.68037
4 4 0.14324 2.7534 0.08630 1.36486
5 5 0.12492 −48.3823 0.50000 1.00000
6 6 0.09991 4.9635 0.50000 2.00560

Step 2: We will take b1, b2, b3 and b4 given at (d1) of the output and regress these values using the X values of the dependent variable.

data final1;set final;
proc glm; model b1=x; run;

***
Parameter Estimate Standard Error t Value Pr > |t|
(d2) (d3) (d4)
Intercept −.0575655521 0.06562982 −0.88 0.4299
x 0.0001201708 0.00004832 2.49 0.0677
 proc glm;  model b2 = x;  run;
***
Parameter Estimate Standard Error t Value Pr > |t|
(d5) (d6) (d7)
Intercept 4.634195173 79.74988058 0.06 0.9564
x −0.012126211 0.05871267 −0.21 0.8465
proc glm;  model b3 = x;  run;
***

Parameter Estimate Standard Error t Value Pr > |t|
(d8) (d9) (d10)
Intercept 11.89518939 4.85592335 2.45 0.0705
x −0.00768873 0.00357498 −2.15 0.0979
proc glm;  model b4 = x;  run;
***

Parameter Estimate Standard Error t Value Pr > |t|
(d11) (d12) (d13)
Intercept 6.298067264 3.49427421 1.80 0.1458
x −0.003227497 0.00257252 −1.25 0.2779

The parameters b1, b2, b3, and b4 for individual patients are summarized at (d1) of the output. The individual linear regressed parameters β1, β2, β3, and β4 are given in the columns (d2), (d5), (d8), and (d11) of the output. The standard errors of these parameters are given in columns (d3), (d6), (d9), and (d12). The p-values for testing these parameters are given in the columns (d4), (d7), (d10), and (d13). In our example, none of these parameters are significant.

In Table 4.6.2, artificial data with different periods was given on the volunteers to show that we can use this kind of general modeling when all periods data are not available on the subjects.

4.7 Joint Action Models

In Section 4.2, we discussed some sigmoidal curves for single-compound dose–response models. The general logistic regression model with one compound X can be rewritten as

(4.7.1)images

Here,

(4.7.2)images

where β indicates the steepness of the dose–response function; γ is ln(dose) corresponding to a response proportion of 0.5, or ln(ED50); di is the ith dose level; and Dx is an indicator variable taking the value 1 (or 0) according to di > 0 (or di = 0), ymin and ymax being the minimum and maximum responses.

Joint action refers to the response of an individual to a combination of compounds. The combination of two compounds X1 and X2 can produce an “additive” or a “nonadditive” response. When the response is additive, no interaction exists between the two compounds. When the response is nonadditive, an interaction exists between the two compounds.

Synergism and antagonism are two terms used to describe the nonadditive joint action. Synergism is when the two compounds work together to produce an effect greater than that which would be expected by the two compounds working alone. Antagonism is when the two compounds work in competition with one another to produce an effect that is less than that which would be expected by the two compounds working alone (Ashford, 1981; Lupinacci, 2000).

From the selection of the appropriate additive and nonadditive joint action model come the concepts of “similar joint action” and “independent joint action.” Compounds competing against one another to work in the same area of the body and in the same manner are known as similar joint action. Compounds working in different areas of the body and by different methods of action are known as independent joint action (Ashford, 1981; Lupinacci, 2000).

In this monograph, we will restrict ourselves to the additive and nonadditive independent joint action models.

Let X1 and X2 be two compounds administered at d1i and d2j levels, then the additive joint response under independent joint action, Yij, can be written (see Barton, Braunberg, and Friedman, 1993) as

where ymin and ymax are defined as earlier and

(4.7.4)images
(4.7.5)images

The data can be analyzed under different assumptions on the error. By writing the model in a linear form using Taylor’s expansion, Antonello and Raghavarao (2000) gave the optimum dose levels.

In the case of nonadditivity, Barton, Braunberg, and Friedman (1993) considered the model

where

and

The optimal design points in the nonadditive case are also given by Antonello and Raghavarao (2000). In Equations (4.7.7) and (4.7.8), λ is known as nonadditivity parameter. Clearly, λ = 0 for additive joint action.

Table 4.7.1 Artificial data on the percentage reduction of diastolic BP

d i1 (mg) d i2 (mg) yij
15 25 9
15 75 9
50 25 12
50 75 11
25 50 10

The following programming lines fit the additive independent joint action model (4.7.3) assuming ymin = 0, ymax = 15 to be known:

data a;
input d1 d2 y @@;cards;
15 25 9 15 75 9 50 25 12 50 75 11 25 50 10
;

proc nlin;
parms beta1=1 beta2=1.5 gamma1=5 gamma2=4;
model y=( (1/(1+exp(−beta1*(log(d1)−gamma1)))) +(1/(1+exp(−beta2*(log(d2)−gamma2))))(1/(1+exp(−beta1*(log(d1)−gamma1))))*(1/(1+exp(−beta2*(log(d2)−gamma2)))) )*15;  run;

***

NOTE: Convergence criterion met.

***

The NLIN Procedure
Source DF Sum of Squares Mean Square F Value Approx Pr > F
Model 4 526.6 131.7 353.38 0.0399 (e1)
Error 1 0.3726 0.3726
Uncorrected Total 5 527.0
Approx
Parameter Estimate Std Error Approximate 95% Confidence Limits
(e2) (e3) (e4)
beta1 0.6573 0.1750 −1.5668 2.8814
beta2 −2.9541 37.8159 −483.4 477.5
gamma1 2.1875 0.5865 −5.2649 9.6399
gamma2 2.3591 10.2145 −127.4 132.1
***

From the output, the p-value given at (e1) tests for the significance of the model and our p-value is significant. The estimated model parameters β1, β2, γ1, and γ2 are given in column (e2). The lower and upper CI for these parameters are given in columns (e3) and (e4).

A similar program as can also be given for the model (4.7.6) in the case of nonadditive joint action model.

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