Modeling marginal features in studies of recurrent events in the presence of a terminal event

  • Per Kragh AndersenEmail author
  • Jules Angst
  • Henrik Ravn


We study models for recurrent events with special emphasis on the situation where a terminal event acts as a competing risk for the recurrent events process and where there may be gaps between periods during which subjects are at risk for the recurrent event. We focus on marginal analysis of the expected number of events and show that an Aalen–Johansen type estimator proposed by Cook and Lawless is applicable in this situation. A motivating example deals with psychiatric hospital admissions where we supplement with analyses of the marginal distribution of time to the competing event and the marginal distribution of the time spent in hospital. Pseudo-observations are used for the latter purpose.


Competing risks Expected number of events Intensity-based models Marginal models Pseudo-observations Recurrent events 



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© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Section of BiostatisticsUniversity of CopenhagenCopenhagen KDenmark
  2. 2.Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric HospitalUniversity of ZürichZurichSwitzerland
  3. 3.Novo-NordiskBagsværdDenmark

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