title: Qualitative longitudinal analysis of symptoms in patients with primary and metastatic brain tumours.
abstract: Primary and metastatic brain tumour patients are treated with surgery, radiation therapy and chemotherapy. Such treatments often result in short- and long-term symptoms that impact cognitive, emotional and physical function. Therefore, understanding the transition of symptom burden over time is important for guiding treatment and follow-up of brain tumour patients with symptom-specific interventions. We describe the use of a hidden Markov model with person-specific random effects for the temporal pattern of symptom burden. Clinically relevant covariates are also incorporated in the analysis through the use of generalized linear models.
authors.affiliation: Vrije Universiteit Medical Center, Amsterdam.
authors.forename: Frank
authors.initials: F
authors.lastname: Rijmen
authors.affiliation: Wake Forest University School of Medicine, Winston-Salem, USA.
authors.forename: Edward H
authors.initials: EH
authors.lastname: Ip
authors.affiliation: Wake Forest University School of Medicine, Winston-Salem, USA.
authors.forename: Stephen
authors.initials: S
authors.lastname: Rapp
authors.affiliation: Wake Forest University School of Medicine, Winston-Salem, USA.
authors.forename: Edward G
authors.initials: EG
authors.lastname: Shaw
keywords: Brain tumours; Hidden Markov model; Latent class; Quality of life; Transition probability