Uniformization and bounded Taylor series in Newton–Raphson method improves computational performance for a multistate transition model estimation and inference.

Multistate transition models (MSTMs) are valuable tools depicting disease progression. However, due to the complexity of MSTMs, larger sample size and longer follow-up time in real-world data, the computation of statistical estimation and inference for MSTMs becomes challenging. A bounded Taylor series in Newton–Raphson procedure is proposed which leverages the uniformization technique to derive maximum likelihood estimates and corresponding covariance matrix. The proposed method, namely uniformization Taylor-bounded Newton–Raphson, is validated in three simulation studies, which demonstrate the accuracy in parameter estimation, the efficiency in computation time and robustness in terms of different situations. This method is also illustrated using a large electronic medical record data related to statin-induced side effects and discontinuation. [ABSTRACT FROM AUTHOR]