A Stochastic Version of the EM Algorithm for Mixture Cure Rate Model with Exponentiated Weibull Family of Lifetimes

Handling missing values plays an important role in the analysis of survival data, especially, the ones marked by cure fraction. In this paper, we discuss the properties and implementation of stochastic approximations to the expectation-maximization (EM) algorithm to obtain maximum likelihood (ML) type estimates in situations where missing data arise naturally due to right censoring and a proportion of individuals are immune to the event of interest. A flexible family of three parameter exponentiated-Weibull (EW) distributions is assumed to characterize lifetimes of the non-immune individuals as it accommodates both monotone (increasing and decreasing) and non-monotone (unimodal and bathtub) hazard functions. To evaluate the performance of the SEM algorithm, an extensive simulation study is carried out under various parameter settings. Using likelihood ratio test we also carry out model discrimination within the EW family of distributions. Furthermore, we study the robustness of the SEM algorithm with respect to outliers and algorithm starting values. Few scenarios where stochastic EM (SEM) algorithm outperforms the well-studied EM algorithm are also examined in the given context. For further demonstration, a real survival data on cutaneous melanoma is analyzed using the proposed cure rate model with EW lifetime distribution and the proposed estimation technique. Through this data, we illustrate the applicability of the likelihood ratio test towards rejecting several well-known lifetime distributions that are nested within the wider class of EW distributions.