mmrm

Mixed models for repeated measures (MMRM) are a popular choice for analyzing longitudinal continuous outcomes in randomized clinical trials and beyond; see Cnaan, Laird and Slasor (1997) for a tutorial and Mallinckrodt, Lane and Schnell (2008) for a review. This package implements MMRM based on the marginal linear model without random effects using Template Model Builder (TMB) which enables fast and robust model fitting. Users can specify a variety of covariance matrices, weight observations, fit models with restricted or standard maximum likelihood inference, perform hypothesis testing with Satterthwaite adjusted degrees of freedom, and extract least square means estimates by using emmeans.

Main Features

• Responses are assumed normally distributed.
• Covariances:
  • Structures: unstructured, Toeplitz, AR1, compound symmetry, and ante-dependence.
  • Groups: shared covariance structure for all subjects, or group specific covariance structures.
  • Variances: homogeneous or heterogeneous across time points.
• Hypothesis testing:
  • Least square means: emmeans package can be used with model outputs to obtain least square means.
  • Degrees of freedom adjustment: Satterthwaite-adjusted one- and multi-dimensional contrasts.
• Model inference:
  • Supports REML and ML.
  • Supports weights.
  • Automatic changing of optimizer in the case of non-convergence.
  • Manual control of optimization routine.

Installation

CRAN

You can install the current stable version from CRAN with:

install.packages("mmrm")

GitHub

You can install the current development version from GitHub with:

if (!require("remotes")) {
  install.packages("remotes")
}
remotes::install_github("openpharma/mmrm")

Getting Started

You can get started by trying out the example:

library(mmrm)
fit <- mmrm(
  formula = FEV1 ~ RACE + SEX + ARMCD * AVISIT + us(AVISIT | USUBJID),
  data = fev_data
)

This specifies an MMRM with the given covariates and an unstructured covariance matrix for the timepoints (also called visits in the clinical trial context, here given by AVISIT) within the subjects (here USUBJID). While by default this uses restricted maximum likelihood (REML), it is also possible to use ML, see ?mmrm.

You can look at the results high-level:

fit
#> mmrm fit
#> 
#> Formula:     FEV1 ~ RACE + SEX + ARMCD * AVISIT + us(AVISIT | USUBJID)
#> Data:        fev_data (used 537 observations from 197 subjects with maximum 4 
#> timepoints)
#> Covariance:  unstructured (10 variance parameters)
#> Method:      REML
#> Deviance:    3386.45
#> 
#> Coefficients: 
#>                   (Intercept) RACEBlack or African American 
#>                   30.77747548                    1.53049977 
#>                     RACEWhite                     SEXFemale 
#>                    5.64356535                    0.32606192 
#>                      ARMCDTRT                    AVISITVIS2 
#>                    3.77423004                    4.83958845 
#>                    AVISITVIS3                    AVISITVIS4 
#>                   10.34211288                   15.05389826 
#>           ARMCDTRT:AVISITVIS2           ARMCDTRT:AVISITVIS3 
#>                   -0.04192625                   -0.69368537 
#>           ARMCDTRT:AVISITVIS4 
#>                    0.62422703 
#> 
#> Model Inference Optimization:
#> Converged with code 0 and message: convergence: rel_reduction_of_f <= factr*epsmch

The summary() method then provides the coefficients table with Satterthwaite degrees of freedom as well as the covariance matrix estimate:

summary(fit)
#> mmrm fit
#> 
#> Formula:     FEV1 ~ RACE + SEX + ARMCD * AVISIT + us(AVISIT | USUBJID)
#> Data:        fev_data (used 537 observations from 197 subjects with maximum 4 
#> timepoints)
#> Covariance:  unstructured (10 variance parameters)
#> Method:      REML
#> 
#> Model selection criteria:
#>      AIC      BIC   logLik deviance 
#>   3406.4   3439.3  -1693.2   3386.4 
#> 
#> Coefficients: 
#>                                Estimate Std. Error        df t value Pr(>|t|)
#> (Intercept)                    30.77748    0.88656 218.80000  34.715  < 2e-16
#> RACEBlack or African American   1.53050    0.62448 168.67000   2.451 0.015272
#> RACEWhite                       5.64357    0.66561 157.14000   8.479 1.56e-14
#> SEXFemale                       0.32606    0.53195 166.13000   0.613 0.540744
#> ARMCDTRT                        3.77423    1.07415 145.55000   3.514 0.000589
#> AVISITVIS2                      4.83959    0.80172 143.88000   6.037 1.27e-08
#> AVISITVIS3                     10.34211    0.82269 155.56000  12.571  < 2e-16
#> AVISITVIS4                     15.05390    1.31281 138.47000  11.467  < 2e-16
#> ARMCDTRT:AVISITVIS2            -0.04193    1.12932 138.56000  -0.037 0.970439
#> ARMCDTRT:AVISITVIS3            -0.69369    1.18765 158.17000  -0.584 0.559996
#> ARMCDTRT:AVISITVIS4             0.62423    1.85085 129.72000   0.337 0.736463
#>                                  
#> (Intercept)                   ***
#> RACEBlack or African American *  
#> RACEWhite                     ***
#> SEXFemale                        
#> ARMCDTRT                      ***
#> AVISITVIS2                    ***
#> AVISITVIS3                    ***
#> AVISITVIS4                    ***
#> ARMCDTRT:AVISITVIS2              
#> ARMCDTRT:AVISITVIS3              
#> ARMCDTRT:AVISITVIS4              
#> ---
#> Signif. codes:  0 '***' 0.001 '**' 0.01 '*' 0.05 '.' 0.1 ' ' 1
#> 
#> Covariance estimate:
#>         VIS1    VIS2    VIS3    VIS4
#> VIS1 40.5537 14.3960  4.9747 13.3867
#> VIS2 14.3960 26.5715  2.7855  7.4745
#> VIS3  4.9747  2.7855 14.8979  0.9082
#> VIS4 13.3867  7.4745  0.9082 95.5568

Details

For a more detailed introduction to all of the features of this package, look at the introduction vignette:

vignette("introduction")

For the available covariance structures, look at the covariance vignette:

vignette("covariance")

In order to understand how mmrm is fitting the models, you can read the details at:

vignette("algorithm")