Past exam of the mathematics course of the University of Cambridge / 2005 / iii / Paper 44 / 2 / a

In a frailty model, an individual's unobserved susceptibility to an event is represented by a nonnegative frailty random variable multiplying that individual's hazard function. Conditional on its value, subjects with the same measured covariates can therefore have different event rates. The frailty is a persistent latent characteristic of the individual, not newly sampled noise at each time.

Here the conditional hazard function is $u{e}^{\beta z}{h}_0(t)$, with baseline hazard $h_0$. A multiplier $u>1$ raises susceptibility and $u<1$ lowers it. Normalization $\mathbb{E}U=1$ fixes the frailty scale: without it, multiplying every frailty by a constant and dividing the baseline hazard by that constant would give the same individual hazards. The variance of $U$ measures unobserved heterogeneity. An atom at $U=0$, if allowed, would give a permanently zero conditional hazard.

The hazard ratio between groups is $e^{\beta }$ for individuals compared at the same frailty. It need not equal the population hazard ratio, because survival selection changes the frailty distribution among those still alive or event-free.