Past exam of the mathematics course of the University of Cambridge 2013 iii Paper 30 6 a Solution Created 2026-10-03 Updated 2026-10-07
Let be the transition intensity from state to , and let be the transition intensity matrix, with . For a continuous-time multi-state model with the time-homogeneous Markov property, the transition probability matrix is , with entry . Condition on each recorded initial state. Panel visits contribute transition probabilities; an exact entry into the absorbing death state contributes a statistical probability densityThis mixed panel and exact-death likelihood sums over the living state just before death. It accounts for survival until the event; replacing its final factor by would count deaths throughout the interval.
Using the actual visit times recovered from the PDF, the three individual likelihood contributions areHere means with , not a transition probability. Subjects 8 and 9 supply no event-density factor after their last panel observation. Assume independent subjects and noninformative examination and censoring times; conditional on their observation schedule, its distribution supplies no additional statistical parameter-dependent factor. The patients' covariates can be incorporated by using their own in these same expressions.
For the progressive structure used in the subsequent output, put , , and . The progressive illness-death model permits no recovery, soWhen , the continuous limit is . Thus the likelihood contributions simplify toIntermediate unobserved disease transitions remain integrated into each panel transition probability.
Past exam of the mathematics course of the University of Cambridge 2013 iii Paper 30 6 b i Solution Created 2026-10-03 Updated 2026-10-07
The fitted progressive illness-death model has three allowed arrows: with estimated transition intensity , with , and with , all in years. State 3 is an absorbing state, and state 2 has no return arrow.
Progressive three-state model with estimated annual transition intensities
. Once in state 2, the holding time has an exponential distribution with rate , so the mean holding time from a transition intensity matrix isApply a confidence interval for an inverse rate to the printed rate interval : since inversion reverses order, the approximate 95% interval for the mean isThe time-homogeneous Markov property makes the future depend only on the current state; the exponential distribution also has the memoryless property. For a person currently in state 2,Equivalently, . Thus the fitted two-year death probability is approximately 11.6%.
