Stochastic EM algorithm for generalized exponential cure rate model and an empirical study

In this paper, we consider two well-known parametric long-term survival models, namely, the Bernoulli cure rate model and the promotion time (or Poisson) cure rate model. Assuming the long-term survival probability to depend on a set of risk factors, the main contribution is in the development of the stochastic expectation maximization (SEM) algorithm to determine the maximum likelihood estimates of the model parameters. We carry out a detailed simulation study to demonstrate the performance of the proposed SEM algorithm. For this purpose, we assume the lifetimes due to each competing cause to follow a two-parameter generalized exponential distribution. We also compare the results obtained from the SEM algorithm with those obtained from the well-known expectation maximization (EM) algorithm. Furthermore, we investigate a simplified estimation procedure for both SEM and EM algorithms that allow the objective function to be maximized to split into simpler functions with lower dimensions with respect to model parameters. Moreover, we present examples where the EM algorithm fails to converge but the SEM algorithm still works. For illustrative purposes, we analyze a breast cancer survival data. Finally, we use a graphical method to assess the goodness-of-fit of the model with generalized exponential lifetimes.