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RecurrentEvents-OUD-Tutorial

This GitHub repository contains all the Rcode and necessary files (R functions and data) for running all the examples presented in the tutorial entitled Modeling recurrent events: a tutorial based on relapse and remitting episodes while using medication for opioid use disorder (OUD).

The repository includes:

  1. DATA: Two .csv files with the simulated dataset mimicking data from the CTN-0051 clinical trial comparing extended-release naltrexone (XR-NTX) and buprenorphine-naloxone (BUP-NX) for treating OUD: i. "survival_models_format.csv" : dataset in the long format for implenting the Extended Cox, Parametric Survival, and longitudinal data regression models. ii. "msm_format.csv": dataset in the required format for fitting the multistate model.

  2. R scripts R scripts necessary for the implementation of the models presented in the tutorial: i. Recurrent events Tutorial_Functions.r ii. Recurrent events Tutorial_Functions_Mstate iii. parfm_sourcepack: folder with modified functions necessary for fiting the survival models with frailty.

  3. R Markdown An anootated R Markdown (.Rmd) file with step-by-step code and explanation of outputs.

  4. Tutorial Content The .pdf file with the complete report produced by the .Rmd file, presenting a polished summary of the methods, results, and plots for easy reading and sharing.

The tutorial illustrates four general modeling frameworks for analyzing recurrent events:

  • Extended Cox models (e.g., Anderson-Gill, PWP, frailty models)
  • Parametric survival models
  • Multistate models
  • Longitudinal models for binary outcomes

Each framework is demonstrated through three applied use case scenarios derived from the CTN-0051 clinical trial comparing extended-release naltrexone (XR-NTX) and buprenorphine-naloxone (BUP-NX) for treating opioid use disorder (OUD):

  • Estimating adjusted treatment effects
  • Making individual-level outcome predictions
  • Modeling recurrent transitions between remission and relapse states

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