Nonparametric estimation of waiting time distributions in a Markov model based on current status data

We construct nonparametric estimators of state waiting time distribution functions in a Markov multistate model using current status data. This is a particularly difficult problem since neither the entry nor the exit times of a given state are directly observed. These estimators are obtained, using the Markov property, from estimators of counting processes of state entry and exit times, as well as, the size of “at risk” sets of state entry and transitions out of that state. Consistency of our estimators is established. Finite-sample behavior of our estimators is studied by simulation, in which we show that our estimators based on current status data compare well with those based on complete data. We also illustrate our method using a pubertal development data set obtained from the NHANES III [1997. NHANES III Reference Manuals and Reports (CD-ROM). Analytic and Reporting Guidelines: The Third National Health and Nutrition Examination Survey (1988–94). National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD] study.