markovMSM

The inference in multi-state models is traditionally performed under a Markov assumption that claims that past and future of the process are independent given the present state. In this package, we consider tests of the Markov assumption that are applicable to general multi-state models. Three approaches using existing methodology are considered: a simple method based on including covariates depending on the history in Cox models for the transition intensities; methods based on measuring the discrepancy of the non-Markov estimators of the transition probabilities to the Markov Aalen-Johansen estimators; and, finally, methods that were developed by considering summaries from families of log-rank statistics where patients are grouped by the state occupied of the process at a particular time point (see Soutinho G, Meira-Machado L (2021) and Titman AC, Putter H (2020) ).

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