A Bayesian Nonparametric Approach for Semi-Competing Risks with Application to Cardiovascular Health

Abstract: We address causal estimation in semi-competing risks settings, where a non-terminal event may be precluded by one or more terminal events. We define a principal-stratification causal estimand for treatment effects on the non-terminal event, conditional on surviving past a specified landmark time. To estimate joint event-time distributions, we employ both vine-copula constructions and Bayesian nonparametric Enriched Dirichlet-process mixtures (EDPM), enabling inference under minimal parametric assumptions. We index our causal assumptions with sensitivity parameters. Posterior summaries via MCMC yield interpretable estimates with credible intervals. We illustrate the proposed method using data from a cardiovascular health study.