Abstract
In clinical medical health research, individual measurements sometimes appear as a mixture of ordinal and continuous responses. There are some statistical correlations between response indicators. Regarding the joint modeling of mixed responses, the effect of a set of explanatory variables on the conditional mean of mixed responses is usually studied based on a mean regression model. However, mean regression results tend to underperform for data with non-normal errors and outliers. Quantile regression (QR) offers not only robust estimates but also the ability to analyze the impact of explanatory variables on various quantiles of the response variable. In this paper, we propose a joint QR modeling approach for mixed ordinal and continuous responses and apply it to the analysis of a set of obesity risk data. Firstly, we construct the joint QR model for mixed ordinal and continuous responses based on multivariate asymmetric Laplace distribution and a latent variable model. Secondly, we perform parameter estimation of the model using a Markov chain Monte Carlo algorithm. Finally, Monte Carlo simulation and a set of obesity risk data analysis are used to verify the validity of the proposed model and method.
Keywords
Introduction
In practical applications, measured responses sometimes contain a mixture of discrete and continuous responses. In medical research, for instance, heart rate in patients with cardiovascular disease is a continuous response, while the severity of disease is an ordinal response. In educational assessment, a student’s performance is a continuous response, while their attitude toward learning is an ordinal response. In environmental science, the air quality index is a continuous response, while the pollution level is an ordinal response. In the context of the present research and the set of obesity risk data analyzed in Section 6 of this paper, the measures for individuals include body mass index (BMI) and individual obesity level, where BMI is a continuous response and obesity level is an ordinal categorical response. In the above examples, separate modeling of mixed responses may lose correlation between responses. To ensure reliable statistical inference, the joint modeling approach allows for the consideration of correlation between mixed responses. Joint modeling methods for discrete and continuous mixed responses include the multivariate marginal model, multivariate correlated error model, shared effects model, and Copula method. 1 Joint modeling methods for mixed discrete and continuous responses have received extensive attention from scholars. Catalano 2 implemented binary modeling of clustered continuous and ordinal categorical outcomes. Gueorguieva and Sanacora 3 proposed a joint correlation probit model to analyze ordinal and continuous outcomes of repeated measures. Bahrami et al. 4 proposed a latent variable model to model both continuous and ordinal correlated mixed responses and to account for missing response variables. Teimourian et al. 5 proposed a joint model for analysing multivariate mixed ordinal and continuous responses where continuous results may be skewed. Buhule et al. 6 proposed a Bayesian hierarchical joint modeling approach for analyzing highly unbalanced continuous and ordinal data on disease severity. Ekvall and Molstad 7 proposed a new method to represent the correlation between mixed continuous and discrete responses using an unstructured covariance matrix. Baghfalaki et al. 8 introduced a new shared parameter joint model of correlated continuous and binary responses by considering different missing patterns for the two longitudinal results. Ahmadi et al. 9 presented a transition copula model for longitudinal continuous and binary mixed outcomes with different missing patterns.
The above researches are based on the use of mean regression models to study joint modeling of mixed responses, however, mean regression does not typically give robust estimates for data with skewed distribution and outliers. Quantile regression ( QR), introduced by Koenker and Bassett,
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offers an alternative approach to mean regression. It allows researchers to study how a set of covariates affects various quantiles of the response variable, providing robust estimation results. Yu and Moyeed
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proposed a Bayesian QR method assuming that the error term obeys an asymmetric Laplace (AL) distribution. Koenker
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introduced a method for estimating longitudinal data in a QR model. Kozumi and Kobayashi
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proposed a Gibbs sampling algorithm to facilitate the implementation of a Bayesian QR method. Tian et al.
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proposed a linear quantile solution method based on an expectation-maximization (EM) algorithm. To analyze multi-response data, some studies have extended univariate QR to multivariate QR, which allows for the simultaneous modeling of multiple dependent variables at different quantile levels. Waldmann and Kneib
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proposed a Bayesian bivariate QR method. Petrella and Raponi
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introduced a likelihood-based approach to jointly estimate marginal conditional quantiles of multiple response variables in a linear regression framework, employing the EM algorithm to estimate the parameters by utilizing a mixed location-scale representation after re-parameterization of the multivariate asymmetric Laplace (MAL) distribution. Tian et al.
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proposed a Bayesian approach for joint estimation of a multivariate QR model and implemented a Bayesian regularization method with
In recent years, scholars have studied joint modeling of mixed responses with QR. Ghasemzadeh et al. 19 proposed a joint modeling method for mixed ordinal and continuous responses based on a random effects model. Ghasemzadeh et al. 20 proposed an EM algorithm QR method for jointly modeling discrete and continuous mixed responses based on the Gaussian Copula method. Khazaei et al. 21 proposed a new semiparametric QR method for joint analysis of mixed responses in a Bayesian framework. However, the above studies are based on univariate quantiles to study the modeling of mixed responses at the same quantile level. Therefore, in this paper, we consider multivariate QR to study the modeling of mixed responses at different quantile levels.
Variable selection is also an important issue in statistical research in mixed responses modeling. The purpose of variable selection is to select the most statistically significant or important variables from a set of covariates to construct the most effective predictive model. Some regularization methods based on penalty functions proposed by scholars are least absolute shrinkage and selection operator (LASSO),
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smoothly clipped absolute deviation,
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elastic net penalty,
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adaptive LASSO,
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bridge regression,
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minimax concave penalty
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and
In this paper, we present and examine a new joint QR modeling approach for mixed ordinal and continuous responses. The rest of this paper is structured as follows: A brief introduction to multivariate QR with the MAL distribution is given in Section 2. In Section 3, we establish the joint QR model for mixed ordinal and continuous responses based on the MAL distribution, and we construct the model’s joint hierarchical likelihood. In Section 4, the Markov chain Monte Carlo (MCMC) algorithm is employed to perform the Bayesian inference of the model. In Section 5, we conduct Monte Carlo simulations, and in Section 6 we apply the proposed method to a set of obesity risk data for analysis. Section 7 provides the discussion and conclusion.
Multivariate QR and the MAL distribution
Conditional quantiles for multi-response regression models
When there are two or more observed response variables, a model must account for the correlation among multiple response variables. Petrella et al.
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introduced the MAL distribution to jointly model the marginal conditional quantiles of multiple response variables, thus extending the AL distribution with univariate QR model to the multivariate case. We consider the following multivariate linear regression model:
In the multiple linear regression model (2.1), it is assumed that the observed response variable
Similar to the AL distribution, to facilitate Bayesian inference in QR,
The proposed model
In this section, we consider our joint regression model for mixed ordinal and continuous responses. The modeling methods for ordinal responses include the probit model, the logit model, and the latent variable model. The probit model and logit model are mainly focused on the conditional mean of ordinal responses, while the latent variable model can model the quantile of ordinal responses. In the following, the joint QR model for the ordinal and continuous mixed responses is constructed based on the latent variable model and the MAL distribution in Section 2.2.
Suppose there are
In order to jointly model the mixed ordinal and continuous responses and simultaneously account for the correlation between them using model errors, we assume that
According to the proof of Petrella,
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the marginal distribution of the MAL distribution is a univariate AL distribution. Then the continuous latent variable associated with the ordinal response
Let
Priors
For unknown parameters, we next consider appropriate prior distributions. The unknown parameters of the proposed model are estimated through posterior inference based on the joint posterior probability density. The Gibbs sampling algorithm is utilized for parameter estimation. The scale parameter
Since it is difficult to compute this prior analytically to obtain the expected posterior, we use the mixed representation of the GGD which is simple and effective in that we can decompose the prior distribution of
Hence, the hierarchical representation of the prior for
The prior distribution with respect to
In this paper, when addressing ordinal responses, we assume a zero intercept term for the ordinal model for the purpose of parameter identifiability. We specify the prior distribution of the cut-point threshold
The Bayesian joint hierarchical representation of the joint QR model for mixed ordinal and continuous responses proposed in this paper is given as
Therefore, the joint prior for the unknown parameter
The following joint posterior probability density can be obtained by combining the joint prior and joint likelihood for the specified unknown parameters:
The full conditional posterior distribution of the regression coefficient matrix The fully conditional posterior distribution of the latent variable The fully conditional posterior distribution of The fully conditional posterior distribution of the latent variable
where
where
where
The unknown parameters can be directly sampled from the corresponding fully conditional posterior distributions by the Gibbs sampling algorithm of the MCMC method. These samples can be utilized to approximate the posterior distributions of parameters. The Appendix provides a detailed derivation of the fully conditional posterior distributions for partial parameters.
Generated data
To validate the performance of the joint QR model proposed in Section 3 of this paper, Monte Carlo simulations under several different scenarios are considered in this section. Finally, we also provide an example to illustrate the performance of finite sample for the proposed estimation approach. First, a dataset with a sample size of
where
For the ordinal response, we considered four categories in the simulation. The threshold value was taken as
In this simulation, to evaluate the convergence of chains in the Bayesian MCMC algorithm, we ran three MCMC chains with different initial values for 12,000 iterations, of which the first 3,000 iterations were the burn-in period. This simulation was based on
Initial value 1:
Initial value 2:
Initial value 3:
Figure 1 shows three MCMC chains, representing the regression coefficients for different initial values of parameters. This figure shows that as the number of MCMC iterations increases, the posterior sample path diagram of MCMC chains corresponding to the three different initial values shows the characteristics of stabilization, overlapping, and flattening, and the chains fluctuate within a certain interval and remain in a stable range on the whole. Figure 2 displays the autocorrelation plot of the posterior samples of regression coefficients, which exhibit the characteristics of gradually weakening autocorrelation, fluctuation around zero, and disappearance of the trailing effect. These features indicate that the MCMC chain has reached a stable state, and has therefore successfully converged to the target posterior distribution, suggesting that reliable posterior estimation results can be obtained. In order to better illustrate the effect of the Gibbs sampling algorithm, Figure 3 displays the MCMC path plots of regression coefficients, and Figure 4 displays the histogram of posterior sample probability density of the regression parameters for 12,000 iterations. Three MCMC chains of regression coefficients when the parameters take three different sets of initial values. Note: Red lines indicate MCMC chains with initial value 1, blue lines indicate MCMC chains with initial value 2, and black lines indicate MCMC chains with initial value 3.

Three Markov chain Monte Carlo (MCMC) chains of regression coefficients when the parameters take three different sets of initial values. Note: Red lines indicate MCMC chains with initial value 1, blue lines indicate MCMC chains with initial value 2, and black lines indicate MCMC chains with initial value 3.

Posterior sample path plots of regression coefficients in Markov chain Monte Carlo (MCMC) posterior samples for 12,000 iterations of Gibbs sampling.

Autocorrelation plots of regression coefficients in Markov chain Monte Carlo (MCMC) posterior samples for 12,000 iterations of Gibbs sampling.

Histogram of the probability density of regression coefficients in Markov chain Monte Carlo (MCMC) posterior samples for 12,000 iterations of Gibbs sampling.
Table 1 summarizes the estimation results of the MCMC algorithm based on
Model 1 (joint QR) fit to strongly correlated data.
RMSE: root mean square error; CR: coverage rate; QR: quantile regression.
Model 1 (separate QR) fit to strongly correlated data.
RMSE: root mean square error; CR: coverage rate; QR: quantile regression.
Model 1 (joint QR) fit to weakly correlated data.
RMSE: root mean square error; CR: coverage rate; QR: quantile regression.
To further validate the performance of the proposed joint QR regression model for mixed responses with different correlations, we considered the weak correlation scenario. The results of parameter estimation for the joint QR model and separate QR model are shown in Tables 3 and 4, respectively. Based on weakly correlated data generated separately under two different error distributions, the regression coefficients estimated by the joint QR model under three different combinations of quantile levels had smaller bias and RMSE than the separate QR model. Compared to the separate QR model, the joint QR model estimates regression coefficients for the ordinal response with smaller bias, which aligns with the findings shown in Tables 1 and 2. These findings indicate that the joint QR model proposed in this paper is applicable to mixed ordinal and continuous responses with different degrees of correlation. Table 5 summarizes the APMSE values of the regression coefficients estimated when fitting the joint QR model and separate QR model to two different degrees of correlation. We can see that the APMSE values of the joint QR model’s regression coefficients estimation are smaller than those of the separate QR model under three different combinations of quantile levels and two assumptions regarding the distribution of error. In addition, the joint QR model performs better under the assumption of the normal error distribution than under the T-distribution, and the model performs better at the quantile level (0.5, 0.5).Taking quantile level (0.5, 0.5) as an example, under two different correlation scenarios, the sample size was increased to
Model 1 (separate QR) fit to weakly correlated data.
RMSE: root mean square error; CR: coverage rate; QR: quantile regression.
APMSE for the estimation of regression coefficients for joint QR and separate QR models.
APMSE: average posteriori mean square error; QR: quantile regression.
Parameter estimation results with sample size
RMSE: root mean square error; CR: coverage rate.
Parameter estimation results of model 2.
RMSE: root mean square error; CR: coverage rate.
In this simulation, based on sparse
Parameter estimation results of model 3.
Parameter estimation results of model 3.
RMSE: root mean square error; CR: coverage rate.
Variable selection for model 2 and model 3.
Description of variables in the obesity risk dataset.
This section applies the proposed joint QR model to the analysis of a set of obesity risk data. The dataset was obtained from the Kaggle platform, and the dataset source link is https://www.kaggle.com/datasets/jpkochar/obesity-risk-dataset. The individual information included gender, age, height, weight, family history of overweight, dietary habits, physical activity, and corresponding obesity level. A description of the variables in this dataset is presented in Table 10. The causes of obesity are complex and various, including both the influence of individual lifestyle, and the constraints of environmental and social factors. Individual dietary structure and exercise habits largely determine an individual’s risk of obesity. Elevated levels of obesity can lead to serious health risks. Obesity risk analysis can help people recognize their level of obesity and associated health risks, reminding them to take positive actions to improve their health such as controlling their diet and increasing exercise.
Obesity risk data from 600 individuals in this dataset were selected for analysis. BMI can provide a preliminary judgment of obesity but does not fully determine an individual’s level of obesity. Therefore, we used data on height and weight from this dataset to obtain the BMI of each individual as continuous response variable

Boxplot of body mass index (BMI) and obesity levels.
The joint model proposed in this paper was thus applied to analyze the effects of obesity risk factors, such as gender, age, and dietary habits, on the ordinal response obesity level and continuous response BMI at three combinations of quantile levels. We used the following joint model for the latent variables of obesity level (
Table 11 shows the (Est.), standard deviation (Std), and 95% confidence interval (95% CI) of the regression coefficients and threshold estimates for the obesity risk data. As shown in the table, eight covariates of interest had different effects on BMI and obesity level. At three combinations of quantile levels,
Parameter estimation results for the obesity risk dataset.
In this paper, we studied a joint QR model of mixed ordinal and continuous correlated responses based on the MAL distribution. In order to consider the correlation between mixed-type responses, we imposed a bivariate AL distribution for the error of ordinal response latent variable and continuous response in a linear regression framework. The model errors characterize the dependence between responses. Compared with the traditional univariate QR, the modeling approach in this paper allows for a more comprehensive study of different quantile levels combinations of mixed responses. In order to facilitate the implementation of Bayesian inference, we conducted Bayesian posterior inference via the MCMC algorithm using a hierarchical normal mixture representation of the MAL distribution and imposing
Footnotes
Acknowledgments
Authors thank editors and two referees for their constructive comments and suggestions which have greatly improved the paper.
Declaration of conflicting interests
The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The authors received the following financial support for the research, authorship, and/or publication of this article: This research was joint supported by grants from National Natural Science Foundation of China (grant 12061065), National Foundation for Social Sciences of China (grant 22BTY037) and Funds for Innovative Fundamental Research Group Project of Gansu Province (grant 23JRRA684).
Detailed derivation of the full conditional posterior distribution as follows
Derivation of the fully conditional posterior distribution of Derivation of the fully conditional posterior distribution of correlation matrix Derivation of fully conditional posterior distributions for latent variables
