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As in any statistical model, identification of influential observations is an essential task, as they can significantly affect the validity of inferred parameters and conclusions drawn from the data. The local influence approach is a set of methods designed to detect the effect of small perturbations of the model or data on the inference, allowing for deeper data analysis. In this paper, we derive local influence methods for multistate models and illustrate their use with a breast cancer dataset. In particular, we develop and implement local influence diagnostic techniques based on a suitable estimation equation. For simplicity, we restrict our consideration to the Multistate Proportional Hazards model, using different case\u2010weight perturbation strategies.<\/jats:p>","DOI":"10.1002\/sim.70556","type":"journal-article","created":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T06:37:03Z","timestamp":1776753423000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Novel Influence Diagnostics in Multistate Models for Breast Cancer"],"prefix":"10.1002","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-1157-7943","authenticated-orcid":false,"given":"Valeria","family":"Leiva\u2010Yamaguchi","sequence":"first","affiliation":[{"name":"MRC Biostatistics University of Cambridge  Cambridge UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0762-7618","authenticated-orcid":false,"given":"Alejandra","family":"Tapia","sequence":"additional","affiliation":[{"name":"Facultad de Matem\u00e1ticas Pontificia Universidad Cat\u00f3lica de Chile  Santiago Chile"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9819-5843","authenticated-orcid":false,"given":"Manuel","family":"Galea","sequence":"additional","affiliation":[{"name":"Facultad de Matem\u00e1ticas Pontificia Universidad Cat\u00f3lica de Chile  Santiago Chile"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0008-4884","authenticated-orcid":false,"given":"Oscar M.","family":"Rueda","sequence":"additional","affiliation":[{"name":"MRC Biostatistics University of Cambridge  Cambridge UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,4,20]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41586-019-1007-8"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0257613"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.9675"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/09622802231206473"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.9984"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.10094"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.70061"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/bimj.200510218"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1191\/0962280202SM276ra"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.4780122408"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.2517-6161.1986.tb01398.x"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00362-016-0838-8"},{"key":"e_1_2_10_14_1","volume-title":"Mixed Models: Theory and Applications With R","author":"Demidenko E.","year":"2013"},{"issue":"2030","key":"e_1_2_10_15_1","first-page":"1","article-title":"Detection of Influential Observations in Spatial Regression Model Based on Outliers and Bad Leverage Classification","volume":"13","author":"Baba A. 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