I am not sure I fully understand how mixed-effects models (such as mixed-effects PK/PD models) can be used for forecasting.
Some notations
Let $p \in \mathbb{N}$ with $p \geq 2$. We assume that for each individual $i \in \lbrace 1,\ldots,p \rbrace$, we have $k_i \in \mathbb{N}^{\ast}$ scalar observations $(y_{i,j})_{1 \leq j \leq k_i}$ obtained at times $(t_{i,j})_{1 \leq j \leq k_i}$. Therefore, for each individual, the observations are $\left( y_{i,j}, t_{i,j} \right)_{1 \leq j \leq k_i}$. We also assume the following model:
$$ y_{i,j} = f\left( t_{i,j}, b_i, \theta \right) + \varepsilon_{i,j} $$
where $\theta$ is a vector of parameters which contains fixed effects and variance-covariance parameters ; $b_i$ is a vector of individual random effects ; $f$ is sometimes called the structural model ; $\varepsilon_{i,j}$ is the observation noise. We assume that:
$$ b_i \sim \mathcal{N}\left( 0, \mathbf{D} \right), \quad \text{and} \quad \varepsilon_i = \begin{bmatrix} \varepsilon_{i,1} \\ \vdots \\ \varepsilon_{i, k_i} \end{bmatrix} \sim \mathcal{N}\left( 0, \mathbf{\Sigma} \right). $$
The individual random effects $b_i$ are assumed i.i.d. and independent from $\varepsilon_i$.
The question
Given $\left( y_{i,j}, t_{i,j} \right)_{\substack{1 \leq i \leq p \\ 1 \leq j \leq k_i}}$, one can obtain an estimate $\hat{\theta}$ of the model parameters $\theta$ (which contain the unique coefficients in $\mathbf{D}$ and $\mathbf{\Sigma}$) by maximizing the model likelihood. This can be done, for instance, using stochastic versions of the EM algorithm (see link above).
Assume that $\hat{\theta}$ is available.
If we are given some observations $y_{s}^{\mathrm{new}}$ for a new individual $s \notin \lbrace 1, \ldots, p \rbrace$, its individual random effects are estimated by:
$$ \widehat{b_s} = \mathop{\mathrm{argmax}} \limits_{b_s} p\left( b_s \mid y_{s}^{\mathrm{new}}, \hat{\theta} \right) $$
where $p\left( \cdot \mid y_{s}^{\mathrm{new}}, \hat{\theta} \right)$ is the posterior distribution of the random effects given the new observations $y_{s}^{\mathrm{new}}$ and the point estimate of the model parameters $\hat{\theta}$. Thanks to Bayes' theorem, this is equivalent to maximizing the product "likelihood $\times$ prior:
$$ \widehat{b_s} = \mathop{\mathrm{argmax}} \limits_{b_s} p\left( y_{s}^{\mathrm{new}} \mid b_{s}, \hat{\theta} \right) p\left( b_{s} \mid \hat{\theta} \right). $$
Now, if $t \, \longmapsto \, f(t, \cdot, \cdot)$ is a continuous function of time, we may call it a growth curve. It describes the evolution of the measurements with time. Let $i_{0} \in \lbrace 1, \ldots, p \rbrace$ and $t$ such that $t_{i_{0},1} < \ldots < t_{i_{0},k_i} < t$.
How can we use this mixed-effects model to predict the most likely value $y_{i_{0}}^{\ast}$ for individual $i_{0}$ at time $t$? This relates to forecasting since we want to predict the measurement value at a future time.
Naively, I would do as follows. Given $\left( y_{i,j}, t_{i,j} \right)_{\substack{1 \leq i \leq p \\ 1 \leq j \leq k_i}}$, I would estimate $\hat{\theta}$ (we estimate the model parameters using all the data including the past observations for individual $i_{0}$). Then I would estimate $\widehat{b_{i_{0}}}$ as described above. Eventually, I would say that:
$$ y_{i_{0}}^{\ast} = f\left( t, \widehat{b_{i_{0}}}, \hat{\theta} \right). $$
If this is right, I don't see how I would prove it mathematically. Still, I'm feeling like I'm missing something because this predicted value $y_{i_{0}}^{\ast}$ does not take into account the noise distribution. Also, I do not see how I would be able to estimate CIs for $y_{i_{0}}^{\ast}$ with this.
In a Bayesian setting (with a prior distribution on $\theta$), would I need to use the posterior predictive distribution (see this post and these notes)? From what I understand, if $y_{i_{0}}$ denotes the vector of the past observations for individual $i_{0}$, this posterior predictive distribution is given by:
$$ p\left( y_{i_{0}}^{\ast} \mid y_{i_{0}} \right) = \int_{\Theta} p\left( y_{i_{0}}^{\ast} \mid \theta, y_{i_{0}} \right) p\left( \theta \mid y_{i_{0}} \right) \, d\theta. $$
However, I'm not sure it applies here and I'm not sure where the random effects come in.
Any reference, explanation, hint,... is welcome ! :-)