Modelling disease progression in terms of exposure history

✍ Scribed by Karen Bandeen-Roche; Charles B. Hall; Walter F. Stewart; Scott L. Zeger

• Publisher: John Wiley and Sons
• Year: 1999
• Tongue: English
• Weight: 229 KB
• Volume: 18
• Category: Article
• ISSN: 0277-6715
• DOI: 10.1002/(sici)1097-0258(19991115)18:21<2899::aid-sim203>3.0.co;2-f

✦ Synopsis

We consider the relationship between accumulating exposure to a putative agent and the associated change in physiologic function. This type of problem is common to prospective studies of cognitive, pulmonary and cardiovascular function. A general model is proposed for data from prospective, observational studies with concurrent measures of exposures and continuous outcome measures. This model permits non-linearity in the relationship between exposure and outcome and is designed to describe outcome in terms of one's entire exposure history. As exposure data are often severely right-skewed, we use regression spline estimation methods which localize the in#uence of extreme points. We illustrate our methodology using data from a longitudinal epidemiologic investigation of the e!ects of amateur boxing on neuropsychologic function.