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Modelling disease progression in terms of exposure history
K Bandeen-Roche1, C B Hall, W F Stewart
1Department of Biostatistics, Johns Hopkins University, Baltimore, MD 21205, USA. kbandeen@jhsph.edu
Abstract:
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 influence of extreme points. We illustrate our methodology using data from a longitudinal epidemiologic investigation of the effects of amateur boxing on neuropsychologic function.