title: Multi-state models and diabetic retinopathy.
abstract: This paper discusses the application of a multi-state model to diabetic retinopathy under the assumption that a continuous time Markov process determines the transition times between disease stages. The multi-state model consists of three transient states that represent the early stages of retinopathy, and one final absorbing state that represent the irreversible stage of retinopathy. By using a model with covariables, we explore the effects of factors that influence the onset, progression, and regression of diabetic retinopathy among subjects with insulin-dependent diabetes mellitus. We can also introduce time-dependent covariables in the model by assuming that the covariables remain constant between two observations. We can also obtain survival-type curves from each stage of the disease and for any combination of patient risk factors.
authors.affiliation: Department of Preventive Medicine and Biometrics, School of Medicine, University of Colorado Health Sciences Center, Denver 80262, USA.
authors.forename: G
authors.initials: G
authors.lastname: Marshall
authors.forename: R H
authors.initials: RH
authors.lastname: Jones
mesh_terms: D000293:Adolescent; D000328:Adult; D003930:Diabetic Retinopathy / Q000175:diagnosis*; D006801:Humans; D008390:Markov Chains; D015233:Models, Statistical; D011336:Probability