title: Modelling disease progression in terms of exposure history.
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.
authors.affiliation: Department of Biostatistics, Johns Hopkins University, Baltimore, MD 21205, USA. kbandeen@jhsph.edu
authors.forename: K
authors.initials: K
authors.lastname: Bandeen-Roche
authors.forename: C B
authors.initials: CB
authors.lastname: Hall
authors.forename: W F
authors.initials: WF
authors.lastname: Stewart
authors.forename: S L
authors.initials: SL
authors.lastname: Zeger
mesh_terms: D000293:Adolescent; D001914:Boxing / Q000706:statistics & numerical data*; D001930:Brain Injuries / Q000209:etiology; D018450:Disease Progression; D004781:Environmental Exposure / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008954:Models, Biological; D015233:Models, Statistical; D011446:Prospective Studies