Modelling disease progression in terms of exposure history

Karen Bandeen-Roche, Charles B. Hall, Walter F. Stewart, Scott L. Zeger

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)2899-2916
Number of pages18
JournalStatistics in Medicine
Issue number21
StatePublished - Nov 15 1999

ASJC Scopus subject areas

  • Epidemiology
  • Statistics and Probability


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