Abstract
The Wisconsin Epidemiologic Study of Diabetic Retinopathy (WESDR) is a population based study to investigate prevalence, incidence, and progression of diabetic retinopathy. To analyze the young-onset insulin-dependent subpopulation of this study, we propose and fit a hidden Markov model. A nonhomogeneous discrete-time Markov chain describes the natural course of the disease. We also account for complicating factors such as treatment intervention and death. The model is formulated on a yearly basis so as to correspond with a common interval for physician visits. Bayesian inference is used to combine the WESDR data with the model. Because the health status of each subject was observed at several separated years, there are many unobserved variables. Markov chain Monte Carlo is used to simulate the posterior. Predictive distributions are discussed as a prognostic tool to assist researchers in evaluating costs and benefits of interventions.
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References
Dasbach, E.J., Fryback, D.G., Newcomb, P.A., Klein, R. and Klein, B.E.K. (1991). Cost-Effectiveness of Strategies for Detecting Diabetic Retinopathy, Medical Care 29 (1), 20–39.
Diabetic Retinopathy Study Group (1981). Photocoagulation Treatment of Proliferative Diabetic Retinopathy: Clinical Application of Diabetic Retinopathy Study (DRS) Findings. (DRS report No. 8), Ophthalmology 88, 583–600.
Diabetic Retinopathy Study Group (1981). Report No. 6, Design, Methods, and Baseline Results, Investigative Ophthalmology and Visual Science 21, 149–209.
Diabetic Retinopathy Study Group (1981). Report No. 7, A Modification of the Airlie House Classification of Diabetic Retinopathy, Investigative Ophthalmology and Visual Science 21, 210–226.
Garg, S.K., Marshall G., Chase, H.P., Jackson, W.E., Archer, P., and Crews, M. (1990). The Use of the Markov Process in Describing the Natural Course of Diabetic Retinopathy, Archives of Ophthalmology 108, 1245–1247.
Klein, R., Klein, B.E.K., Moss, S.E., Davis, M.D., and Demets, D.L. (1984). The Wisconsin Epidemiologic Study of Diabetic Retinopathy. II. Prevalence and Risk of Diabetic Retinopathy When Age at Diagnosis is less than 30 Years, Archives of Ophthalmology 102, 520–526.
Klein, R., Klein, B.E.K., Moss, S.E., and Cruickshanks, K.J. (1994). The Wisconsin Epidemiologic Study of diabetic retinopathy. XIV. Ten-year incidence and progression of diabetic retinopathy Archives of Ophthalmology 112(9), 1217–1228.
Klein, R., Moss, S.E., Klein, B.E.K., DeMets, D.L. (1989). Relation of ocular and systemic factors to survival in diabetes Archives of Internal Medicine 149, 266–272
McCullagh, P. and Neider, J.A. (1983). Generalized Linear Models, Chapman & Hall, London, 149–155.
Metropolis, N., Rosenbluth, A.W., Rosenbluth, M.N., Teller, A.H. and Teller, E. (1953). Equation of State Calculations by Fast Computing Machines, Journal of Chemical Physics 21, 1087–1092.
Smith, A.F.M. and Roberts, G.O. (1993). Bayesian Computation via the Gibbs Sampler and Related Markov Chain Monte Carlo Methods (with Discussion), Journal of the Royal Statistical Society, Series B 55, 3–24.
Tierney, L. (1992). Comment of papers by A. Gelman and D.B. Rubin, and C. J. Geyer, Statistical Science 7, 499–501.
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© 1997 Springer-Verlag New York, Inc.
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Craig, B.A., Newton, M.A. (1997). Modeling the History of Diabetic Retinopathy. In: Gatsonis, C., Hodges, J.S., Kass, R.E., McCulloch, R., Rossi, P., Singpurwalla, N.D. (eds) Case Studies in Bayesian Statistics. Lecture Notes in Statistics, vol 121. Springer, New York, NY. https://doi.org/10.1007/978-1-4612-2290-3_7
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DOI: https://doi.org/10.1007/978-1-4612-2290-3_7
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