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ABSTRACT Paul Albert, National Heart Lung and Blood Institute Many longitudinal studies of children are concerned with the modeling of
monotonic
responses such as growth and maturation. The National Heart, Lung, and
Blood Institute
Growth and Health Study (NGHS) is a longitudinal study designed to examine
the effect of
growth and maturation on the development of obesity and related
cardiovascular risk
factors among black and white adolescent girls. Sexual maturation is
measured with an
ordinal outcome and is known to be measured with sizable diagnostic error.
Of interest is
examining the effects of race and age on the sexual maturation process.
Here we propose
a class of models for analyzing repeated monotonic ordinal responses with
diagnostic
misclassification in which we separately model the underlying monotonic
response and
misclassification processes. We develop an EM algorithm for
maximum-likelihood
estimation that incorporates covariates and randomly missing data. We use
the method to
analyze the NGHS sexual maturation data.
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