Markov structure based logistic regression for repeated measures: An application to diabetes mellitus data

In longitudinal studies, as repeated observations are made on the same individual the response variables will usually be correlated. In analyzing such data, this dependence must be taken into account to avoid misleading inferences. The focus of this paper is to apply a logistic marginal model with Markovian dependence proposed by Azzalini [A. Azzalini, Logistic regression for autocorrelated data with application to repeated measures, Biometrika 81 (1994) 767–775] to the study of the influence of time-dependent covariates on the marginal distribution of the binary response in serially correlated binary data. We have shown how to construct the model so that the covariates relate only to the mean value of the process, independent of the association parameters. After formulating the proposed model for repeated measures data, the same approach is applied to missing data. An application is provided to the diabetes mellitus data of registered patients at the Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM) in 1984, using both time stationary and time varying covariates.