MODELING REPEATED-MEASURES WITH MONOTONIC ORDINAL RESPONSES AND MISCLASSIFICATION, WITH APPLICATIONS TO STUDYING MATURATION

Many longitudinal studies of children are concerned with the modelling of monotonic responses such as growth and sexual maturation. The Nati onal Heart, Lung, and Blood Institute Growth and Health Study (NGHS) i s a longitudinal study designed to examine the effect of growth and ma turation 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 siza ble diagnostic error. Of interest is examining the effects of race and age on the sexual maturation process. Here we propose a class of mode ls for analyzing repeated monotonic ordinal responses with diagnostic misclassification in which we separately model the underlying monotoni c response and misclassification processes. We develop an EM algorithm for maximum likelihood estimation that incorporates covariates and ra ndomly missing data. We use the method to analyze the NGHS sexual matu ration data.