Longitudinal studies are a useful tool for investigating the course of chronic diseases. Many chronic diseases can be characterized by a set of health states. We can improve our understanding of the natural history of the disease by modeling the sequence of visited health states and the duration in each state. However, in most applications, subjects are observed only intermittently. This observation scheme creates a major modeling challenge: the transition times are not known exactly, and in some cases the path through the health states is not known.

In this manuscript we review existing approaches for modeling multi-state longitudinal data. We introduce Bayesian estimation methods and illustrate their use in two longitudinal studies of chronic disease.


Longitudinal Data Analysis and Time Series