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Abstract:
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Female menstrual cycle length has been shown to play an important role in couple fecundity, or the biologic capacity for reproduction irrespective of pregnancy intentions. Persistent organochlorine compounds, namely Polychlorinated biphenyls, Pesticides, Perflouroalkyls etc are persistent compounds that have been associated with changes in menstrual cycle characteristics or fecundity when modeled as individual outcomes and covariates. Given the interrelatedness of the health outcomes and the exposure to whole host of chemicals in the humans, we sought to evaluate these outcomes jointly relative to the joint profile of the chemical exposures. We employ a joint modeling approach consisting of a mixed effects accelerated failure time model for longitudinal menstrual cycle lengths and a discrete survival model for the time-to-pregnancy. In order to assess the joint effect of the highly correlated chemicals/toxicants, we explore various tree based methods in the context of joint modeling of longitudinal and time to event data.We will illustrate our method by analyzing data from the Longitudinal Investigation of Fertility and the Environment Study, a couple based prospective pregnancy
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