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Researchers are often interested in analyzing data that arise from a longitudinal or clustered design. Although there are a variety of standard likelihood-based approaches to analysis when the outcome variables are approximately multivariate normal, models for discrete-type outcomes generally require a different approach. Liang and Zeger formalized an approach to this problem using generalized estimating equations (GEEs) to extend generalized linear models (GLMs) to a regression setting withdoi:10.2307/2685737 fatcat:iu4jluedtvg2hey33zvhxr6uca