ArticleStatistics in medicine2015
A tutorial on structural equation modeling for analysis of overlapping symptoms in co-occurring conditions using MPlus.
Article in Statistics in medicine, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
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21 citing papers in PubMed, 82 citations in OpenAlex.
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- Disordered Eating in Asian American Women: Sociocultural and Culture-Specific Predictors.Frontiers in psychology · 2019Article
- Depression in people with type 2 diabetes: current perspectives.Diabetes, metabolic syndrome and obesity : targets and therapy · 2018Review
- Validation of a Scale for Mentoring Practices Specific to Scientific Communication among Trainees.UI journal · 2018Article
- Heterogeneous depression trajectories in multiple sclerosis patients.Multiple sclerosis and related disorders · 2016Article
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Authors and funding
2 authors at 1 institution in 1 country.
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Abstract
Structural equation modeling (SEM) is a very general approach to analyzing data in the presence of measurement error and complex causal relationships. In this tutorial, we describe SEM, with special attention to exploratory factor analysis, confirmatory factor analysis, and multiple indicator multiple cause modeling. The tutorial is motivated by a problem of symptom overlap routinely faced by clinicians and researchers, in which symptoms or test results are common to two or more co-occurring conditions. As a result of such overlap, diagnoses, treatment decisions, and inferences about the effectiveness of treatments for these conditions can be biased. This problem is further complicated by increasing reliance on patient-reported outcomes, which introduces systematic error based on an individual's interpretation of a test questionnaire. SEM provides flexibility in handling this type of differential item functioning and disentangling the overlap. Scales and scoring approaches can be revised to be free of this overlap, leading to better care. This tutorial uses an example of depression screening in multiple sclerosis patients in which depressive symptoms overlap with other symptoms, such as fatigue, cognitive impairment, and functional impairment. Details of how MPlus (Muthén & Muthén, Los Angeles, CA, USA) software can be used to address the symptom overlap problem, including data requirements, code and output are described in this tutorial.
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