Structural equation modeling in medical research: a primer

Beran, Tanya; Violato, Claudio

doi:10.1186/1756-0500-3-267

Cited by 314 publications

(245 citation statements)

References 29 publications

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“…The goal of predictive analysis is to maximize model fit and a decision on whether to retain a particular covariate is based on statistical considerations (Bellazzi and Zupan 2008). By contrast, in an explanatory (hypothesis testing) analysis, inclusion and exclusion of control variables (confounders, mediators or effect modifiers) are driven, at least in part, by a priori reasoning (Concato et al 1993;Hernan et al 2002;Beran and Violato 2010).…”

Section: Data Analysis and Reporting Of Resultsmentioning

confidence: 99%

Systematic review of the literature on triclosan and health outcomes in humans

Goodman

Naiman

LaKind

2017

Critical Reviews in Toxicology

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The ability of epidemiologic evidence to inform regulatory decisions is largely dependent on the coherence and quality of the published literature. This systematic review examines the quality and consistency of studies assessing health outcomes associated with exposure to triclosan (TCS), an antimicrobial chemical with a short physiologic half-life. We used elements of the Biomonitoring, Environmental Epidemiology, and Short-Lived Chemicals instrument to evaluate aspects of study quality. Each methodological domain -overall design, exposure assessment, and data analysis -was categorized according to three tiers where Tier 1 indicated the highest quality. We also examined consistency of methods, results and reporting as considerations for weight of evidence (WOE) assessment. Studies were considered sufficiently comparable if they addressed the same or similar research questions. Forty-two studies met the criteria for inclusion. Only one randomized cross-over clinical trial of TCS was assigned to Tier 1 for all three domains. Most other studies were assigned to Tier 3 for at least one domain. Although the available literature examined more than 100 different health endpoints and reported hundreds of different measures of association, few studies were considered comparable. For reported measures of association, most were not significantly different from the null; the few statistically significant results represented isolated findings without a discernable across-or within-study pattern. We conclude that the current body of epidemiologic literature does not allow a meaningful WOE assessment due to methodological limitations of individual studies and lack of inter-study consistency. On the other hand, methodologically stronger studies may be used to inform future research. ARTICLE HISTORY

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Section: Data Analysis and Reporting Of Resultsmentioning

confidence: 99%

Systematic review of the literature on triclosan and health outcomes in humans

Goodman

Naiman

LaKind

2017

Critical Reviews in Toxicology

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“…The model-generated covariance structure can be as complicated as the conceptual model being tested, and has the scope of including latent variables via the observed variables in the data. One of the greatest advantages of SEM is perhaps its ability to manage measurement error, which is one of the greatest limitations of most studies (Beran and Violato 2010). Hence, SEM is a powerful multivariate tool that encompasses the techniques of multiple regression as well as factor models.…”

Section: Structural Equations Modellingmentioning

confidence: 99%

“…Buncher et al (1991) indicated that the methods of SEM are useful in studying environmental issues as this technique is well-suited to studies involving measurements at successive time points with complex interrelationships (Kelloway 1995). SEM has since been applied in disciplines, such as medicine (Stephenson et al 2006), organisational behaviour (Das et al 2011), education (Teo and Khine 2009) and evolutionary biology (Bruce et al 2003), to name a few, but has not been used extensively in epidemiology (Beran and Violato 2010). SEM allows one to move away from individual level modelling, as in regular regression models, towards modelling the overall covariance structure prevalent among the variables and captured via individual observations.…”

Section: Structural Equations Modellingmentioning

confidence: 99%

Vulnerability of a low-income community in South Africa to air pollution: Exploring the use of structural equations modelling to identify appropriate interventions

John

Das

2012

Journal of Integrative Environmental Sciences

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In this study, the relationship between certain household traits and specific environmental health outcome variables was explored in a low-income community from a peri-urban settlement in eMbalenhle, South Africa, with the aim of locating focus areas for targeting appropriate intervention. The susceptibility of this community to environmental pollution-related health outcomes may also be influenced by household-characterizing factors such as nutritional status, hygiene behaviours and other diseases that affect their immune system. Structural equations modelling was used to capture the possible web of relationships between the household traits and a combined respiratory health outcome variable. Specifically, the two traits considered at household level were socioeconomic status and household environment, both of which were latent. Results revealed that primary interventions to improve respiratory health should include converting non-flush toilets to flush toilets, increasing the number of toilets, ensuring regular waste collection, increasing access to medical care and increasing the household income.

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“…El ajuste del modelo fue examinado con: 1) la prueba χ 2 de bondad de ajuste (un valor p no significativo es deseable); 2) el índice de ajuste comparativo y el índice de ajuste no normalizado de Bentler-Bonet (CFI y BBNNFI por sus siglas en inglés; valores mayores a 0.90 son deseables) (20) ; y 3) la raíz cuadrada del cuadrado medio del error de aproximación (RMSEA por sus siglas en inglés; valores menores a 0.05 indican un excelente ajuste y entre (0.05-0.08) son aceptables (21) ). En la elección del modelo más parsimonioso se empleó el estadístico del multiplicador de Lagrange.…”

Section: Métodosunclassified

Creencias, actitudes y normas subjetivas como predictores de la intención de realizar comportamientos preventivos en hijos de personas que padecen diabetes mellitus tipo 2

Bautista¹,

Arroyo²,

Lezama³

2014

RBPS

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CREENCIAS, ACTITUDES Y NORMAS SUBJETIVAS COMO PREDICTORES DE LA INTENCIÓN DE REALIZAR COMPORTAMIENTOS PREVENTIVOS EN HIJOS DE PERSONAS QUE PADECEN DIABETES MELLITUS TIPO 2Crenças, atitudes e normas subjetivas como preditores da intenção de realizar comportamentos preventivos em filhos de indivíduos com Diabetes Mellitus tipo 2 Beliefs, attitudes and subjective norms as predictors of preventive behavioral intentions in offspring of people with Type 2 Diabetes Mellitus RESUMEN Objetivo: Analizar los conocimientos, las actitudes y las normas subjetivas como predictores de la intención de realizar comportamientos preventivos en hijos de personas con diabetes mellitus tipo 2, en dos ciudades del estado de Hidalgo, México. Métodos: Se trata de un estudio cuantitativo, no experimental, de naturaleza analítica y transversal. A través de una muestra probabilística de dos etapas, 246 hijos (entre 15 y 59 años de edad) de pacientes apuntados en un programa de diabetes en el servicio de seguridad social fueron encuestados de manera personal. Resultados: Se observó que la reducción del riesgo de contraer diabetes afecta la intención de desarrollar comportamientos preventivos mediada por la actitud hacia la prevención (p=0,000) que es el predictor más importante de tal intención (p=0,000). Las normas subjetivas también tienen un impacto significativo en la intención del comportamiento preventivo (p=0,000), aunque la actitud hacia la prevención no es afectada por las creencias sobre la obtención (p=0,095) y la gravedad de la enfermedad (p=0,056). Conclusión: La aplicación del modelo permitió identificar aspectos relevantes para apoyar la promoción de la salud orientada a influir en los procesos de cambio de comportamiento social en una población con el riesgo de contraer diabetes mellitus tipo 2 en México.Descriptores: Actitud; Promoción de la Salud; Diabetes Mellitus. RESUMO Objetivo: Analisar os conhecimentos, atitudes e normas subjetivas como preditores da intenção de realizar comportamentos preventivos em filhos de indivíduos com diabetes

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Structural equation modeling in medical research: a primer

Cited by 314 publications

References 29 publications

Systematic review of the literature on triclosan and health outcomes in humans

Systematic review of the literature on triclosan and health outcomes in humans

Vulnerability of a low-income community in South Africa to air pollution: Exploring the use of structural equations modelling to identify appropriate interventions

Creencias, actitudes y normas subjetivas como predictores de la intención de realizar comportamientos preventivos en hijos de personas que padecen diabetes mellitus tipo 2

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