Structural equation models in medical research
- 1 August 1992
- journal article
- review article
- Published by SAGE Publications in Statistical Methods in Medical Research
- Vol. 1 (2), 159-181
- https://doi.org/10.1177/096228029200100203
Abstract
Structural equation modelling (SEM) is a modern statistical method that allows one to evaluate causal hypotheses on a set of intercorrelated nonexperimental data. The sample variances and covariances, and possibly the means, are compared to those predicted by a theory-based hypothetical model after optimal estimation of the parameters of the model. The goodness-of-fit of the empirical data to the hypothesized model is evaluated statistically. This review describes the underlying statistical theory and rationale of SEM. Both confirmatory factor analysis and latent variable path models are discussed. The applicability of SEM to assessment of reliability and validity is noted. A detailed example is provided, and several examples from the medical literature are briefly reviewed. Cautions regarding the possible misuse or misinterpretation of the technique are also mentioned. Possible future directions for the use of SEM in medical research are suggested. Two appendices provide more technical details.Keywords
This publication has 64 references indexed in Scilit:
- The Relation between Perinatal Conditions and Developmental Outcome in Low Birthweight Infants: Comparison of Two CohortsActa Paediatrica, 1991
- Simultaneous genetic analysis of longitudinal means and covariance structure in the simplex model using twin dataBehavior Genetics, 1991
- The Body-Mass Index of Twins Who Have Been Reared ApartThe New England Journal of Medicine, 1990
- Univariate genetic analysis of blood pressure in children (The Medical College of Virginia Twin Study)The American Journal of Cardiology, 1989
- Neurobehavioral effects of prenatal alcohol: Part III. PLS analyses of neuropsychologic testsNeurotoxicology and Teratology, 1989
- Neurobehavioral effects of prenatal alcohol: Part II. Partial Least Squares analysisNeurotoxicology and Teratology, 1989
- Discriminant validity of lateral sensorimotor tests in childrenJournal of Clinical and Experimental Neuropsychology, 1988
- Effectiveness in Health CareThe New England Journal of Medicine, 1988
- An introduction to structural equation modelsJournal of Clinical and Experimental Neuropsychology, 1988
- Goodness-of-fit indexes in confirmatory factor analysis: The effect of sample size.Psychological Bulletin, 1988