Framework to construct and interpret latent class trajectory modelling
File(s)2018_Lennon_Latent trajctory modeling_BMJ Open_2018.pdf (790.37 KB)
Published version
Author(s)
Type
Journal Article
Abstract
OBJECTIVES: Latent class trajectory modelling (LCTM) is a relatively new methodology in epidemiology to describe life-course exposures, which simplifies heterogeneous populations into homogeneous patterns or classes. However, for a given dataset, it is possible to derive scores of different models based on number of classes, model structure and trajectory property. Here, we rationalise a systematic framework to derive a 'core' favoured model. METHODS: We developed an eight-step framework: step 1: a scoping model; step 2: refining the number of classes; step 3: refining model structure (from fixed-effects through to a flexible random-effect specification); step 4: model adequacy assessment; step 5: graphical presentations; step 6: use of additional discrimination tools ('degree of separation'; Elsensohn's envelope of residual plots); step 7: clinical characterisation and plausibility; and step 8: sensitivity analysis. We illustrated these steps using data from the NIH-AARP cohort of repeated determinations of body mass index (BMI) at baseline (mean age: 62.5 years), and BMI derived by weight recall at ages 18, 35 and 50 years. RESULTS: From 288 993 participants, we derived a five-class model for each gender (men: 177 455; women: 111 538). From seven model structures, the favoured model was a proportional random quadratic structure (model F). Favourable properties were also noted for the unrestricted random quadratic structure (model G). However, class proportions varied considerably by model structure-concordance between models F and G were moderate (Cohen κ: men, 0.57; women, 0.65) but poor with other models. Model adequacy assessments, evaluations using discrimination tools, clinical plausibility and sensitivity analyses supported our model selection. CONCLUSION: We propose a framework to construct and select a 'core' LCTM, which will facilitate generalisability of results in future studies.
Date Issued
2018-06
Date Acceptance
2018-03-28
Citation
BMJ Open, 2018, 8 (7)
ISSN
2044-6055
Publisher
BMJ Journals
Journal / Book Title
BMJ Open
Volume
8
Issue
7
Copyright Statement
© 2018 The Author(s). This is an open access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/29982203
PII: bmjopen-2017-020683
Subjects
growth curves
growth mixture models
latent class models
lifetime obesity
trajectories
Publication Status
Published
Coverage Spatial
England
Article Number
e020683
Date Publish Online
2018-07-07