Multimorbidity from Diabetes, Heart Failure, and Related Conditions: Assessing a Panel of Depressive Symptoms as Both Formative and Reflective Indicators of a Latent Trait

Through exploring specific conditions (diabetes, heart failure, related vascular/metabolic diagnoses) and their multimorbidities, I develop a more thorough means to adjust confounders of clinical targets within main or interactive contexts in epidemiological panel studies. Regression-based multiple...

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Autor principal:	Richard B. Francoeur
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	diabetes heart failure depression symptom clusters metabolite panels formative indicators Mathematics QA1-939
Acceso en línea:	https://doaj.org/article/ba54fc39d39d47a9a1c3820274ed5d7b
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spelling	oai:doaj.org-article:ba54fc39d39d47a9a1c3820274ed5d7b2021-11-11T18:16:18ZMultimorbidity from Diabetes, Heart Failure, and Related Conditions: Assessing a Panel of Depressive Symptoms as Both Formative and Reflective Indicators of a Latent Trait10.3390/math92127152227-7390https://doaj.org/article/ba54fc39d39d47a9a1c3820274ed5d7b2021-10-01T00:00:00Zhttps://www.mdpi.com/2227-7390/9/21/2715https://doaj.org/toc/2227-7390Through exploring specific conditions (diabetes, heart failure, related vascular/metabolic diagnoses) and their multimorbidities, I develop a more thorough means to adjust confounders of clinical targets within main or interactive contexts in epidemiological panel studies. Regression-based multiple indicators-multiple causes (MIMIC) models combine multiple or moderated regression and confirmatory factor analysis. In a novel specification, each of twenty depressive symptoms is both a “formative” (causal) indicator and a “reflective” (effect) indicator of a latent trait (Depression). Although both indicators provide identical information (under different variable names), formative indicators provide “exogenous” information (outside the model) to estimate, within groups or subgroups, “endogenous” effects (recovered by the model) from the latent trait and its reflective indicators. Formative indicators within the multiple regressions constitute comprehensive proxies for unspecified confounders by completely mediating all unspecified confounder effects on the endogenous latent trait and its reflective indicators, the latter estimated through confirmatory factor analysis. Findings of symptom clusters of Depression in these specific conditions, and in subgroups that capture their synergies, corroborate parallel MIMIC models with instrumental variables that specify several known confounders, but suggest some confounding biases remain. All multimorbidities involve synergy from co-occurring diabetes and heart failure. There may be opportunities to target screening and optimize metformin treatment for these co-occurring conditions. This strategy avoids the need to specify all confounders, which may not be possible or verifiable.Richard B. FrancoeurMDPI AGarticlediabetesheart failuredepressionsymptom clustersmetabolite panelsformative indicatorsMathematicsQA1-939ENMathematics, Vol 9, Iss 2715, p 2715 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	diabetes heart failure depression symptom clusters metabolite panels formative indicators Mathematics QA1-939
spellingShingle	diabetes heart failure depression symptom clusters metabolite panels formative indicators Mathematics QA1-939 Richard B. Francoeur Multimorbidity from Diabetes, Heart Failure, and Related Conditions: Assessing a Panel of Depressive Symptoms as Both Formative and Reflective Indicators of a Latent Trait
description	Through exploring specific conditions (diabetes, heart failure, related vascular/metabolic diagnoses) and their multimorbidities, I develop a more thorough means to adjust confounders of clinical targets within main or interactive contexts in epidemiological panel studies. Regression-based multiple indicators-multiple causes (MIMIC) models combine multiple or moderated regression and confirmatory factor analysis. In a novel specification, each of twenty depressive symptoms is both a “formative” (causal) indicator and a “reflective” (effect) indicator of a latent trait (Depression). Although both indicators provide identical information (under different variable names), formative indicators provide “exogenous” information (outside the model) to estimate, within groups or subgroups, “endogenous” effects (recovered by the model) from the latent trait and its reflective indicators. Formative indicators within the multiple regressions constitute comprehensive proxies for unspecified confounders by completely mediating all unspecified confounder effects on the endogenous latent trait and its reflective indicators, the latter estimated through confirmatory factor analysis. Findings of symptom clusters of Depression in these specific conditions, and in subgroups that capture their synergies, corroborate parallel MIMIC models with instrumental variables that specify several known confounders, but suggest some confounding biases remain. All multimorbidities involve synergy from co-occurring diabetes and heart failure. There may be opportunities to target screening and optimize metformin treatment for these co-occurring conditions. This strategy avoids the need to specify all confounders, which may not be possible or verifiable.
format	article
author	Richard B. Francoeur
author_facet	Richard B. Francoeur
author_sort	Richard B. Francoeur
title	Multimorbidity from Diabetes, Heart Failure, and Related Conditions: Assessing a Panel of Depressive Symptoms as Both Formative and Reflective Indicators of a Latent Trait
title_short	Multimorbidity from Diabetes, Heart Failure, and Related Conditions: Assessing a Panel of Depressive Symptoms as Both Formative and Reflective Indicators of a Latent Trait
title_full	Multimorbidity from Diabetes, Heart Failure, and Related Conditions: Assessing a Panel of Depressive Symptoms as Both Formative and Reflective Indicators of a Latent Trait
title_fullStr	Multimorbidity from Diabetes, Heart Failure, and Related Conditions: Assessing a Panel of Depressive Symptoms as Both Formative and Reflective Indicators of a Latent Trait
title_full_unstemmed	Multimorbidity from Diabetes, Heart Failure, and Related Conditions: Assessing a Panel of Depressive Symptoms as Both Formative and Reflective Indicators of a Latent Trait
title_sort	multimorbidity from diabetes, heart failure, and related conditions: assessing a panel of depressive symptoms as both formative and reflective indicators of a latent trait
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/ba54fc39d39d47a9a1c3820274ed5d7b
work_keys_str_mv	AT richardbfrancoeur multimorbidityfromdiabetesheartfailureandrelatedconditionsassessingapanelofdepressivesymptomsasbothformativeandreflectiveindicatorsofalatenttrait
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Multimorbidity from Diabetes, Heart Failure, and Related Conditions: Assessing a Panel of Depressive Symptoms as Both Formative and Reflective Indicators of a Latent Trait

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