TY - JOUR AU - Zhang, Zhongheng PY - 2016 TI - Structural equation modeling in the context of clinical research JF - Annals of Translational Medicine; Vol 5, No 5 (March 15, 2017): Annals of Translational Medicine Y2 - 2016 KW - N2 - Structural equation modeling (SEM) has been widely used in economics, sociology and behavioral science. However, its use in clinical medicine is quite limited, probably due to technical difficulties. Because SEM is particularly suitable for analysis of complex relationships among observed variables, it must have potential applications to clinical medicine. The article introduces basic ideas of SEM in the context of clinical medicine. A simulated dataset is employed to show how to do model specification, model fit, visualization and assessment of goodness-of-fit. The first example fits a SEM with continuous outcome variable using sem() function, and the second explores the binary outcome variable using lavaan() function. UR - https://atm.amegroups.org/article/view/11780