Paper detail

A bootstrap approach for validating the number of groups identified by latent class growth models

The use of longitudinal finite mixture models such as group-based trajectory modeling has seen a sharp increase during the last decades in the medical literature. However, these methods have been criticized especially because of the data-driven modelling process which involves statistical decision-making. In this paper, we propose an approach that uses bootstrap to sample observations with replacement from the original data to validate the number of groups identified and to quantify the uncertainty in the number of groups. The method allows investigating the statistical validity and the uncertainty of the groups identified in the original data by checking if the same solution is also found across the bootstrap samples. In a simulation study, we examined whether the bootstrap-estimated variability in the number of groups reflected the replication-wise variability. We also compared the replication-wise variability to the Bayesian posterior probability. We evaluated the ability of three commonly used adequacy criteria (average posterior probability, odds of correct classification and relative entropy) to identify uncertainty in the number of groups. Finally, we illustrated the proposed approach using data from the Quebec Integrated Chronic Disease Surveillance System to identify longitudinal medication patterns between 2015 and 2018 in older adults with diabetes.