A biomedical application of latent class models with random effects

Traditional latent class modelling has been used in many biomedical settings. Unfortunately, many of these applications assume that the diagnostic tests are independent given the true disease status, an assumption that is often violated in practice. Qu, Tan and Kutner developed general latent class models with random effects to model the conditional dependence among multiple diagnostic tests. In this paper latent class modelling with random effects is used to estimate the sensitivity and specificity of six screening tests for detecting Chlamydia trachomatis in endo-cervical specimens from women attending family planning clinics.