Relating Latent Class Membership to Continuous Distal Outcomes: Improving the LTB Approach and a Modified Three-Step Implementation

Latent class analysis often aims to relate the classes to continuous external consequences ("distal outcomes"), but estimating such relationships necessitates distributional assumptions. Lanza, Tan, and Bray (2013) suggested circumventing such assumptions with their LTB approach: Linear logistic regression of latent class membership on each distal outcome is first used, after which this estimated relationship is reversed using Bayes' rule. However, the LTB approach currently has 3 drawbacks, which we address in this article. First, LTB interchanges the assumption of normality for one of homoskedasticity, or, equivalently, of linearity of the logistic regression, leading to bias. Fortunately, we show introducing higher order terms prevents this bias. Second, we improve coverage rates by replacing approximate standard errors with resampling methods. Finally, we introduce a bias-corrected 3-step version of LTB as a practical alternative to standard LTB. The improved LTB methods are validated by a simulation study, and an example application demonstrates their usefulness.