J Clin Monit Comput - The importance of using the correct bounds on the Bland-Altman limits of agreement when multiple measurements are recorded per patient.

Tópicos

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Resumo

The limits of agreement originally derived by Bland and Altman (Lancet i:307-310, 1986) are the most commonly used method for investigating statistical agreement between two medical devices. Bland and Altman describe a confidence interval for these limits that should always accompany the limits themselves. However, this interval presumes that the recorded differences between the two devices in question are independent. This is a reasonable assumption when only one measurement is recorded per device per patient. Bland and Altman (StatMethods Med Res 8:135-160, 1999) subsequently derived bounds for the more general case where multiple observations are recorded within each patient. Unfortunately, in practice, the bounds assuming independence are typically reported when in fact the repeated measures bounds are more appropriate. This communication illustrates the dangers of using the "original" (independence-based) bounds derived in Bland and Altman (Lancet i:307-310, 1986) in the presence of repeated measures per patient.

Resumo Limpo

limit agreement origin deriv bland altman lancet common use method investig statist agreement two medic devic bland altman describ confid interv limit alway accompani limit howev interv presum record differ two devic question independ reason assumpt one measur record per devic per patient bland altman statmethod med res subsequ deriv bound general case multipl observ record within patient unfortun practic bound assum independ typic report fact repeat measur bound appropri communic illustr danger use origin independencebas bound deriv bland altman lancet presenc repeat measur per patient

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