title: Improvements in the application and reporting of advanced Bland-Altman methods of comparison.
abstract: Bland and Altman have developed a measure called "limits of agreement" to assess correspondence of two methods of clinical measurement. In many circumstances, comparisons are made using several paired measurements in each individual subject. If such measurements are considered as statistically independent pairs, rather than as sets of measurements from separate individuals, limits of agreement will be too narrow. In addition, the confidence intervals for these limits will also be too narrow. Suitable software to compute valid limits of agreement and their confidence intervals is not readily available. Therefore, we set out to provide a freely available implementation accompanied by a formal description of the more advanced Bland-Altman comparison methods. We validate the implementation using simulated data, and demonstrate the effects caused by failing to take the presence of multiple paired measurements per individual properly into account. We propose a standard format of reporting that would improve analysis and interpretation of comparison studies.
authors.affiliation: Department of Anesthesiology P5Q, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, The Netherlands, e.olofsen@lumc.nl.
authors.forename: Erik
authors.initials: E
authors.lastname: Olofsen
authors.forename: Albert
authors.initials: A
authors.lastname: Dahan
authors.forename: Gerard
authors.initials: G
authors.lastname: Borsboom
authors.forename: Gordon
authors.initials: G
authors.lastname: Drummond
mesh_terms: D000465:Algorithms; D001699:Biometry / Q000379:methods*; D003198:Computer Simulation; D016001:Confidence Intervals; D006801:Humans; D057230:Limit of Detection; D015233:Models, Statistical; D008962:Models, Theoretical; D009010:Monte Carlo Method; D011381:Programming Languages; D015203:Reproducibility of Results; D012984:Software