title: Characterizing accuracy and precision of glucose sensors and meters.
abstract: There is need for a method to describe precision and accuracy of glucose measurement as a smooth continuous function of glucose level rather than as a step function for a few discrete ranges of glucose. We propose and illustrate a method to generate a "Glucose Precision Profile" showing absolute relative deviation (ARD) and /or %CV versus glucose level to better characterize measurement errors at any glucose level. We examine the relationship between glucose measured by test and comparator methods using linear regression. We examine bias by plotting deviation = (test - comparator method) versus glucose level. We compute the deviation, absolute deviation (AD), ARD, and standard deviation (SD) for each data pair. We utilize curve smoothing procedures to minimize the effects of random sampling variability to facilitate identification and display of the underlying relationships between ARD or %CV and glucose level. AD, ARD, SD, and %CV display smooth continuous relationships versus glucose level. Estimates of MARD and %CV are subject to relatively large errors in the hypoglycemic range due in part to a markedly nonlinear relationship with glucose level and in part to the limited number of observations in the hypoglycemic range. The curvilinear relationships of ARD and %CV versus glucose level are helpful when characterizing and comparing the precision and accuracy of glucose sensors and meters.
authors.affiliation: Biomedical Informatics Consultants LLC, Potomac, MD, USA drodbard@comcast.net.
authors.forename: David
authors.initials: D
authors.lastname: Rodbard
mesh_terms: D001786:Blood Glucose / Q000032:analysis*; D015190:Blood Glucose Self-Monitoring / Q000592:standards*; D006801:Humans; D015233:Models, Statistical; D008991:Monitoring, Physiologic / Q000592:standards
chemical_list: D001786:Blood Glucose
keywords: Bland–Altman plot; Clarke error grid; Parkes error grid; accuracy; bias; continuous glucose monitoring; diabetes mellitus type 1; diabetes mellitus type 2; glucose monitoring; mean absolute relative deviation (MARD); precision; precision absolute relative deviation (PARD); self-monitoring of blood glucose; statistical analysis