Statistical methods used to test for agreement of medical instruments measuring continuous variables in method comparison studies: a systematic review

BACKGROUND: Accurate values are a must in medicine. An important parameter in determining the quality of a medical instrument is agreement with a gold standard. Various statistical methods have been used to test for agreement. Some of these methods have been shown to be inappropriate. This can resul...

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Main Authors: Zaki, Rafdzah Ahmad, Bulgiba, Awang, Ismail, Roshidi, Ismail, Noor Azina
Format: Article
Language:English
Published: Public Library of Science 2012
Subjects:
Online Access:http://eprints.um.edu.my/3729/1/Statistical_Methods_Used_to_Test_for_Agreement_of_medical_instrument.pdf
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author Zaki, Rafdzah Ahmad
Bulgiba, Awang
Ismail, Roshidi
Ismail, Noor Azina
author_facet Zaki, Rafdzah Ahmad
Bulgiba, Awang
Ismail, Roshidi
Ismail, Noor Azina
author_sort Zaki, Rafdzah Ahmad
collection UM
description BACKGROUND: Accurate values are a must in medicine. An important parameter in determining the quality of a medical instrument is agreement with a gold standard. Various statistical methods have been used to test for agreement. Some of these methods have been shown to be inappropriate. This can result in misleading conclusions about the validity of an instrument. The Bland-Altman method is the most popular method judging by the many citations of the article proposing this method. However, the number of citations does not necessarily mean that this method has been applied in agreement research. No previous study has been conducted to look into this. This is the first systematic review to identify statistical methods used to test for agreement of medical instruments. The proportion of various statistical methods found in this review will also reflect the proportion of medical instruments that have been validated using those particular methods in current clinical practice. METHODOLOGY/FINDINGS: Five electronic databases were searched between 2007 and 2009 to look for agreement studies. A total of 3,260 titles were initially identified. Only 412 titles were potentially related, and finally 210 fitted the inclusion criteria. The Bland-Altman method is the most popular method with 178 (85) studies having used this method, followed by the correlation coefficient (27) and means comparison (18). Some of the inappropriate methods highlighted by Altman and Bland since the 1980s are still in use. CONCLUSIONS: This study finds that the Bland-Altman method is the most popular method used in agreement research. There are still inappropriate applications of statistical methods in some studies. It is important for a clinician or medical researcher to be aware of this issue because misleading conclusions from inappropriate analyses will jeopardize the quality of the evidence, which in turn will influence quality of care given to patients in the future.
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spelling um.eprints-37292019-11-22T01:02:42Z http://eprints.um.edu.my/3729/ Statistical methods used to test for agreement of medical instruments measuring continuous variables in method comparison studies: a systematic review Zaki, Rafdzah Ahmad Bulgiba, Awang Ismail, Roshidi Ismail, Noor Azina R Medicine BACKGROUND: Accurate values are a must in medicine. An important parameter in determining the quality of a medical instrument is agreement with a gold standard. Various statistical methods have been used to test for agreement. Some of these methods have been shown to be inappropriate. This can result in misleading conclusions about the validity of an instrument. The Bland-Altman method is the most popular method judging by the many citations of the article proposing this method. However, the number of citations does not necessarily mean that this method has been applied in agreement research. No previous study has been conducted to look into this. This is the first systematic review to identify statistical methods used to test for agreement of medical instruments. The proportion of various statistical methods found in this review will also reflect the proportion of medical instruments that have been validated using those particular methods in current clinical practice. METHODOLOGY/FINDINGS: Five electronic databases were searched between 2007 and 2009 to look for agreement studies. A total of 3,260 titles were initially identified. Only 412 titles were potentially related, and finally 210 fitted the inclusion criteria. The Bland-Altman method is the most popular method with 178 (85) studies having used this method, followed by the correlation coefficient (27) and means comparison (18). Some of the inappropriate methods highlighted by Altman and Bland since the 1980s are still in use. CONCLUSIONS: This study finds that the Bland-Altman method is the most popular method used in agreement research. There are still inappropriate applications of statistical methods in some studies. It is important for a clinician or medical researcher to be aware of this issue because misleading conclusions from inappropriate analyses will jeopardize the quality of the evidence, which in turn will influence quality of care given to patients in the future. Public Library of Science 2012 Article PeerReviewed application/pdf en http://eprints.um.edu.my/3729/1/Statistical_Methods_Used_to_Test_for_Agreement_of_medical_instrument.pdf Zaki, Rafdzah Ahmad and Bulgiba, Awang and Ismail, Roshidi and Ismail, Noor Azina (2012) Statistical methods used to test for agreement of medical instruments measuring continuous variables in method comparison studies: a systematic review. PLoS ONE, 7 (5). e37908. ISSN 1932-6203, DOI https://doi.org/10.1371/journal.pone.0037908 <https://doi.org/10.1371/journal.pone.0037908>. https://doi.org/10.1371/journal.pone.0037908 doi:10.1371/journal.pone.0037908
spellingShingle R Medicine
Zaki, Rafdzah Ahmad
Bulgiba, Awang
Ismail, Roshidi
Ismail, Noor Azina
Statistical methods used to test for agreement of medical instruments measuring continuous variables in method comparison studies: a systematic review
title Statistical methods used to test for agreement of medical instruments measuring continuous variables in method comparison studies: a systematic review
title_full Statistical methods used to test for agreement of medical instruments measuring continuous variables in method comparison studies: a systematic review
title_fullStr Statistical methods used to test for agreement of medical instruments measuring continuous variables in method comparison studies: a systematic review
title_full_unstemmed Statistical methods used to test for agreement of medical instruments measuring continuous variables in method comparison studies: a systematic review
title_short Statistical methods used to test for agreement of medical instruments measuring continuous variables in method comparison studies: a systematic review
title_sort statistical methods used to test for agreement of medical instruments measuring continuous variables in method comparison studies a systematic review
topic R Medicine
url http://eprints.um.edu.my/3729/1/Statistical_Methods_Used_to_Test_for_Agreement_of_medical_instrument.pdf
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