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Estimating the average bias and the limits of agreement

If the differences are not related to magnitude, the mean of the differences provides an estimate of the average bias between the methods. The limits of agreement estimate the interval that a given proportion of differences between measurements is likely to lie within. The limits can be used to determine if the methods can be used interchangeably, or if a new method can replace an old method without changing the interpretation of the results.

  1. On the Analyse-it ribbon tab, in the Method Comparison group, click Estimate Agreement Limits.
    The Fit Differences task is added to the analysis task pane. Provided the differences are normally distributed, the default settings are suitable for analyzing methods with constant bias and variability.
  2. Click Recalculate.
    The results are recalculated and the analysis report updates.

The mean difference estimate is 2.1, which indicates that the Mini Wright meter reads on average 2.1 l/min higher than the Wright meter. A hypothesis test could be performed to determine if this is significantly different from zero. If it is, adjusting readings from the Mini Wright meter by subtracting 2.1 will make them agree more closely with the Wright meter.

limits of agreement

The limits of agreement estimate an interval of -73.9 to 78.1, which indicates that the Mini Wright meter may measure as much as 73.9 l/min below and 78.1 l/min above the large meter. This would be unacceptable for clinical purposes.

The confidence intervals for the mean difference and limits of agreement indicate the uncertainty in the estimates. The wide intervals are due to the small sample size and large variation of the differences. Even the most optimistic interpretation would conclude that the agreement is unacceptable.

Next topic: Understanding the importance of repeatability

  •  Tutorials
  •  Distribution tutorial
  •  Correlation / PCA tutorial
  •  Compare groups means tutorial
  •  Association in 2-way contingency tables tutorial
  •  Simple linear regression tutorial
  •  Bland-Altman method comparison tutorial
  •  Plotting the relationship between methods
  •  Estimating the average bias and the limits of agreement
  •  Understanding the importance of repeatability
  •  Using repeated measurements
  •  Dealing with a relationship between difference and magnitude of measurement
  •  Transforming the measurements to remove a relationship between differences and magnitude
  •  Estimating regression based limits of agreement when transformation is not enough
  •  Estimating nonparametric limits of agreement in non-normally distributed data
  •  Estimating the precision of a measurement procedure (CLSI EP05-A3)
  •  Evaluating the linearity of a measurement procedure (CLSI EP06-A)
  •  Verifying the precision of a measurement procedure against a performance claim and estimating the bias (CLSI EP15-A3)
  •  Pareto charts tutorial
  •  Process control charts tutorial
  •  Process capability tutorial



Version 6.15
Published 18-Apr-2023
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