JOURNAL HOME CME HOME THIS MONTH PAST ISSUES ETOC COLLECTIONS
AUTHORS REVIEWERS EDITORIAL BOARD FEEDBACK RSS HELP
A&A International Anesthesia Research Society
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a colleague
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via ISI Web of Science (46)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Mantha, S.
Right arrow Articles by Foss, J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Mantha, S.
Right arrow Articles by Foss, J.
Anesth Analg 2000;90:593-602
© 2000 International Anesthesia Research Society

ECONOMICS AND HEALTH SYSTEMS MANAGEMENT

Comparing Methods of Clinical Measurement: Reporting Standards for Bland and Altman Analysis

Srinivas Mantha, MD*,{dagger}, Michael F. Roizen, MD{dagger}, Lee A. Fleisher, MD, FACC§, Ronald Thisted, PhD{ddagger}, and Joseph Foss, MD{dagger}

*Department of Anesthesiology and Intensive Care, Nizam’s Institute of Medical Sciences, Hyderabad, India; Departments of {dagger}Anesthesia and Critical Care and {ddagger}Statistics and Health Studies, University of Chicago, Chicago, Illinois; and §Department of Anesthesiology, Johns Hopkins School of Medicine, Baltimore, Maryland

Address correspondence and reprint requests to Srinivas Mantha, MD, 13/4 RT, LIGH, Barkatpura, Hyderabad 500027, India. Address e-mail to smantha{at}satyam.net.in

Abstract

In this era of medical technology assessment and evidence-based medicine, evaluating new methods to measure physiologic variables is facilitated by standardization of reporting results. It has been proposed that assessing repeatability be followed by assessing agreement with an established technique. If the "limits of agreement" (mean bias ± 2SD) are not clinically important, then one could use two measurements interchangeably. Generalizability to larger populations is facilitated by reporting confidence intervals. We identified 44 studies that compared methods of clinical measurement published during 1996 to 1998 in seven anesthesia journals. Although 42 of 44 (95.4%) used the limits of agreement methodology for analysis, several inadequacies and inconsistencies in reporting the results were noted. Limits of agreement were defined a priori in 7.1%, repeatability was evaluated in 21.4%, and relationship (pattern) between difference and average was evaluated in 7.1%. Only one of the articles reported confidence intervals. A computer macro for the Minitab statistical package (State College, PA) is described to facilitate reporting of Bland and Altman analysis with confidence intervals. We propose standardization of nomenclature in clinical measurement comparison studies.

Implications: A literature review of anesthesia journals revealed several inadequacies and inconsistencies in statistical reports of results of comparison studies with regard to interchangeability of measurement methods. We encourage journal editors to evaluate submissions on this subject carefully to ensure that their readers can draw valid conclusions about the value of new technologies.




This article has been cited by other articles:


Home page
 Anesth. Analg.Home page
D. M. Takanishi, M. Yu, F. Lurie, E. Biuk-Aghai, H. Yamauchi, H. C. Ho, and A. D. Chapital
Peripheral Blood Hematocrit in Critically Ill Surgical Patients: An Imprecise Surrogate of True Red Blood Cell Volume
Anesth. Analg., June 1, 2008; 106(6): 1808 - 1812.
[Abstract] [Full Text] [PDF]

Home page
 Anesth. Analg.Home page
S. Hwan Kim, K. Hun Lee, K. Bong Yoon, W. Young Park, and D.-M. Yoon
Sonographic Estimation of Needle Depth for Cervical Epidural Blocks
Anesth. Analg., May 1, 2008; 106(5): 1542 - 1547.
[Abstract] [Full Text] [PDF]

Home page
 Br J AnaesthHome page
P. S. Halvorsen, A. Sokolov, M. Cvancarova, P. K. Hol, R. Lundblad, and T. I. Tonnessen
Continuous cardiac output during off-pump coronary artery bypass surgery: pulse-contour analyses vs pulmonary artery thermodilution
Br. J. Anaesth., October 1, 2007; 99(4): 484 - 492.
[Abstract] [Full Text] [PDF]

Home page
 Br J AnaesthHome page
R. E. Anderson, U. Sartipy, and J. G. Jakobsson
Use of conventional ECG electrodes for depth of anaesthesia monitoring using the cerebral state index: a clinical study in day surgery
Br. J. Anaesth., May 1, 2007; 98(5): 645 - 648.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
S. Boodhan, A. M. Maloney, and L. L. Dupuis
Extent of Agreement in Gentamicin Concentration Between Serum That Is Drawn Peripherally and From Central Venous Catheters
Pediatrics, December 1, 2006; 118(6): e1650 - e1656.
[Abstract] [Full Text] [PDF]

Home page
 Canadian J. AnesthesiaHome page
M. Bock, U. Hohlfeld, K. von Engeln, P. A. Meier, J. Motsch, and A. J. Tasman
The accuracy of a new infrared ear thermometer in patients undergoing cardiac surgery: [La precision d'un nouveau thermometre auriculaire infrarouge chez des patients de cardiochirurgie]
Can J Anesth, December 1, 2005; 52(10): 1083 - 1087.
[Abstract] [Full Text] [PDF]

Home page
 Anesth. Analg.Home page
L. A. Critchley, Z. Y. Peng, B. S. Fok, A. Lee, and R. A. Phillips
Testing the Reliability of a New Ultrasonic Cardiac Output Monitor, the USCOM, by Using Aortic Flowprobes in Anesthetized Dogs
Anesth. Analg., March 1, 2005; 100(3): 748 - 753.
[Abstract] [Full Text] [PDF]

Home page
 Anesth. Analg.Home page
J. S. Jahr, S. Osgood, S. J. Rothenberg, Q.-L. Li, A. W. Butch, R. Gunther, A. Cheung, and B. Driessen
Lactate Measurement Interference by Hemoglobin-Based Oxygen Carriers (Oxyglobin(R), Hemopure(R), and HemolinkTM)
Anesth. Analg., February 1, 2005; 100(2): 431 - 436.
[Abstract] [Full Text] [PDF]

Home page
 Anesth. Analg.Home page
S. L. Osgood, J. S. Jahr, P. Desai, J. Tsukamoto, and B. Driessen
Does Methemoglobin from Oxidized Hemoglobin-Based Oxygen Carrier (Hemoglobin Glutamer-200) Interfere with Lactate Measurement (YSI 2700 SELECTTM Biochemistry Analyzer)?
Anesth. Analg., February 1, 2005; 100(2): 437 - 439.
[Abstract] [Full Text] [PDF]

Home page
 Clin. Chem.Home page
D. Stockl, D. Rodriguez Cabaleiro, K. Van Uytfanghe, and L. M. Thienpont
Interpreting Method Comparison Studies by Use of the Bland-Altman Plot: Reflecting the Importance of Sample Size by Incorporating Confidence Limits and Predefined Error Limits in the Graphic
Clin. Chem., November 1, 2004; 50(11): 2216 - 2218.
[Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
J. A. Victorino, J. B. Borges, V. N. Okamoto, G. F. J. Matos, M. R. Tucci, M. P. R. Caramez, H. Tanaka, F. S. Sipmann, D. C. B. Santos, C. S. V. Barbas, et al.
Imbalances in Regional Lung Ventilation: A Validation Study on Electrical Impedance Tomography
Am. J. Respir. Crit. Care Med., April 1, 2004; 169(7): 791 - 800.
[Abstract] [Full Text] [PDF]

Home page
 Am J Crit CareHome page
N. L. Szaflarski
"Physicians' estimates of cardiac index and intravascular volume based on clinical assessment versus transesophageal Doppler measurements obtained by critical care nurses".
Am. J. Crit. Care., March 1, 2004; 13(2): 100 - 101.
[Full Text] [PDF]

Home page
 Am J Crit CareHome page
N. L. Szaflarski, P. Potter, M. Schallom, S. Davis, C. Sona, and M. McSweeney
"Evaluation of chemical dot thermometers in orally intubated patients".
Am. J. Crit. Care., March 1, 2004; 13(2): 169 - 170.
[Full Text] [PDF]

Home page
 Br J AnaesthHome page
M. Ganter and A. Zollinger
Continuous intravascular blood gas monitoring: development, current techniques, and clinical use of a commercial device
Br. J. Anaesth., September 1, 2003; 91(3): 397 - 407.
[Abstract] [Full Text] [PDF]

Home page
 J. Appl. Physiol.Home page
R. Serianni, J. Barash, T. Bentley, P. Sharma, J. L. Fontana, D. Via, J. Duhm, R. Bunger, and P. D. Mongan
Porcine-specific hemoglobin saturation measurements
J Appl Physiol, February 1, 2003; 94(2): 561 - 566.
[Abstract] [Full Text] [PDF]

Home page
 Anesth. Analg.Home page
A. M.-H. Ho, A. Lee, E. Ling, A. Daly, K. Teoh, and T. E. Warkentin
Agreements Between the Prothrombin Times of Blood Treated In Vitro with Heparinase During Cardiopulmonary Bypass (CPB) and Blood Sampled After CPB and Systemic Protamine
Anesth. Analg., January 1, 2003; 96(1): 15 - 20.
[Abstract] [Full Text] [PDF]

Home page
 Anesth. Analg.Home page
F. Lurie, J. S. Jahr, and B. Driessen
The Novel HemoCue(R) Plasma/Low Hemoglobin System Accurately Measures Small Concentrations of Three Different Hemoglobin-Based Oxygen Carriers in Plasma: Hemoglobin Glutamer-200 (Bovine) (Oxyglobin(R)), Hemoglobin Glutamer-250 (Bovine) (Hemopure(R)), and Hemoglobin-Raffimer (HemolinkTM)
Anesth. Analg., October 1, 2002; 95(4): 870 - 873.
[Abstract] [Full Text] [PDF]

Home page
 Clin. Chem.Home page
K. Dewitte, C. Fierens, D. Stockl, and L. M. Thienpont
Application of the Bland-Altman Plot for Interpretation of Method-Comparison Studies: A Critical Investigation of Its Practice
Clin. Chem., May 1, 2002; 48(5): 799 - 801.
[Full Text] [PDF]

Home page
 Canadian J. AnesthesiaHome page
J. S. Jahr, F. Lurie, B. Driessen, J. A. Davis, R. Gosselin, and R. A. Gunther
The HemoCue(R), a point of care B-hemoglobin photometer, measures hemoglobin concentrations accurately when mixed in vitro with canine plasma and three hemoglobin-based oxygen carriers (HBOC): [Le photometre de chevet HemoCue(R) fournit une mesure exacte de concentrations d'hemoglobine combinees in vitro a du plasma canin et a trois transporteurs d'oxygene a base d'hemoglobine]
Can J Anesth, March 1, 2002; 49(3): 243 - 248.
[Abstract] [Full Text] [PDF]

Home page
 Br J AnaesthHome page
C. K. Hofer, M. Ganter, M. Tucci, R. Klaghofer, and A. Zollinger
How reliable is length-based determination of body weight and tracheal tube size in the paediatric age group? The Broselow tape reconsidered
Br. J. Anaesth., February 1, 2002; 88(2): 283 - 285.
[Abstract] [Full Text] [PDF]

Home page
 Anesth. Analg.Home page
A. A. Awad, M. A. M. Ghobashy, R. G. Stout, D. G. Silverman, and K. H. Shelley
How Does the Plethysmogram Derived from the Pulse Oximeter Relate to Arterial Blood Pressure in Coronary Artery Bypass Graft Patients?
Anesth. Analg., December 1, 2001; 93(6): 1466 - 1471.
[Abstract] [Full Text] [PDF]


Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2000 by the International Anesthesia Research Society.