HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Supplemental Data Submit an electronic Letter to the Editor about this paper View responses Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (52) Citing Articles via Google Scholar Google Scholar Articles by Dewitte, K. Articles by Thienpont, L. M. Search for Related Content PubMed PubMed Citation Articles by Dewitte, K. Articles by Thienpont, L. M. Related Collections Laboratory Management Evidence Based Laboratory Medicine and Test Utilization

Application of the Bland–Altman Plot for Interpretation of Method-Comparison Studies: A Critical Investigation of Its Practice

¹ Laboratorium voor Analytische Chemie Universiteit Gent Harelbekestraat 72 9000 Gent, Belgium

^aAuthor for correspondence. Fax 32-9-264-81-98; e-mail Linda.thienpont@rug.ac.be.

To the Editor:

Current guidelines for the combined graphical/statistical interpretation of method-comparison studies (1) include a scatter plot combined with correlation and regression analysis (2) and/or a difference plot combined with calculation of the 2s limits of the differences between the methods (the so-called 95% limits of agreement) (3)(4). The former approach has a long tradition in clinical chemistry, and its advantages and pitfalls are well known (5). The latter approach, however, which was deemed "simple both to do and to interpret" and was propagated as a substitute for regression analysis (4)(5), became available only in recent years and has increased in popularity. The general features of the Bland–Altman plot have been well described (4) (see also Fig. 1A ). The x axis shows the mean of the results of the two methods ([A + B]/2), whereas the y axis represents the absolute difference between the two methods ([B - A]). When the standard deviation increases with concentration, Bland and Altman recommend a logarithmic y scale, whereas others propose a percent y scale (6). Although generally there is not much difference in effect between using percentages and using a log transformation of the data, we prefer the percent plot (except when data extend over several orders of magnitude) because numbers can be read directly from the plot without the need for back-transformation. Additionally, the plot includes the line for the mean difference . . . [Full Text of this Article]

Acknowledgments

References

The following articles in journals at HighWire Press have cited this article:

				E. Gineikiene, M. Stoskus, and L. Griskevicius Single Nucleotide Polymorphism-Based System Improves the Applicability of Quantitative PCR for Chimerism Monitoring J. Mol. Diagn., January 1, 2009; 11(1): 66 - 74. [Abstract] [Full Text] [PDF]

				N. V. Dawson, M. E. Singer, L. Lenert, M. B. Patterson, S. A. Sami, I. Gonsenhouser, H. A. Lindstrom, K. A. Smyth, M. J. Barber, and P. J. Whitehouse Health State Valuation in Mild to Moderate Cognitive Impairment: Feasibility of Computer-Based, Direct Patient Utility Assessment Med Decis Making, April 1, 2008; 28(2): 220 - 232. [Abstract] [PDF]

				N. Janzen, M. Peter, S. Sander, U. Steuerwald, M. Terhardt, U. Holtkamp, and J. Sander Newborn Screening for Congenital Adrenal Hyperplasia: Additional Steroid Profile using Liquid Chromatography-Tandem Mass Spectrometry J. Clin. Endocrinol. Metab., July 1, 2007; 92(7): 2581 - 2589. [Abstract] [Full Text] [PDF]

				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]

				C.-C. Lin, C.-F. Chang, H.-J. Chiou, Y.-C. Sun, S.-S. Chiang, M.-W. Lin, P.-C. Lee, and W.-C. Yang Variable Pump Flow-Based Doppler Ultrasound Method: A Novel Approach to the Measurement of Access Flow in Hemodialysis Patients J. Am. Soc. Nephrol., January 1, 2005; 16(1): 229 - 236. [Abstract] [Full Text] [PDF]

				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]

				C. Wang, D. H. Catlin, L. M. Demers, B. Starcevic, and R. S. Swerdloff Measurement of Total Serum Testosterone in Adult Men: Comparison of Current Laboratory Methods Versus Liquid Chromatography-Tandem Mass Spectrometry J. Clin. Endocrinol. Metab., February 1, 2004; 89(2): 534 - 543. [Abstract] [Full Text] [PDF]

				J. T. Olesberg, M. A. Arnold, and M. J. Flanigan Online Measurement of Urea Concentration in Spent Dialysate during Hemodialysis Clin. Chem., January 1, 2004; 50(1): 175 - 181. [Abstract] [Full Text] [PDF]

				T. B. Ledue and N. Rifai Preanalytic and Analytic Sources of Variations in C-reactive Protein Measurement: Implications for Cardiovascular Disease Risk Assessment Clin. Chem., August 1, 2003; 49(8): 1258 - 1271. [Abstract] [Full Text] [PDF]

				Y. Tan, X. Sun, L. Tang, N. Zhang, Q. Han, M. Xu, X. Tan, X. Tan, and R. M. Hoffman Automated Enzymatic Assay for Homocysteine Clin. Chem., June 1, 2003; 49(6): 1029 - 1030. [Full Text] [PDF]

				M. Panteghini and F. Pagani On the Comparison of Serum and Plasma Samples in Troponin Assays Clin. Chem., May 1, 2003; 49(5): 835 - 836. [Full Text]

				R. M. Dorizzi, M. Caputo, A. Ferrari, L. Lippa, and P. Rizzotti Comparison of Serum and Heparin-Plasma Samples in Different Generations of Dimension Troponin I Assay Clin. Chem., December 1, 2002; 48(12): 2294 - 2296. [Full Text] [PDF]

eLetters: