Tipton Elizabeth, Shuster Jonathan
Teachers College, Columbia University, New York, NY, U.S.A.
University of Florida, Gainesville, FL, U.S.A.
Stat Med. 2017 Oct 15;36(23):3621-3635. doi: 10.1002/sim.7352. Epub 2017 Jun 29.
Bland-Altman method comparison studies are common in the medical sciences and are used to compare a new measure to a gold-standard (often costlier or more invasive) measure. The distribution of these differences is summarized by two statistics, the 'bias' and standard deviation, and these measures are combined to provide estimates of the limits of agreement (LoA). When these LoA are within the bounds of clinically insignificant differences, the new non-invasive measure is preferred. Very often, multiple Bland-Altman studies have been conducted comparing the same two measures, and random-effects meta-analysis provides a means to pool these estimates. We provide a framework for the meta-analysis of Bland-Altman studies, including methods for estimating the LoA and measures of uncertainty (i.e., confidence intervals). Importantly, these LoA are likely to be wider than those typically reported in Bland-Altman meta-analyses. Frequently, Bland-Altman studies report results based on repeated measures designs but do not properly adjust for this design in the analysis. Meta-analyses of Bland-Altman studies frequently exclude these studies for this reason. We provide a meta-analytic approach that allows inclusion of estimates from these studies. This includes adjustments to the estimate of the standard deviation and a method for pooling the estimates based upon robust variance estimation. An example is included based on a previously published meta-analysis. Copyright © 2017 John Wiley & Sons, Ltd.
布兰德-奥特曼方法比较研究在医学领域很常见，用于将一种新的测量方法与金标准测量方法（通常成本更高或侵入性更强）进行比较。这些差异的分布由两个统计量概括，即“偏差”和标准差，并且这些测量值相结合以提供一致性界限（LoA）的估计值。当这些一致性界限处于临床无显著差异的范围内时，新的非侵入性测量方法更受青睐。通常，已经进行了多项布兰德-奥特曼研究来比较相同的两种测量方法，随机效应荟萃分析提供了一种汇总这些估计值的方法。我们提供了一个布兰德-奥特曼研究荟萃分析的框架，包括估计一致性界限的方法和不确定性测量方法（即置信区间）。重要的是，这些一致性界限可能比布兰德-奥特曼荟萃分析中通常报告的要宽。通常，布兰德-奥特曼研究基于重复测量设计报告结果，但在分析中未对该设计进行适当调整。由于这个原因，布兰德-奥特曼研究的荟萃分析经常排除这些研究。我们提供了一种荟萃分析方法，允许纳入这些研究的估计值。这包括对标准差估计值的调整以及基于稳健方差估计汇总估计值的方法。基于之前发表的一项荟萃分析给出了一个示例。版权所有© 2017约翰威立父子有限公司。
