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Erschienen in: Critical Care 1/2009

01.02.2009 | Review

Bench-to-bedside review: The importance of the precision of the reference technique in method comparison studies – with specific reference to the measurement of cardiac output

verfasst von: Maurizio Cecconi, Andrew Rhodes, Jan Poloniecki, Giorgio Della Rocca, R Michael Grounds

Erschienen in: Critical Care | Ausgabe 1/2009

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Abstract

Bland-Altman analysis is used for assessing agreement between two measurements of the same clinical variable. In the field of cardiac output monitoring, its results, in terms of bias and limits of agreement, are often difficult to interpret, leading clinicians to use a cutoff of 30% in the percentage error in order to decide whether a new technique may be considered a good alternative. This percentage error of ± 30% arises from the assumption that the commonly used reference technique, intermittent thermodilution, has a precision of ± 20% or less. The combination of two precisions of ± 20% equates to a total error of ± 28.3%, which is commonly rounded up to ± 30%. Thus, finding a percentage error of less than ± 30% should equate to the new tested technique having an error similar to the reference, which therefore should be acceptable. In a worked example in this paper, we discuss the limitations of this approach, in particular in regard to the situation in which the reference technique may be either more or less precise than would normally be expected. This can lead to inappropriate conclusions being drawn from data acquired in validation studies of new monitoring technologies. We conclude that it is not acceptable to present comparison studies quoting percentage error as an acceptability criteria without reporting the precision of the reference technique.
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Metadaten
Titel
Bench-to-bedside review: The importance of the precision of the reference technique in method comparison studies – with specific reference to the measurement of cardiac output
verfasst von
Maurizio Cecconi
Andrew Rhodes
Jan Poloniecki
Giorgio Della Rocca
R Michael Grounds
Publikationsdatum
01.02.2009
Verlag
BioMed Central
Erschienen in
Critical Care / Ausgabe 1/2009
Elektronische ISSN: 1364-8535
DOI
https://doi.org/10.1186/cc7129

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