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      A Tutorial of Bland Altman Analysis in A Bayesian Framework

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          Abstract

          There are two schools of thought in statistical analysis, frequentist, and Bayesian. Though the two approaches produce similar estimations and predictions in large-sample studies, their interpretations are different. Bland Altman analysis is a statistical method that is widely used for comparing two methods of measurement. It was originally proposed under a frequentist framework, and it has not been used under a Bayesian framework despite the growing popularity of Bayesian analysis. It seems that the mathematical and computational complexity narrows access to Bayesian Bland Altman analysis. In this article, we provide a tutorial of Bayesian Bland Altman analysis. One approach we suggest is to address the objective of Bland Altman analysis via the posterior predictive distribution. We can estimate the probability of an acceptable degree of disagreement (fixed a priori) for the difference between two future measurements. To ease mathematical and computational complexity, an interface applet is provided with a guideline.

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          STATISTICAL METHODS FOR ASSESSING AGREEMENT BETWEEN TWO METHODS OF CLINICAL MEASUREMENT

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            Understanding Bland Altman analysis

            In a contemporary clinical laboratory it is very common to have to assess the agreement between two quantitative methods of measurement. The correct statistical approach to assess this degree of agreement is not obvious. Correlation and regression studies are frequently proposed. However, correlation studies the relationship between one variable and another, not the differences, and it is not recommended as a method for assessing the comparability between methods.
In 1983 Altman and Bland (B&A) proposed an alternative analysis, based on the quantification of the agreement between two quantitative measurements by studying the mean difference and constructing limits of agreement.
The B&A plot analysis is a simple way to evaluate a bias between the mean differences, and to estimate an agreement interval, within which 95% of the differences of the second method, compared to the first one, fall. Data can be analyzed both as unit differences plot and as percentage differences plot.
The B&A plot method only defines the intervals of agreements, it does not say whether those limits are acceptable or not. Acceptable limits must be defined a priori, based on clinical necessity, biological considerations or other goals.
The aim of this article is to provide guidance on the use and interpretation of Bland Altman analysis in method comparison studies.
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              Measures of Reliability in Sports Medicine and Science

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                Author and article information

                Journal
                100893864
                38335
                Meas Phys Educ Exerc Sci
                Meas Phys Educ Exerc Sci
                Measurement in physical education and exercise science
                1091-367X
                1532-7841
                16 February 2021
                20 December 2020
                2021
                19 May 2021
                : 25
                : 2
                : 137-148
                Affiliations
                Department of Mathematics and Statistics, California State University, Monterey Bay, Seaside, California, USA
                Author notes
                CONTACT Steven B. Kim stkim@ 123456csumb.edu
                Article
                NIHMS1657659
                10.1080/1091367X.2020.1853130
                8133695
                34017163
                2ca501f2-e227-455e-a360-e2567686db80

                This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License ( http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited, and is not altered, transformed, or built upon in any way.

                Published with license by Taylor & Francis Group, LLC.

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                bland altman analysis,reliability study,bayesian inference,posterior predictive distribution,informative prior

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