NDLI: 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

Content Provider	Springer Nature : BioMed Central
Author	Cecconi, Maurizio Rhodes, Andrew Poloniecki, Jan Della Rocca, Giorgio Grounds, R Michael
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.
Related Links	https://ccforum.biomedcentral.com/counter/pdf/10.1186/cc7129.pdf
Ending Page	6
Page Count	6
Starting Page	1
File Format	HTM / HTML
ISSN	13648535
DOI	10.1186/cc7129
Journal	Critical Care
Issue Number	1
Volume Number	13
Language	English
Publisher	BioMed Central
Publisher Date	2009-01-13
Access Restriction	Open
Subject Keyword	Intensive Critical Care Medicine Emergency Medicine Cardiac Output Percentage Error Pulmonary Artery Catheter Fluid Challenge Reference Technique
Content Type	Text
Resource Type	Review
Subject	Critical Care and Intensive Care Medicine
Journal Impact Factor	8.8/2023
5-Year Journal Impact Factor	10.4/2023

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