广西师范大学学报（自然科学版） ›› 2022, Vol. 40 ›› Issue (1): 125-138.doi: 10.16088/j.issn.1001-6600.2021060916

• 研究论文 • 上一篇    下一篇

临床测量中定量数据Bland-Altman一致性评价

付美子, 林炳清*   

  1. 深圳大学 数学与统计学院, 广东 深圳 518060
  • 收稿日期:2021-06-09 修回日期:2021-07-13 出版日期:2022-01-25 发布日期:2022-01-24
  • 通讯作者: 林炳清(1984—), 男, 福建三明人, 深圳大学副教授, 博士。E-mail: bqlin1416@163.com
  • 基金资助:
    国家自然科学基金(11701386)

Bland-Altman Method for Assessing Agreement of Quantitative Data in Clinical Measurement

FU Meizi, LIN Bingqing*   

  1. School of Mathematics and Statistics, Shenzhen University, Shenzhen Guangdong 518060, China
  • Received:2021-06-09 Revised:2021-07-13 Online:2022-01-25 Published:2022-01-24

PDF (PC)

1174

摘要： 随着医疗技术的进步,各种新技术与新方法不断涌现,评价这些方法测量结果的一致性尤为重要。可靠的一致性评价结果对提高医疗服务质量、减少医疗资源浪费具有重要意义。目前我国对临床测量中Bland-Altman一致性评价方法的研究较少,且在临床应用中该方法的使用不当问题凸显。本文讨论单次测量和重复测量情况下的Bland-Altman一致性评价流程,针对不同数据类型介绍其处理方式,并对该方法的使用规范进行梳理,以帮助医学工作人员在临床数据分析中正确使用统计分析方法。

关键词: 一致性评价, Bland-Altman方法, 临床测量, 定量数据, 医疗器械

Abstract: With the advancement of medical technology, new technologies and new methods continue to emerge. It is particularly important to compare and evaluate the agreement of the measurement results of the old and new methods. Reliable evaluation results of agreement are of great importance to improve the quality of medical services and reduce the waste of medical resources. Currently, there are few studies on the Bland-Altman method of agreement evaluation in clinical measurement in China, and there are many problems in the clinical application of the method. This paper discusses the Bland-Altman evaluation process of agreement in the case of single measurement and repeated measurement, and provides processing methods for different data types and the overall guideline in the hope that this can help medical researchers to choose and use statistical analysis methods properly in clinical data analysis.

Key words: assessing agreement, Bland-Altman method, clinical measurement, quantitative data, medical devices

中图分类号: 

  • R195.1
[1] BLAND J M, ALTMAN D G. Statistical methods for assessing agreement between two methods of clinical measurement[J]. The Lancet, 1986, 327(8476): 307-310. DOI: 10.1016/S0140-6736(86)90837-8.
[2]ZAKI R, BULGIBA A, ISMAIL R, et al. Statistical methods used to test for agreement of medical instruments measuring continuous variables in method comparison studies: a systematic review[J]. PLoS ONE, 2012, 7(5): e37908. DOI: 10.1371/journal.pone.0037908.
[3]LUIZ R R, SZKLO M. More than one statistical strategy to assess agreement of quantitative measurements may usefully be reported[J]. Journal of Clinical Epidemiology, 2005, 58(3): 215-216. DOI: 10.1016/j.jclinepi.2004.07.007.
[4]CAMARA O, SCHNABEL J A, RIDGWAY G R, et al. Accuracy assessment of global and local atrophy measurement techniques with realistic simulated longitudinal Alzheimer’s disease images[J]. NeuroImage, 2008, 42(2): 696-709. DOI: 10.1016/j.neuroimage.2008.04.259.
[5]周宇豪, 许金芳, 贺佳. 诊断试验一致性评价中几种方法的比较及应用[J]. 中国卫生统计, 2011, 28(1): 40-42, 46. DOI: 10.3969/j.issn.1002-3674.2011.01.012.
[6]陈卉. Bland-Altman分析在临床测量方法一致性评价中的应用[J]. 中国卫生统计, 2007, 24(3): 308-309, 315. DOI: 10.3969/j.issn.1002-3674.2007.03.029.
[7]萨建, 刘桂芬. 定量测量结果的一致性评价及Bland-Altman法的应用[J]. 中国卫生统计, 2011, 28(4): 409-411, 413. DOI: 10.3969/j.issn.1002-3674.2011.04.018.
[8]ALTMAN D G, BLAND J M. Measurement in medicine: the analysis of method comparison studies[J]. Journal of the Royal Statistical Society: Series D (The Statistician), 1983, 32(3): 307-317. DOI:10.2307/2987937.
[9]BLAND J M, ALTMAN D G. Comparing methods of measurement: why plotting difference against standard method is misleading[J]. The Lancet, 1995, 346(8982): 1085-1087. DOI: 10.1016/S0140-6736(95)91748-9.
[10]BLAND J M, ALTMAN D G. Measuring agreement in method comparison studies[J]. Statistical Methods in Medical Research, 1999, 8(2): 135-160. DOI: 10.1177/096228029900800204.
[11]BLAND J M, ALTMAN D G. Statistical methods for assessing agreement between two methods of clinical measurement[J]. International Journal of Nursing Studies, 2010, 47(8): 931-936. DOI: 10.1016/j.ijnurstu.2009.10.001.
[12]WOODMAN R J. Bland-Altman beyond the basics: creating confidence with badly behaved data[J]. Clinical and Experimental Pharmacology and Physiology, 2010, 37(2): 141-142. DOI: 10.1111/j.1440-1681.2009.05320.x.
[13]CHHAPOLA V, KANWAL S K, BRAR R. Reporting standards for Bland-Altman agreement analysis in laboratory research: a cross-sectional survey of current practice[J]. Annals of Clinical Biochemistry, 2015, 52(3): 382-386. DOI: 10.1177/0004563214553438.
[14]BLAND J M, ALTMAN D G, WARNER D S. Agreed statistics: measurement method comparison[J]. Anesthesiology, 2012, 116(1): 182-185. DOI: 10.1097/ALN.0b013e31823d7784.
[15] MANTHA S, ROIZEN M F, FLEISHER L A, et al. Comparing methods of clinical measurement: reporting standards for Bland and Altman analysis[J]. Anesthesia & Analgesia, 2000, 90(3): 593-602. DOI:10.1097/00000539-200003000-00018.
[16]DEWITTE K, FIERENS C, STÖCKL D, et al. Application of the Bland-Altman plot for interpretation of method-comparison studies: a critical investigation of its practice[J]. Clinical Chemistry, 2002, 48(5): 799-801. DOI: 10.1093/ clinchem/48.5.799.
[17]闻浩, 陆梦洁, 刘玉秀, 等. 定量测量Bland-Altman一致性评价方法研究及临床应用[J]. 医学研究生学报, 2015, 28(10): 1107-1111. DOI: 10.16571/j.cnki.1008-8199.2015.10.023.
[18]李镒冲, 李晓松. 两种测量方法定量测量结果的一致性评价[J]. 现代预防医学, 2007, 34(17): 3263-3266, 3269. DOI: 10.3969/j.issn.1003-8507.2007.17.025.
[19]王杨, 陈涛, 徐涛, 等. Bland-Altman分析结果散点分布趋势与测量方法变异程度间的关联度分析[J]. 中华疾病控制杂志, 2012, 16(6): 535-538.
[20]GIAVARINA D. Understanding Bland Altman analysis[J]. Biochemia Medica, 2015, 25(2): 141-151. DOI: 10.11613/ BM.2015.015.
[21]ZOU G. Confidence interval estimation for the Bland-Altman limits of agreement with multiple observations per individual[J]. Statistical Methods in Medical Research, 2013, 22(6): 630-642. DOI: 10.1177/0962280211402548.
[22]CARKEET A, GOH Y T. Confidence and coverage for Bland-Altman limits of agreement and their approximate confidence intervals[J]. Statistical Methods in Medical Research, 2018, 27(5): 1559-1574. DOI: 10.1177/0962280216665419.
[23]缪华章, 陈林, 刘玉秀. 定量方法对比研究一致性评价Bland-Altman法LoA的可信区间估计[J]. 中国卫生统计,2014, 31(1): 64-67.
[24]MYLES P S, CUI J. Using the Bland-Altman method to measure agreement with repeated measures[J]. British Journal of Anaesthesia, 2007, 99(3): 309-311. DOI: 10.1093/bja/aem214.
[25]TAFFÉ P. Assessing bias, precision, and agreement in method comparison studies[J]. Statistical Methods in Medical Research, 2020, 29(3): 778-796. DOI: 10.1177/0962280219844535.
[26]GERKE O. Reporting standards for a Bland-Altman agreement analysis: a review of methodological reviews[J]. Diagnostics, 2020, 10(5): 334. DOI: 10.3390/diagnostics10050334.
[1] 艾艳, 贾楠, 王媛, 郭静, 潘东东. 多性状多位点遗传关联分析的统计方法研究及其应用进展[J]. 广西师范大学学报（自然科学版）, 2022, 40(1): 1-14.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
[1] 刘国伦, 宋树祥, 岑明灿, 李桂琴, 谢丽娜. 带宽可调带阻滤波器的设计[J]. 广西师范大学学报（自然科学版）, 2018, 36(3): 1 -8 .
[2] 刘铭, 张双全, 何禹德. 基于改进SOM神经网络的异网电信用户细分研究[J]. 广西师范大学学报（自然科学版）, 2018, 36(3): 17 -24 .
[3] 胡郁葱, 陈栩, 罗嘉陵. 多起终点多车型混载的定制公交线路规划模型[J]. 广西师范大学学报（自然科学版）, 2018, 36(4): 1 -11 .
[4] 唐堂, 魏承赟, 罗晓曙, 丘森辉. 基于附加惯性项人群搜索算法的四旋翼无人机姿态控制研究[J]. 广西师范大学学报（自然科学版）, 2018, 36(4): 12 -19 .
[5] 林越, 刘廷章, 黄莉荣, 奚晓晔, 潘建. 基于双向KL距离聚类算法的变压器状态异常检测[J]. 广西师范大学学报（自然科学版）, 2018, 36(4): 20 -26 .
[6] 韦振汉, 宋树祥, 夏海英. 基于随机森林的锂离子电池荷电状态估算[J]. 广西师范大学学报（自然科学版）, 2018, 36(4): 27 -33 .
[7] 许远静, 胡维平. 基于随机森林的不同程度病态嗓音识别[J]. 广西师范大学学报（自然科学版）, 2018, 36(4): 34 -41 .
[8] 张灿龙, 苏建才, 李志欣, 王智文. 基于AdaBoost置信图的红外与可见光目标跟踪[J]. 广西师范大学学报（自然科学版）, 2018, 36(4): 42 -50 .
[9] 刘电霆, 吴丽娜. 社会网络中基于信任的LDA主题模型领域专家推荐[J]. 广西师范大学学报（自然科学版）, 2018, 36(4): 51 -58 .
[10] 姜影星, 黄文念. 非线性薛定谔-麦克斯韦方程的基态解[J]. 广西师范大学学报（自然科学版）, 2018, 36(4): 59 -66 .
版权所有 © 广西师范大学学报（自然科学版）编辑部
地址：广西桂林市三里店育才路15号　邮编：541004
电话：0773-5857325　E-mail: gxsdzkb@mailbox.gxnu.edu.cn
本系统由北京玛格泰克科技发展有限公司设计开发