ArticlePloS one2022
The Bland-Altman method should not be used when one of the two measurement methods has negligible measurement errors.
Article in PloS one, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Analytical Agreement Between the Vision C Automated ESR Analyzer and the Manual Westergren Reference Method: A Prospective Method Comparison Study.Diagnostics (Basel, Switzerland) · 2026Article
- Electroretinographic Findings in Fragile X, Premutation, and Controls: A Study of Biomarker Correlations.International journal of molecular sciences · 2025Article
- Some common statistical methods for assessing rater agreement in radiological studies.Acta radiologica (Stockholm, Sweden : 1987) · 2025Review
- Assessing Shoulder Proprioceptive Sense of Force: Hand-Held Dynamometer Reliability and Comparison with Isokinetic Protocols.International journal of sports physical therapy · 2025Article
- Preliminary comparisons between a point-of-care ketometer and reference method using Steller sea lion pup whole blood and plasma.Conservation physiology · 2024Article
- Reliability Associated with the Measurement of Continuous Variables in Veterinary Medicine: What the Different Possible Indicators Tell, and How to Use and Report Them.Animals : an open access journal from MDPI · 2023Article
- Performance of the Digital Dietary Assessment Tool MyFoodRepo.Nutrients · 2022Article
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Authors and funding
4 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundThe Bland-Altman limits of agreement (LoA) method is almost universally used to compare two measurement methods when the outcome is continuous, despite warnings regarding the often-violated strong underlying statistical assumptions. In settings where only a single measurement per individual has been performed and one of the two measurement methods is exempt (or almost) from any measurement error, the LoA method provides biased results, whereas this is not the case for linear regression.
methodsThus, our goal is to explain why this happens and illustrate the advantage of linear regression in this particular setting. For our illustration, we used two data sets: a sample of simulated data, where the truth is known, and data from a validation study on the accuracy of a smartphone image-based dietary intake assessment tool.
resultsOur results show that when one of the two measurement methods is exempt (or almost) from any measurement errors, the LoA method should not be used as it provides biased results. In contrast, linear regression of the differences on the precise method was unbiased.
conclusionsThe LoA method should be abandoned in favor of linear regression when one of the two measurement methods is exempt (or almost) from measurement errors.
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