Assessing agreement between two methods of measuring blood glucose level without Bland–Altman limits

• Published in: Diabetes & metabolic syndrome clinical research & reviews 2023-07, Vol.17 (7), p.102805-102805, Article 102805
• Main Author: Indrayan, Abhaya
• Format: Article
• Language: English
• Subjects: Agreement assessment; Bland-Altman method; Blood Glucose; Blood glucose measurement; Clinical tolerance limits; Humans; Nonparametric method; Reproducibility of Results
• ISSN: 1871-4021; 1878-0334
• DOI: 10.1016/j.dsx.2023.102805

To describe a new method of assessing agreement between two methods of measuring blood glucose level in view of several problems with the currently used Bland-Altman method. Study the deficiencies in the Bland-Altman method and propose a simple method that overcomes these deficiencies. The simple method does not require the calculation of Bland-Altman limits. Clinical tolerance limits, which are needed anyway, can be directly used to obtain the agreement by the percentage of differences within these limits. This method is simple, robust, and nonparametric. It is more flexible also as the clinical tolerance limits can be varied for different values of the measurement such as to have close agreement at critical values and relaxed agreement at other values. Non-symmetric limits can also be set up under the simple method. The method of assessing agreement between two methods of measuring blood glucose level can be greatly improved by directly using clinical tolerance limits without calculating the Bland-Altman limits. •The Bland-Altman method is used to assess agreement between the blood glucose levels by two methods or two sites.•This method has several limitations and can give misleading results in many cases.•We describe a simple, robust, and nonparametric method that measures agreement without calculating B-A limits.•Our method has many other positive features and they are illustrated with the help of examples.