How to use difference plots in quantitative method comparison studies

Ann Clin Biochem 2006;43:124-129
doi:10.1258/000456306776021616
© 2006 Association for Clinical Biochemistry

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Original Articles


Patrick J Twomey


Department of Clinical Biochemistry, The Ipswich Hospital, Ipswich IP4 2SU, UK

Quantitative method comparison studies are fundamental to clinicalbiochemistry. The interpretation of quantitative method comparisonstudies relied heavily on correlation and regression methodsuntil Bland and Altman first described the concept of absolutedifference plots. Since then, many clinical biochemistry journalsadvocate the use of difference plots; however, there is a lotof ignorance about the validity as well as the pros and consof the various difference plots. The most important issue inquantitative method comparisons studies is to determine limitsof agreement that are valid across the whole range of valuesin the study so that correct data interpretation and conclusionsoccur. This article discusses validity as well as the pros andcons of difference plots and provides means to determine limitsof agreement that are valid across the whole range of valuesin method comparison studies. Accordingly, correct data interpretationwill be more likely and better conclusions should be arrivedas a result.


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