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Background:  Allowable total error is derived in many ways, often from data on biological variation in normal individuals. We present a new principle for evaluating allowable total error: What are the diagnostic consequences of allowable total errors in terms of errors in likelihood ratio (LR)? Glycated hemoglobin A 1c  in blood (HbA 1c ) in diagnosing diabetes mellitus is used as an example. Allowable total error for HbA 1c  is 3.0% derived from data on biological variation compared to 6.0% as defined by National Glycohemoglobin Standardization Program (NGSP).

Using the likelihood ratio to evaluate allowable total error – an example with glycated hemoglobin (HbA 1c )