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When evaluating the clinical performance of a medical imaging device, amulti-reader multi-case (MRMC) analysis is usually applied to account for bothcase and reader variability. For a clinical task that equates to a quantitativemeasurement, an agreement analysis such as a limits of agreement (LOA) methodcan be used to compare different measurement methods. In this work, weintroduce four types of comparisons; these types differ depending on whetherthe measurements are within or between readers and within or betweenmodalities. A three-way mixed effect ANOVA model is applied to estimate thevariances of individual differences, which is an essential step for estimatingLOA. To verify the estimates of LOA, we propose a hierarchical model tosimulate quantitative MRMC data. Two simulation studies were conducted tovalidate both the simulation and the LOA variance estimates. From thesimulation results, we can conclude that our estimate of variance is unbiased,and the uncertainty of the estimation drops as the number of readers and casesincreases and rises as the value of true variance increases.

Three-way Mixed Effect ANOVA to Estimate MRMC Limits of Agreement