Method Comparison (Agreement) Studies: Myths and Rationale

Unprecedented technological growth in the last quarter of twentieth century has resulted in improved health care and opened new domains of health care research. This technological leap also facilitated the paradigm shift from hospital care to home care through development of 'point of care' devices. As early diagnoses and timely referral is a key to health management, these devices play an important role in improving health. Validation of the new technology in different settings is necessary before adopting it to practice. For a binary result like pregnancy test, it is trivial to use statistical tools like sensitivity, specificity etc. For a continuous variable like blood glucose level the analysis is not straightforward. Many of us misinterpret 'association' as 'agreement'. This misinterpretation is reflected in studies which have compared two different technologies. The findings of well conducted studies do not contribute to the evidence base just because of wrong analysis strategy. We delineate on finer nuances of analysis and interpretation of method comparison studies.