The limits of agreement and the intraclass correlation coefficient may be inconsistent in the interpretation of agreement

• Type: Article in International Scientific Journal
• Date: 2011

Authors

Cristina Costa Santos (Author) FMUP; Joao Bernardes (Author) FMUP; Diogo Ayres de Campos (Author) FMUP; Antonia Costa (Author) FMUP; Celia Costa (Author) Other

Journal

Title: Journal of Clinical Epidemiology

Vol. 64 No. 3

Pages: 264-269

ISSN: 0895-4356

Publisher: Elsevier

Indexing

ISI Web of Knowledge - 70 Citations

Scopus - 73 Citations

Scientific classification

FOS: Medical and Health sciences > Health sciences

Other information

Authenticus ID: P-002-TZA

DOI: 10.1016/j.jclinepi.2009.11.010

Abstract (EN): Objective: To compare the interpretation of agreement in the prediction of neonatal outcome variables, using the limits of agreement (LA) and the intraclass correlation coefficient (ICC). Study Design and Setting: Three obstetricians were asked to predict neonatal outcomes independently based on the evaluation of intrapartum cardiotocographic tracings. Interobserver agreement was assessed with the LA and the ICC, and the results obtained were interpreted by six clinicians and six statisticians on a scale that established agreement as very poor, poor, fair, good, or very good. Results: Interpretation of the LA results was less consensual than the ICC results, with proportions of agreement of 0.36 (95% confidence interval [CI]: 0.28-0.44) vs. 0.63 (95% CI: 0.54-0.73), respectively. LA results suggested a fair to good agreement among obstetricians, whereas "interpretation of ICC results suggested a poor to fair agreement. LA results were more plausible with reality, suggesting that obstetricians predicted neonatal outcomes better than randomly generated values, whereas it was not always the case with the ICC. Conclusions: LA and ICC can provide inconsistent results in agreement studies. Accordingly, in the absence of better strategies to assess agreement, both should be used for this purpose, but their results need to be interpreted with caution keeping their respective limitations in mind.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 6