Abstract #301636

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JSM 2003 Abstract #301636
Activity Number: 462
Type: Invited
Date/Time: Thursday, August 7, 2003 : 10:30 AM to 12:20 PM
Sponsor: General Methodology
Abstract - #301636
Title: Combining Limits of Agreement in a Meta-analysis of the Diagnostic Performance of a Noninvasive Measure of Cardiac Output
Author(s): Norma C. Terrin*+
Companies: Tufts--New England Medical Center
Address: Box 63, Boston, MA, 02111,
Keywords:
Abstract:

Invasive techniques for measuring cardiac output (volume of blood pumped by the heart) are risky, expensive, and impractical for outpatient use. A systematic review comparing a noninvasive technology (thoracic electrical bioimpedence, or TEB) with more invasive methods was carried out by the Evidence-based Practice Center at Tufts-New England Medical Center. One of several issues addressed by the review was the diagnostic performance of TEB. Because the overwhelming majority of diagnostic studies used only the correlation coefficient when comparing TEB to a reference standard, the systematic review combined correlation coefficients. I review the drawbacks of using the correlation coefficient to assess performance of a continuous diagnostic measure, as compared with a reference standard. I discuss why the limits of agreement (the mean difference between the measures +/- 2 * standard deviation of the difference) are preferable, and present a meta-analysis of those studies that reported limits of agreement.

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