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Use and reporting of Bland-Altman analyses in studies of self-reported versus measured weight and height.

ABSTRACT: BACKGROUND/OBJECTIVES:Bland-Altman methods for assessing the agreement between two measures are highly cited. However, these methods may often not be used to assess agreement, and when used, they are not always presented or interpreted correctly. Our objective was to evaluate the use and the quality of reporting of Bland-Altman analyses in studies that compare self-reported with measured weight and height. METHODS:We evaluated the use of Bland-Altman methods in 394 published articles that compared self-reported and measured weight and height data for adolescents or adults. Six reporting criteria were developed: assessment of the normality of the distribution of differences, a complete and correctly labeled Bland-Altman plot displaying the mean difference and limits of agreement (LOA), numerical values and confidence intervals, standard errors, or standard deviations for mean difference, numerical values of LOA, confidence intervals for LOA, and prespecified criteria for acceptable LOA. RESULTS:Only 72/394 (18%) studies comparing self-reported with measured weight and height or BMI used some form of Bland-Altman analyses. No study using Bland-Altman analyses satisfied more than four of the six criteria. Of the 72 studies, 64 gave mean differences along with confidence intervals or standard deviations, 55 provided complete Bland-Altman plots that were appropriately labeled and described, 37 provided numerical values for LOA, 4 reported that they examined the normality of the distribution of differences, 3 provided confidence intervals for LOA, and 3 had prespecified criteria for agreement. CONCLUSIONS:Bland-Altman methods appear to be infrequently used in studies comparing measured with self-reported weight, height, or BMI, and key information is missing in many of those that do use Bland-Altman methods. Future directions would be defining acceptable LOA values and improving the reporting and application of Bland-Altman methods in studies of self-reported anthropometry.

SUBMITTER: Flegal KM

PROVIDER: S-EPMC7261640 | biostudies-literature | 2020 Jun

REPOSITORIES: biostudies-literature

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Use and reporting of Bland-Altman analyses in studies of self-reported versus measured weight and height.

Flegal Katherine M KM Graubard Barry B Ioannidis John P A JPA

International journal of obesity (2005) 20191202 6

<h4>Background/objectives</h4>Bland-Altman methods for assessing the agreement between two measures are highly cited. However, these methods may often not be used to assess agreement, and when used, they are not always presented or interpreted correctly. Our objective was to evaluate the use and the quality of reporting of Bland-Altman analyses in studies that compare self-reported with measured weight and height.<h4>Methods</h4>We evaluated the use of Bland-Altman methods in 394 published artic ...[more]

PMID: 31792334

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Project description:BackgroundSelf-reported pre-pregnancy weight and weight measured in the first trimester are both used to estimate pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) but there is limited information on how they compare, especially in low- and middle-income countries, where access to a weight scale can be limited. Thus, the main goal of this study was to evaluate the agreement between self-reported pre-pregnancy weight and weight measured during the first trimester of pregnancy among Brazilian women so as to assess whether self-reported pre-pregnancy weight is reliable and can be used for calculation of BMI and GWG.MethodsData from the Brazilian Maternal and Child Nutrition Consortium (BMCNC, n = 5563) and the National Food and Nutritional Surveillance System (SISVAN, n = 393,095) were used to evaluate the agreement between self-reported pre-pregnancy weight and weights measured in three overlapping intervals (30-94, 30-60 and 30-45 days of pregnancy) and their impact in BMI classification. We calculated intraclass correlation and Lin's concordance coefficients, constructed Bland and Altman plots, and determined Kappa coefficient for the categories of BMI.ResultsThe mean of the differences between self-reported and measured weights was < 2 kg during the three intervals examined for BMCNC (1.42, 1.39 and 1.56 kg) and about 1 kg for SISVAN (1.0, 1.1 and 1.2 kg). Intraclass correlation and Lin's coefficient were > 0.90 for both datasets in all time intervals. Bland and Altman plots showed that the majority of the difference laid in the ±2 kg interval and that the differences did not vary according to measured first-trimester BMI. Kappa coefficient values were > 0.80 for both datasets at all intervals. Using self-reported pre-pregnancy or measured weight would change, in total, the classification of BMI in 15.9, 13.5, and 12.2% of women in the BMCNC and 12.1, 10.7, and 10.2% in the SISVAN, at 30-94, 30-60 and 30-45 days, respectively.ConclusionIn Brazil, self-reported pre-pregnancy weight can be used for calculation of BMI and GWG when an early measurement of weight during pregnancy is not available. These results are especially important in a country where the majority of woman do not initiate prenatal care early in pregnancy.

Project description:Reliable quantification in biological systems of endogenous low- and high-molecular substances, drugs and their metabolites, is of particular importance in diagnosis and therapy, and in basic and clinical research. The analytical characteristics of analytical approaches have many differences, including in core features such as accuracy, precision, specificity, and limits of detection (LOD) and quantitation (LOQ). Several different mathematic approaches were developed and used for the comparison of two analytical methods applied to the same chemical compound in the same biological sample. Generally, comparisons of results obtained by two analytical methods yields different quantitative results. Yet, which mathematical approach gives the most reliable results? Which mathematical approach is best suited to demonstrate agreement between the methods, or the superiority of an analytical method A over analytical method B? The simplest and most frequently used method of comparison is the linear regression analysis of data observed by method A (y) and the data observed by method B (x): y = α + βx. In 1986, Bland and Altman indicated that linear regression analysis, notably the use of the correlation coefficient, is inappropriate for method-comparison. Instead, Bland and Altman have suggested an alternative approach, which is generally known as the Bland-Altman approach. Originally, this method of comparison was applied in medicine, for instance, to measure blood pressure by two devices. The Bland-Altman approach was rapidly adapted in analytical chemistry and in clinical chemistry. To date, the approach suggested by Bland-Altman approach is one of the most widely used mathematical approaches for method-comparison. With about 37,000 citations, the original paper published in the journal The Lancet in 1986 is among the most frequently cited scientific papers in this area to date. Nevertheless, the Bland-Altman approach has not been really set on a quantitative basis. No criteria have been proposed thus far, in which the Bland-Altman approach can form the basis on which analytical agreement or the better analytical method can be demonstrated. In this article, the Bland-Altman approach is re-valuated from a quantitative bioanalytical perspective, and an attempt is made to propose acceptance criteria. For this purpose, different analytical methods were compared with Gold Standard analytical methods based on mass spectrometry (MS) and tandem mass spectrometry (MS/MS), i.e., GC-MS, GC-MS/MS, LC-MS and LC-MS/MS. Other chromatographic and non-chromatographic methods were also considered. The results for several different endogenous substances, including nitrate, anandamide, homoarginine, creatinine and malondialdehyde in human plasma, serum and urine are discussed. In addition to the Bland-Altman approach, linear regression analysis and the Oldham-Eksborg method-comparison approaches were used and compared. Special emphasis was given to the relation of difference and mean in the Bland-Altman approach. Currently available guidelines for method validation were also considered. Acceptance criteria for method agreement were proposed, including the slope and correlation coefficient in linear regression, and the coefficient of variation for the percentage difference in the Bland-Altman and Oldham-Eksborg approaches.

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Use and reporting of Bland-Altman analyses in studies of self-reported versus measured weight and height.

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Use and reporting of Bland-Altman analyses in studies of self-reported versus measured weight and height.

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