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Quintessence Publishing: Journals: ORTHODONTICS
The Art and Practice of Dentofacial Enhancement

Formerly World Journal of Orthodontics

Edited by
Rafi Romano, DMD, MSc (Editor-in-Chief)

ISSN 2160-2999 (print) / ISSN 2160-3006 (online)

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Yearbook 2012
Volume 13 , Issue 1

Share Abstract:

Alternative methods for evaluating the equivalence of measurement systems

David W. Chambers, EdM, MBA, PhD

Aim: Reports are common in the orthodontic and dental radiographic literature comparing measurement systems. Typically, such comparisons are made using differences in mean scores across methods, correlation coefficients, or Bland-Altman plots. These methods are subject to known limitations, including an inability to detect bias. Methods: A hypothetical dataset was created to contain a small, common random variance and two types of bias to compare three alternative measurement systems against a common standard. One comparison included only random error and no bias. Two types of bias were investigated: systemic overestimation on the part of one measurement system and the more complex case of overestimation in one part of the range and underestimation in the other. Results: Each of the commonly used methods for comparing alternative measurement systems was inadequate for detecting one or the other type of bias. The traditional regression analysis, by contrast, provided a useful characterization of the alternative measurement systems, including quantification of the nature of bias. Conclusion: Regression analysis can reveal biases masked in the common comparison of means, correlation coefficients, and Bland-Altman plots for evaluating alternative measurement systems and thereby improve confidence in clinical applicability of research. ORTHODONTICS (CHIC) 2012;13:192199.

Key words: bias, Bland-Altman plots, correlation coefficients, measurement systems, methods of comparison

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