Abstract

AZZIMONTI RENZO, Juan Carlos. Agreement between two clinical tests in binary cases: problems and solution. Acta bioquím. clín. latinoam. [online]. 2005, vol.39, n.4, pp.435-444. ISSN 0325-2957.

This report can be considered a resource for the analysis of agreement among clinical tests, observers, judges or experts. When the true results of two clinical tests cannot be obtained, the difference between them can be reflected by studying their agreement. Normal statistical procedures tackling this are not enough to decide whether there is agreement, because they show problems or paradoxes from the clinical viewpoint. The solution to these problems is introduced by using the dual vision method. The overall agreement is a duality, and needs to be studied in two steps. In the tackling this are not enough to decide whether there is agreement, because they show problems or paradoxes from the clinical viewpoint. The solution to these problems is introduced by using the dual vision method. The overall agreement is a duality, and needs to be studied in two steps. In the first step, a condition for the acceptance of the agreement is proposed: both methods need to have the same nosologic sensitivity and specificity. But since this is not enough, another condition is proposed in the second step: the level of agreement should be greater than a critical value defined by the clinicians. When both steps show satisfactory results, the new method can replace the old one. In this way, it is showed that statistical agreement is not the same as clinical agreement.

Keywords : dual vision method; Clinical agreement; Statistical agreement; Agreement table; Diagnostic Table; Level of agreement; sensitivity; specificity.

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