Application of Mixed Effects Limits of Agreement in the Presence of Multiple Sources of Variability: Exemplar from the Comparison of Several Devices to Measure Respiratory Rate in COPD Patients.
<h4>Introduction</h4>The Bland-Altman limits of agreement method is widely used to assess how well the measurements produced by two raters, devices or systems agree with each other. However, mixed effects versions of the method which take into account multiple sources of variability are...
Saved in:
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2016-01-01
|
| Series: | PLoS ONE |
| Online Access: | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0168321&type=printable |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850133487849308160 |
|---|---|
| author | Richard A Parker Christopher J Weir Noah Rubio Roberto Rabinovich Hilary Pinnock Janet Hanley Lucy McCloughan Ellen M Drost Leandro C Mantoani William MacNee Brian McKinstry |
| author_facet | Richard A Parker Christopher J Weir Noah Rubio Roberto Rabinovich Hilary Pinnock Janet Hanley Lucy McCloughan Ellen M Drost Leandro C Mantoani William MacNee Brian McKinstry |
| author_sort | Richard A Parker |
| collection | DOAJ |
| description | <h4>Introduction</h4>The Bland-Altman limits of agreement method is widely used to assess how well the measurements produced by two raters, devices or systems agree with each other. However, mixed effects versions of the method which take into account multiple sources of variability are less well described in the literature. We address the practical challenges of applying mixed effects limits of agreement to the comparison of several devices to measure respiratory rate in patients with chronic obstructive pulmonary disease (COPD).<h4>Methods</h4>Respiratory rate was measured in 21 people with a range of severity of COPD. Participants were asked to perform eleven different activities representative of daily life during a laboratory-based standardised protocol of 57 minutes. A mixed effects limits of agreement method was used to assess the agreement of five commercially available monitors (Camera, Photoplethysmography (PPG), Impedance, Accelerometer, and Chest-band) with the current gold standard device for measuring respiratory rate.<h4>Results</h4>Results produced using mixed effects limits of agreement were compared to results from a fixed effects method based on analysis of variance (ANOVA) and were found to be similar. The Accelerometer and Chest-band devices produced the narrowest limits of agreement (-8.63 to 4.27 and -9.99 to 6.80 respectively) with mean bias -2.18 and -1.60 breaths per minute. These devices also had the lowest within-participant and overall standard deviations (3.23 and 3.29 for Accelerometer and 4.17 and 4.28 for Chest-band respectively).<h4>Conclusions</h4>The mixed effects limits of agreement analysis enabled us to answer the question of which devices showed the strongest agreement with the gold standard device with respect to measuring respiratory rates. In particular, the estimated within-participant and overall standard deviations of the differences, which are easily obtainable from the mixed effects model results, gave a clear indication that the Accelerometer and Chest-band devices performed best. |
| format | Article |
| id | doaj-art-6d79ca2336264b4aa1fba849b70d3abd |
| institution | OA Journals |
| issn | 1932-6203 |
| language | English |
| publishDate | 2016-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj-art-6d79ca2336264b4aa1fba849b70d3abd2025-08-20T02:31:57ZengPublic Library of Science (PLoS)PLoS ONE1932-62032016-01-011112e016832110.1371/journal.pone.0168321Application of Mixed Effects Limits of Agreement in the Presence of Multiple Sources of Variability: Exemplar from the Comparison of Several Devices to Measure Respiratory Rate in COPD Patients.Richard A ParkerChristopher J WeirNoah RubioRoberto RabinovichHilary PinnockJanet HanleyLucy McCloughanEllen M DrostLeandro C MantoaniWilliam MacNeeBrian McKinstry<h4>Introduction</h4>The Bland-Altman limits of agreement method is widely used to assess how well the measurements produced by two raters, devices or systems agree with each other. However, mixed effects versions of the method which take into account multiple sources of variability are less well described in the literature. We address the practical challenges of applying mixed effects limits of agreement to the comparison of several devices to measure respiratory rate in patients with chronic obstructive pulmonary disease (COPD).<h4>Methods</h4>Respiratory rate was measured in 21 people with a range of severity of COPD. Participants were asked to perform eleven different activities representative of daily life during a laboratory-based standardised protocol of 57 minutes. A mixed effects limits of agreement method was used to assess the agreement of five commercially available monitors (Camera, Photoplethysmography (PPG), Impedance, Accelerometer, and Chest-band) with the current gold standard device for measuring respiratory rate.<h4>Results</h4>Results produced using mixed effects limits of agreement were compared to results from a fixed effects method based on analysis of variance (ANOVA) and were found to be similar. The Accelerometer and Chest-band devices produced the narrowest limits of agreement (-8.63 to 4.27 and -9.99 to 6.80 respectively) with mean bias -2.18 and -1.60 breaths per minute. These devices also had the lowest within-participant and overall standard deviations (3.23 and 3.29 for Accelerometer and 4.17 and 4.28 for Chest-band respectively).<h4>Conclusions</h4>The mixed effects limits of agreement analysis enabled us to answer the question of which devices showed the strongest agreement with the gold standard device with respect to measuring respiratory rates. In particular, the estimated within-participant and overall standard deviations of the differences, which are easily obtainable from the mixed effects model results, gave a clear indication that the Accelerometer and Chest-band devices performed best.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0168321&type=printable |
| spellingShingle | Richard A Parker Christopher J Weir Noah Rubio Roberto Rabinovich Hilary Pinnock Janet Hanley Lucy McCloughan Ellen M Drost Leandro C Mantoani William MacNee Brian McKinstry Application of Mixed Effects Limits of Agreement in the Presence of Multiple Sources of Variability: Exemplar from the Comparison of Several Devices to Measure Respiratory Rate in COPD Patients. PLoS ONE |
| title | Application of Mixed Effects Limits of Agreement in the Presence of Multiple Sources of Variability: Exemplar from the Comparison of Several Devices to Measure Respiratory Rate in COPD Patients. |
| title_full | Application of Mixed Effects Limits of Agreement in the Presence of Multiple Sources of Variability: Exemplar from the Comparison of Several Devices to Measure Respiratory Rate in COPD Patients. |
| title_fullStr | Application of Mixed Effects Limits of Agreement in the Presence of Multiple Sources of Variability: Exemplar from the Comparison of Several Devices to Measure Respiratory Rate in COPD Patients. |
| title_full_unstemmed | Application of Mixed Effects Limits of Agreement in the Presence of Multiple Sources of Variability: Exemplar from the Comparison of Several Devices to Measure Respiratory Rate in COPD Patients. |
| title_short | Application of Mixed Effects Limits of Agreement in the Presence of Multiple Sources of Variability: Exemplar from the Comparison of Several Devices to Measure Respiratory Rate in COPD Patients. |
| title_sort | application of mixed effects limits of agreement in the presence of multiple sources of variability exemplar from the comparison of several devices to measure respiratory rate in copd patients |
| url | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0168321&type=printable |
| work_keys_str_mv | AT richardaparker applicationofmixedeffectslimitsofagreementinthepresenceofmultiplesourcesofvariabilityexemplarfromthecomparisonofseveraldevicestomeasurerespiratoryrateincopdpatients AT christopherjweir applicationofmixedeffectslimitsofagreementinthepresenceofmultiplesourcesofvariabilityexemplarfromthecomparisonofseveraldevicestomeasurerespiratoryrateincopdpatients AT noahrubio applicationofmixedeffectslimitsofagreementinthepresenceofmultiplesourcesofvariabilityexemplarfromthecomparisonofseveraldevicestomeasurerespiratoryrateincopdpatients AT robertorabinovich applicationofmixedeffectslimitsofagreementinthepresenceofmultiplesourcesofvariabilityexemplarfromthecomparisonofseveraldevicestomeasurerespiratoryrateincopdpatients AT hilarypinnock applicationofmixedeffectslimitsofagreementinthepresenceofmultiplesourcesofvariabilityexemplarfromthecomparisonofseveraldevicestomeasurerespiratoryrateincopdpatients AT janethanley applicationofmixedeffectslimitsofagreementinthepresenceofmultiplesourcesofvariabilityexemplarfromthecomparisonofseveraldevicestomeasurerespiratoryrateincopdpatients AT lucymccloughan applicationofmixedeffectslimitsofagreementinthepresenceofmultiplesourcesofvariabilityexemplarfromthecomparisonofseveraldevicestomeasurerespiratoryrateincopdpatients AT ellenmdrost applicationofmixedeffectslimitsofagreementinthepresenceofmultiplesourcesofvariabilityexemplarfromthecomparisonofseveraldevicestomeasurerespiratoryrateincopdpatients AT leandrocmantoani applicationofmixedeffectslimitsofagreementinthepresenceofmultiplesourcesofvariabilityexemplarfromthecomparisonofseveraldevicestomeasurerespiratoryrateincopdpatients AT williammacnee applicationofmixedeffectslimitsofagreementinthepresenceofmultiplesourcesofvariabilityexemplarfromthecomparisonofseveraldevicestomeasurerespiratoryrateincopdpatients AT brianmckinstry applicationofmixedeffectslimitsofagreementinthepresenceofmultiplesourcesofvariabilityexemplarfromthecomparisonofseveraldevicestomeasurerespiratoryrateincopdpatients |