Abstract

Complex clinical scenarios involving a high degree of uncertainty frequently lead to a poor agreement over diagnosis and management. However, inconsistent results can be found with the most widely used measures of agreement for continuous variables - the limits of agreement and the intraclass correlation coefficient. We aim to improve the interpretation of agreement studies using continues variables. Evaluation of agreement may be improved by complexity analysis and by categorization of variables, followed by the use of the proportions of agreement. The average never characterizes a complex phenomenon and the methods used to access agreement in continuous variables are based on the mean. For future agreement studies, involving complex continuous variables, we recommend a complexity and categorical analysis.

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