NakedSignal

Change explorer · Chemistry

LDL cholesterol by the Martin-Hopkins equation vs directly measured LDL

Public dataBuilt from a published open-access study.

Central lab analyser, directly measured LDL cholesterol compared with LDL cholesterol calculated by the Martin-Hopkins equation: 1,301 paired results from a published study by Dintshi et al. (2022), re-analysed by NakedSignal as if one laboratory had switched from the first system to the second. At 100, 130, 160, 190 mg/dL (from mmol/L x 38.67), 252 results fall in a different category on the second system than on the first, against about 134 expected from repeat testing alone. That expected count uses a default repeat-test imprecision, the setting our program uses when no precision data are supplied, not one measured in this study, so the two numbers are not a test of whether the switch moves more results than repeat testing would.

Chemistry

LDL cholesterol, mg/dL (from mmol/L x 38.67)

Central lab analyser, directly measured LDL cholesterol compared with LDL cholesterol calculated by the Martin-Hopkins equation. 1,301 paired results.

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Comparison line

The new system reads 10% lower than the old system on average. The comparison line (Passing-Bablok) has a slope of 0.956 (95% interval 0.942 to 0.967) and an intercept of -4.565.

Public data
Comparison line, LDL cholesterol (mg/dL, from mmol/L x 38.67)Comparison line with slope 0.956 (95% interval 0.942 to 0.967) and intercept -4.565, drawn against the line of no change. Decision limits drawn at 100, 130, 160, 190 mg/dL (from mmol/L x 38.67). Where the comparison line sits above the line of no change, the new system reads higher; below, lower.5010015020050100150200100130160190No changeComparison lineOld system, mg/dL (from mmol/L x 38.67)New system, mg/dL (from mmol/L x 38.67)

Fig. 1. The comparison line against the line of no change, over the range of the decision limits (100, 130, 160, 190 mg/dL (from mmol/L x 38.67)). Dots mark where each line meets each limit; the gap between them is the bias at that limit.

Crossing each limit

Results that fall on the other side of a decision limit on the new system than on the old, read as if the new system had replaced the old, against the number repeat testing on one unchanged system would move. The program reports the count across all limits together.

All decision limits together (100, 130, 160, 190 mg/dL, from mmol/L x 38.67)

Crossed between the two systems: 252

Expected from repeat testing alone: about 134

Grade and warnings

  • Re-test band: full (at least the protocol minimum of pairs).
  • Band half-width around each limit: 3.21%.
  • Results re-tested on data the band was not fitted to, median: 15%.
  • Share of the excess crossings caught on unseen data, comparison line and band together: 97%; comparison line alone: 63%. The excess is the crossings above what repeat testing alone would cause, so the share can exceed 100% or fall below zero.
  • Repeat-test imprecision: default value.
  • A secondary comparison: a calculated value against a measured one, shown for completeness.

Source

Dintshi M, Kone N, Khoza S (2022). Comparison of measured LDL cholesterol with calculated LDL-cholesterol using the Friedewald and Martin-Hopkins formulae in diabetic adults at Charlotte Maxeke Johannesburg Academic Hospital/NHLS Laboratory. PLoS One. doi:10.1371/journal.pone.0277981 (opens in a new tab); PMC9749991 (opens in a new tab). Licence: CC BY 4.0 (opens in a new tab). Re-analysed by NakedSignal. The deposit names the systems.

Show the numbers
All values for LDL cholesterol, Central lab analyser, directly measured LDL cholesterol to LDL cholesterol calculated by the Martin-Hopkins equation
FieldValue
Paired results used1,301
Comparison line slope0.955959
Slope, 95% interval0.941526 to 0.967002
Comparison line intercept-4.565491
Mean difference, new minus old, as % of old-10.034
Decision limits (mg/dL, from mmol/L x 38.67)100, 130, 160, 190
Crossed between the two systems252
Expected from repeat testing alone133.78
Band half-width (%)3.21
Re-tested, unseen data, median (%)14.95
Re-tested, unseen data, range (%)14.68 to 15.37
Excess caught, line and band (%)97.14
Excess caught, line alone (%)63.44

Related

Other comparisons from the same study:

Guide: Crossings by chance

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