Correlation versus agreement; protein/creatinine ratio in spot urine and 24-hour urine protein
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spot urine versus 24-hour urine protein" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "134" "paginaFinal" => "135" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Cociente proteína/creatinina en orina esporádica versus proteínas en orina de 24 horas" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig1" "etiqueta" => "Tab. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "copyright" => "Elsevier España" "figura" => array:1 [ 0 => array:4 [ "imagen" => "11764_16025_36360_en_t1.11764.jpg" "Alto" => 516 "Ancho" => 1425 "Tamanyo" => 130237 ] ] "descripcion" => array:1 [ "en" => "95% limits of agreement in the Bland-Altman plot" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Nuria Montero, Sergio Mojal, Julio Pascual, María José Soler" "autores" => array:6 [ 0 => array:2 [ "nombre" => "Nuria" "apellidos" => "Montero" ] 1 => array:2 [ "nombre" => "Nuria" "apellidos" => "Montero" ] 2 => array:2 [ "nombre" => "Sergio" "apellidos" => "Mojal" ] 3 => array:2 [ "nombre" => "Julio" "apellidos" => "Pascual" ] 4 => array:2 [ "nombre" => "Julio" "apellidos" => "Pascual" ] 5 => array:2 [ "nombre" => "María José" "apellidos" => "Soler" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "X0211699513002551" "doi" => "10.3265/Nefrologia.pre2012.Oct.11764" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X0211699513002551?idApp=UINPBA000064" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251413002559?idApp=UINPBA000064" "url" => "/20132514/0000003300000001/v0_201502091555/X2013251413002559/v0_201502091556/en/main.assets" ] "en" => array:9 [ "idiomaDefecto" => true "titulo" => "Correlation versus agreement; protein/creatinine ratio in spot urine and 24-hour urine protein" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "134" ] ] "autores" => array:1 [ 0 => array:3 [ "autoresLista" => "Donal Sexton" "autores" => array:1 [ 0 => array:4 [ "nombre" => "Donal" "apellidos" => "Sexton" "email" => array:1 [ 0 => "donalsexton0@hotmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] ] ] ] "afiliaciones" => array:1 [ 0 => array:3 [ "entidad" => "Department of Nephrology, Clinical Research Facility, Cork, Ireland, " "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] ] ] ] "textoCompleto" => "<p class="elsevierStylePara"><span class="elsevierStyleBold">Dear Editor,</span></p><p class="elsevierStylePara">I read with interest the article by Montero et al.<span class="elsevierStyleSup">1</span> in this month’s issue of Nefrología. This was an interesting study assessing the correlation between protein/creatinine ratio and 24-hour urine protein excretion.  The authors assessed the strength of correlation by measuring the intra-class correlation coefficient (ICC) and the Spearman correlation coefficient (SCC).</p><p class="elsevierStylePara">I would argue that although the authors did construct a Bland Altman Plot, they did not address the agreement between protein/creatinine ratio and 24 hour urine protein excretion exhaustively. Montero et al. report the 95% limits of agreement graphically in the Bland-Altman plot but not numerically. The authors focus on the use of intra-class correlation coefficient which is often used to assess measurement error and reliability. However this measure is influenced by the amount of variation between subjects.<span class="elsevierStyleSup">2</span></p><p class="elsevierStylePara">When measuring urinary protein excretion, all methods are extremely likely to be correlated because they will all be attempting to measure the same construct i.e. the amount of protein in the urine, and so assessing whether the two measurements are correlated is not necessarily very informative. What we are more interested in as clinicians is whether or not we can use the two methods interchangeably or the agreement.</p><p class="elsevierStylePara">The standard deviation of the differences between measurements made by urine protein/creatinine ratio and 24 hour urine protein excretion provides a good index of the comparability of the two methods.<span class="elsevierStyleSup">2</span> This leads to the 95% limits of agreement between the two measurements. Although Montero et al. do report the 95% limits on the Bland-Altman plot, perhaps the authors could have reported the 95% limits of agreement for a specific number of thresholds of proteinuria for example <300mg, <3.5 grams or >3.5 grams individually which would be useful for clinicians trying to interpret spot urine protein/creatinine ratio. I worry that readers of this excellent study may be left focusing too much on correlations rather than agreement or concordance.</p><p class="elsevierStylePara"> </p><p class="elsevierStylePara"><span class="elsevierStyleBold">Conflict of interest</span></p><p class="elsevierStylePara"> </p><p class="elsevierStylePara">The authors declare that there is no conflict of interest associated with this manuscript.</p>" "pdfFichero" => "P1-E547-S3874-A11649-EN.pdf" "tienePdf" => true "bibliografia" => array:2 [ "titulo" => "Bibliography" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:2 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Montero N, Soler MJ,\u{A0}Pascual MJ,\u{A0}Barrios C,\u{A0}Márquez E,\u{A0}Rodríguez E,\u{A0}et al.\u{A0}Correlation between the protein/creatinine ratio in spot urine and 24-hour urine protein. Nefrologia 2012;32(4):494-501. <a href="http://www.ncbi.nlm.nih.gov/pubmed/22806284" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Bland M, ed. An Introduction to Medical Statistics. Third Edition. London: Oxford Press; 2009." "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/20132514/0000003300000001/v0_201502091555/X2013251413002567/v0_201502091556/en/main.assets" "Apartado" => array:4 [ "identificador" => "35439" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Letters to the Editor - Comments on published articles" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/20132514/0000003300000001/v0_201502091555/X2013251413002567/v0_201502091556/en/P1-E547-S3874-A11649-EN.pdf?idApp=UINPBA000064&text.app=https://www.revistanefrologia.com/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251413002567?idApp=UINPBA000064" ]
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