Assessing inter- and intra-agreement for dependent binary data: a Bayesian hierarchical correlation approach

Agreement measures are designed to assess consistency between different instruments rating measurements of interest. When the individual responses are correlated with multilevel structure of nestings and clusters, traditional approaches are not readily available to estimate the inter- and intra-agreement for such complex multilevel settings. Our research stems from conformity evaluation between optometric devices with measurements on both eyes, equality tests of agreement in high myopic status between monozygous twins and dizygous twins, and assessment of reliability for different pathologists in dysplasia. In this paper, we focus on applying a Bayesian hierarchical correlation model incorporating adjustment for explanatory variables and nesting correlation structures to assess the inter- and intra-agreement through correlations of random effects for various sources. This Bayesian generalized linear mixed-effects model (GLMM) is further compared with the approximate intra-class correlation coefficients and kappa measures by the traditional Cohen’s kappa statistic and the generalized estimating equations (GEE) approach. The results of comparison studies reveal that the Bayesian GLMM provides a reliable and stable procedure in estimating inter- and intra-agreement simultaneously after adjusting for covariates and correlation structures, in marked contrast to Cohen’s kappa and the GEE approach.